< Back Ankle Fractures B A ankle-fractures Previous Next

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< Back Dr. Korhan OZKAN Professor, M.D. Acıbadem Healthcare Group, Orthopaedics and Traumatology – Orthopaedic Oncology Location: Istanbul, Türkiye Education and Training 2013 – Medical University of Vienna , Orthopaedic Oncology Center, Austria 2012 – Royal Orthopaedic Hospital , Birmingham, United Kingdom 2011 – Universitätsklinikum Münster , Orthopaedic Oncology Center (Prof. Dr. Georg Gosheger), Germany 2005 – Istanbul University, Istanbul Faculty of Medicine , Department of Orthopaedics and Traumatology 2005 – Allgemeines und Orthopaedisches Landeskrankenhaus Stolzalpe (Prof. Reinhard Graf), Austria 2000 – Marmara University Faculty of Medicine , Istanbul, Türkiye Professional Experience 2023 – Present – Acıbadem Healthcare Group , Department of Orthopaedics and Traumatology 2006 – 2023 – Istanbul Medeniyet University, Göztepe Training and Research Hospital , Department of Orthopaedics and Traumatology 2006 – Zeynep Kamil Training and Research Hospital , Orthopaedic Surgeon 2006 – İznik State Hospital , Orthopaedic Surgeon 2005 – 2006 – Florence Nightingale Hospital , Department of Orthopaedics and Traumatology 2000 – 2005 – Istanbul University, Istanbul Faculty of Medicine , Research Assistant, Department of Orthopaedics and Traumatology https://www.ortopediktumor.com/ https://www.acibadem.com.tr/doktor/korhan-ozkan/ Oncologic Orthopaedics korhanozkan76@gmail.com Previous Next

< Back Dr. H. Bilgehan CEVIK MD, Assoc. Prof. is an orthopaedic surgeon and Associate Professor at the University of Health Sciences–Ankara Etlik City Hospital, specializing in orthopaedic oncology, complex joint reconstruction, and orthopaedic trauma. He completed an Orthopaedic Oncology clinical fellowship at the University of Ottawa (2025-2026) and at the University of Hong Kong (2024), as well as an AO Trauma fellowship at the University of Leeds (2023). Dr. Çevik has authored 100+ peer-reviewed publications and several book chapters, and serves as a reviewer for leading journals. As a TOTBİD, ISOLS, EMSOS, and AO Trauma member, he is active in national and international teaching programs. bilgehancevik@gmail.com www.linkedin.com/in/h-bilgehan-çevik-b8a4061a0 https://scholar.google.com/citations?user=RYGQ6ekAAAAJ&hl=en https://www.researchgate.net/profile/Bilgehan-Cevik?ev=hdr_xprf Oncologic Orthopaedics huseyinbilgehan.cevik@sbu.edu.tr Previous Next

< Back Dr. Kayahan KARAYTUG Robotic Assisted UKA Robotic unicompartmental knee arthroplasty (R-UKA) is an evolution of traditional unicompartmental knee replacement, developed to improve component accuracy, reduce outliers, and enhance short-term recovery. It is indicated for isolated medial or lateral compartment osteoarthritis (Kellgren–Lawrence grade IV) when the remaining compartments are intact. 💡 Approximately 20% of knee OA cases are unicompartmental — most involve the medial side. Robotic Unicompartmental Knee Arthroplasty (R-UKA) Why Robotics? Conventional UKA is highly technique-sensitive ; even 2–3° of malalignment can shorten implant life. Robotic systems minimize this variability by integrating preoperative imaging, 3-D planning, and intra-operative feedback, allowing precise bone preparation and implant positioning. 💡 Accuracy translates to reproducibility and potentially longer survivorship. Robotic Platforms Common systems: MAKO (Stryker, NJ, USA) – most extensively validated Cuvis Joint ( Meril, India) NAVIO / CORI® (Smith & Nephew, MN, USA) ACROBOT (UK) Systems are categorized as passive (navigational), semi-active , or active , depending on the degree of robotic autonomy. Accuracy & Alignment R-UKA achieves superior coronal and sagittal alignment compared to manual UKA. Tibial slope variation and component overhang are significantly reduced. Fewer alignment deviations >2° are reported. Improved restoration of joint line and mechanical axis alignment. 💡 Most alignment-related failures seen in conventional UKA are rare in robotic surgery. Functional & Clinical Outcomes Early postoperative pain and opioid use are reduced . Faster return to daily activities and physiotherapy. Improved early range of motion and hospital discharge time. At 1-year, gait studies show more physiological motion patterns during stance phase. Mid-term outcomes (2–5 years) are comparable to conventional UKA in survivorship. 💡 Robotic precision benefits early recovery, but long-term differences remain under investigation. Implant Survivorship Short- to mid-term survival rates: ≈98–99% at 2–3 years. Failures in robotic series are rarely due to malalignment — mostly aseptic loosening or progression of arthritis in untreated compartments. Long-term (>10 years) data are still limited. 💡 Accuracy may delay mechanical failure but cannot prevent disease progression. Limitations & Considerations Higher cost and longer setup time. Requires specific training and case volume to justify system investment. Outcomes depend on surgeon experience, platform type, and patient selection. Clinical Pearls Ideal candidates: isolated unicompartmental OA, intact cruciate ligaments, correctable deformity, BMI < 35. Avoid in: inflammatory arthritis, tricompartmental OA, fixed deformity > 15°, severe bone loss. Precision ≠ Perfection: robotic systems guide, but do not replace, surgical judgment. Integration with AI-based planning and patient-specific implants will likely define the next generation of R-UKA. Summary Robotic UKA enhances surgical precision, reproducibility, and early functional recovery compared to conventional techniques. While radiographic and short-term clinical outcomes are consistently superior, long-term survivorship equivalence underscores the importance of patient selection, surgical skill, and individualized alignment goals . References Cobb JP et al. J Bone Joint Surg Br. 2006;88-B:188–197. Cool CL et al. J Arthroplasty. 2023;38(4):754–763. Herry Y et al. Bone Joint J. 2022;104-B:325–333. Bell SW et al. Knee Surg Sports Traumatol Arthrosc. 2021;29:1001–1012. Pandit H et al. J Arthroplasty. 2020;35:S15–S22. Previous Next

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< Back Dr. Abdullah IYIGUN He graduated from Erciyes University Faculty of Medicine in 2009. He received his specialist training in Orthopedics and Traumatology at Ankara Training and Research Hospital in 2015. He is still working in SBU Umraniye Research and Education Hospital as a trauma and spine surgeon. Spine - Trauma Surgery abdullahiyigun@gmail.com Previous Next

< Back Compartment Syndrome A surgical emergency caused by increased pressure within a closed muscle compartment, compromising circulation and function. Compartment syndrome occurs when increased pressure within a closed osteofascial compartment reduces capillary perfusion, leading to ischaemia and tissue necrosis . 🔍 Key Features: Commonly affects the leg and forearm 5 P’s : Pain (out of proportion), Paresthesia, Pallor, Paralysis, Pulselessness (late) Most reliable early sign: Pain with passive stretch 🧪 Diagnosis: Clinical diagnosis is paramount. Intracompartmental pressure measurement: Consider fasciotomy if ΔP (diastolic BP – compartment pressure) < 30 mmHg. 🔧 Management: Urgent fasciotomy is the definitive treatment. Delay leads to irreversible muscle/nerve damage and contractures. compartment-syndrome Previous Next

< Back Dr. Natig VELI Biopsy Principles Biopsy is a crucial diagnostic step in musculoskeletal oncology that must be carefully planned after full imaging and in coordination with the treating surgical team. The chosen approach should align with the future resection line to prevent tumor seeding and preserve limb-salvage options. Core needle biopsy is preferred for most lesions, while incisional biopsy is reserved for deep or non-diagnostic cases, and excisional biopsy only for small, superficial benign tumors. Proper tract placement, meticulous hemostasis, and clear marking are essential. A well-planned biopsy ensures accurate diagnosis and optimal oncologic outcomes, whereas an unplanned one can compromise definitive treatment. Definition and Purpose Biopsy is a critical diagnostic step in musculoskeletal oncology, providing tissue for histopathological, immunohistochemical, and molecular evaluation. It confirms diagnosis, determines tumor grade and type, and guides the surgical and oncologic treatment plan. A poorly planned biopsy can compromise definitive surgery and negatively affect patient outcomes. Pre-Biopsy Evaluation Imaging first: All biopsies must be performed after complete imaging — plain radiographs, MRI, and CT if necessary — to define the lesion’s anatomy, extent, and relation to neurovascular structures. Multidisciplinary planning: The procedure should be planned collaboratively by the orthopaedic oncologist, radiologist, and pathologist to ensure diagnostic yield and safe resection later. Never biopsy without imaging: This avoids contamination of uninvolved compartments or incorrect approach that may preclude limb salvage. Types of Biopsy Core Needle Biopsy (CNB): Preferred method in most cases; minimally invasive and highly diagnostic (accuracy >90%). Multiple cores should be taken from viable, non-necrotic areas under image guidance (CT or USG) . Especially suitable for deep-seated or pelvic lesions. Incisional Biopsy: Indicated when core biopsy is non-diagnostic or tissue architecture is required. Performed through a small longitudinal incision in line with the planned surgical approach, directly over the lesion. The tract must be placed within the future resection field , as it will be excised en bloc during definitive surgery. Excisional Biopsy: Reserved for small (<3 cm), superficial, easily accessible masses suspected to be benign. Should only be performed when wide excision can be achieved without compromising margins. Technical Principles Approach: Follow the most direct route to the tumor; avoid crossing multiple compartments or uninvolved joints. Hemostasis: Essential to prevent hematoma and tumor seeding. Use minimal cautery and avoid suctioning into clean planes. Contamination control: Avoid biopsy through skin that will not be included in the definitive resection field. Suture placement: Mark the biopsy tract clearly to facilitate complete removal during tumor surgery. Specimen handling: Send fresh tissue in sterile saline for histopathology, microbiology, and molecular studies. Common Pitfalls Inadequate imaging or unplanned approach leading to tumor spread along biopsy tract . Incision placed transversely instead of longitudinally, complicating excision. Sampling necrotic tissue , resulting in non-diagnostic pathology. Performing biopsy before referral to a specialized musculoskeletal oncology center . Key Points Biopsy must be performed by — or in consultation with — the surgeon who will perform definitive tumor resection . Plan the biopsy incision as part of the final surgical approach . The entire biopsy tract must be excised with the tumor during definitive surgery. A well-planned biopsy enables accurate diagnosis and limb salvage; a poorly planned one can convert a resectable lesion into an inoperable case. References Mankin HJ, Lange TA, Spanier SS. The Hazards of Biopsy in Patients with Malignant Primary Bone and Soft-Tissue Tumors. J Bone Joint Surg Am. 1982;64(8):1121–1127. Skrzynski MC, Biermann JS, Montag AG, Simon MA. Diagnostic Accuracy and Complications of Open vs Core Needle Biopsy. J Bone Joint Surg Am. 1996;78(5):644–649. Puri A, Gulia A. Musculoskeletal Tumor Biopsy: Planning, Principles and Techniques. Indian J Orthop. 2022;56(1):21–28. Enneking WF. Surgical Staging of Musculoskeletal Neoplasms. Clin Orthop Relat Res. 1986;(204):9–24. Previous Next