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    Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum
    (Turkish Joint Diseases Foundation, 2014) Oktas, Birhan; Orhan, Zafer; Erbil, Baris; Degirmenci, Erdem; Ustundag, Nil
    Objectives: The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Materials and methods: Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. Results: In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. Conclusion: According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.
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    EXPERIMENTAL EVALUATION OF TIGECYCLINE AND TEIKOPLANIN IN THE TREATMENT OF IMPLANT RELATED METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) OSTEOMYELITIS
    (Int Journal Pharmaceutical Sciences & Research, 2014) Orhan, Zafer; Degirmenci, Erdem; Oktas, Birhan; Karaduman, Okan; Kir, Gozde; Mulazimoglu, Lutfiye
    Treatment of implant related MRSA osteomyelitis is a real challenge both for the physician and the patient. We evaluated the comparative efficacy of tigecycline, a novel broad-spectrum glycycline antibiotic and the glycopeptide antibiotic teicoplanin in the treatment of implant related MRSA osteomyelitis in an experimental rat model. Implant related MRSA osteomyelitis was studied in tibial metaphysis of 60 rats. When compared to the control groups, the number of microorganisms was found to be significantly lower in the study groups, but there was no statistically significant difference between tigecycline and teicoplanin respectively. Tigecycline with its good tissue penetration and lower side effects was found to be as effective as teicoplanin in implant related MRSA osteomyelitis, even if the implant is retained. It could be considered as an alternative to glycopeptides because of the efficacy and because of the lower adverse effects in long term usage. Further studies are warranted to suggest a standard medical treatment for implant-related osteomyelitis.