Publications by authors named "M Nedim Doral"

122 Publications

Anterior cruciate ligament surgery and rehabilitation: does anybody really know what time it is?

Knee Surg Sports Traumatol Arthrosc 2021 Apr 20;29(4):1015-1017. Epub 2020 Nov 20.

Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.

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http://dx.doi.org/10.1007/s00167-020-06364-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678772PMC
April 2021

Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 15;29(4):1206-1214. Epub 2020 Jul 15.

Department of Orthopaedics and Traumatology, Ufuk University, Ankara, Turkey.

Purpose: It is unclear how high-intensity physical activity (HIPA) affects the knee joint, specifically the femoral cartilage (FC). Therefore, the aims of this study were to evaluate FC thickness via ultrasound among elite athletes involved in different types of HIPA, and to determine whether there is a correlation between serum cartilage oligomeric matrix protein (sCOMP) and rectus femoris (RF) thickness.

Method: A total of 132 male individuals participated in this study and were assigned to two groups, the sedentary (n = 43, 23.9 ± 3.7) and athlete groups (n = 89, 22.7 ± 4.6), which did not significantly differ in age. The athletes were elite and performed HIPA during sports such as volleyball (n = 20), soccer (n = 21), basketball (n = 28), and weightlifting (n = 20). RF thickness and three (mid-point) measurements were obtained for each knee. The mean FC thickness for each knee was defined as the sum of the medial, lateral condyles, and intercondylar areas. Blood samples for sCOMP analyses were also obtained.

Results: All the measurements of the FC of both knees were significantly higher in the athletes than in the sedentary individuals (p < 0.001 and p = 0.001). The mean right and left FC values were also higher in the athletes (p < 0.001). Multiple linear regression analysis showed that participation in sporting activities was a significant predictor associated with the right and left mean FC thickness (p < 0.001 for both). No significant differences in the sCOMP levels were found between the two groups.

Conclusion: It was found that the mean FC was higher among athletes than among sedentary individuals. As a result, it is suggested that sports' participation is an independent factor associated with the right and left mean FC thickness.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-020-06146-7DOI Listing
April 2021

The challenging battle of mankind against COVID-19 outbreak: Is this global international biological catastrophe the beginning of a new era?

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020923501

Department of Orthopaedics and Traumatology & Sports Medicine, Meram Medical Faculty Hospital, Necmettin Erbakan University, Selcuklu, Konya, Turkey.

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http://dx.doi.org/10.1177/2309499020923501DOI Listing
May 2020

Effects on Lower Extremity Neuromuscular Control Exercises on Knee Proprioception, Muscle Strength, and Functional Level in Patients with ACL Reconstruction.

Biomed Res Int 2019 15;2019:1694695. Epub 2019 Nov 15.

Department of Orthopaedics & Traumatology, Faculty of Medicine, Ufuk University, Ankara, Turkey.

Objective: The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R).

Materials And Methods: Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated.

Results: There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I ( > 0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II ( < 0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups ( < 0.05).

Conclusions: The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.
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http://dx.doi.org/10.1155/2019/1694695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881759PMC
April 2020

Quadriceps tendon autograft ACL reconstructed subjects overshoot target knee extension angle during active proprioception testing.

Knee Surg Sports Traumatol Arthrosc 2020 Feb 27;28(2):645-652. Epub 2019 Nov 27.

Faculty of Medicine Orthopedics and Traumatology Department, Ufuk University, 06510, Ankara, Turkey.

Purpose: To compare the active joint position sense (JPS), muscle strength, and knee functions in individuals who had anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft, hamstring tendon autograft, tibialis anterior allograft and healthy individuals. It was hypothesized that when compared to an age and gender-matched healthy control group, subjects who were post-ACL reconstruction would display impaired active joint position sense, knee extensor and flexor strength symmetry and knee function at 1 year post-surgery. A secondary hypothesis was that differences would exist between the quadriceps tendon autograft, hamstring tendon autograft and tibialis anterior allograft groups.

Methods: Sixty-seven patients with ACL reconstruction and 20 healthy individuals were included. Active JPS reproduction was measured at 15°, 45° and 75° of knee flexion. International Knee Documentation Committee (IKDC) subjective score and one-leg hop test were used to assess the functional status of the patients.

Results: The JPS detection was different at the 15° target angle between groups (F = 24.56, p < 0.001). A significantly higher proportion of quadriceps tendon autograft group patients failed to identify the 15° active JPS assessment position compared to the other groups (p < 0.0001). The quadriceps index was lower in patients compared to healthy individuals (p < 0.001), while the hamstring index was similar (n.s.). The knee functional outcomes were similar between ACL reconstructed groups and healthy controls (n.s.).

Conclusion: Knee proprioception deficits and impaired muscle strength were evident among patients at a mean 13.5 months post-ACL reconstruction compared with healthy controls. Patients who underwent ACL reconstruction using a quadriceps tendon autograft may be more likely to actively over-estimate knee position near terminal extension. Physiotherapists may need to focus greater attention on terminal knee extension proprioceptive awareness among this patient group.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-019-05795-7DOI Listing
February 2020