Mahmoud Karimi Mobarakeh, MD; Mohsen Mardani Kivi, MD; Masoud Hadjikhani, MD
Abstract
Background: Knee arthroplasty has been traditionally based on mechanical alignment restoration. In the newer, “Kinematically aligned knee replacement”, the eroded bone and joint surfaces in addition to saw-blade thickness are removed and replaced by the components. This study compared the ...
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Background: Knee arthroplasty has been traditionally based on mechanical alignment restoration. In the newer, “Kinematically aligned knee replacement”, the eroded bone and joint surfaces in addition to saw-blade thickness are removed and replaced by the components. This study compared the results of two techniques of knee arthroplasty.
Methods: In a clinical trial study, 90 patients who were candidates for knee arthroplasty were divided into 2 groups: 45 cases received knee arthroplasty by “mechanically aligned” and 45 by “Kinematically aligned” technique. The two groups were compared after 1 year by Lysholm score, hospitalization period, subjective satisfaction, and period of need for ambulatory aid.
Results: 73 patients referred for follow up: 37 patients in the kinematic and 36 in the mechanical group. The mean hemoglobin drop was not significantly different between the two kinematic and mechanical groups; while the post operation mean hemoglobin drop difference was significant (p < /em>=.001). No significant difference in the patient satisfaction of the operation was observed between two groups. The difference of mean Lyshlom score was different between two groups (p < /em>=.000).
Conclusions: kinematically aligned” knee replacement is associated with less pain, earlier return to daily activity, lesser intra operative bleeding and more patient satisfaction.
Mahmood Karimi Mobarakeh; Mohsen Mardani-Kivi
Abstract
Hihg tibia osteotomy has its own position even with successful total knee replacement. A high tibial osteotomy affects not only the joint function as a whole, but also the dyferent sections of the knee joint. The biomechanical changes affect the patella inedial collateral ligament, quadriceps alignment ...
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Hihg tibia osteotomy has its own position even with successful total knee replacement. A high tibial osteotomy affects not only the joint function as a whole, but also the dyferent sections of the knee joint. The biomechanical changes affect the patella inedial collateral ligament, quadriceps alignment and Q-angle and tibial plateau slope. The goal of high tibia osteotomy is more normal load distribution in nonarthritic knee in young persons, and slowing degeneration in arthritic knee in adults. All the high tibia osteotomies cause patellofemoral biomechanical changes, through tubercle displacement, or patellar tendon fibrosis or calcification. Q angle also increase with lateral displacement of tibial tuberosity when osteotomy is done proximal to the tibial tuberosity. The medial collateral ligament needs to be released in open wedge high tibia osteotiomy. If intact medial ligament is necessary, osteotomy should be done distal to medial collateral attachment. The proximal tibia configuration is roughly similar to a rectangle. Lateral cortex is in right angle to the posterior one. The posteromedial corner opens three times the anterior one in open wedge osteotomy otherwise there would be tibial slope change.
Mohsen Mardani Kivi; Ali Karimi; Keyvan Hashemi Motlagh
Abstract
Background: The purpose of clinical examination is to make a correct diagnosis. There are several clinical tests with different diagnostic values for meniscus injuries. The aim of the present study was to evaluate the diagnostic value of modified "axial loading McMurray test". Methods: In a cross sectional ...
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Background: The purpose of clinical examination is to make a correct diagnosis. There are several clinical tests with different diagnostic values for meniscus injuries. The aim of the present study was to evaluate the diagnostic value of modified "axial loading McMurray test". Methods: In a cross sectional diagnostic study, 146 patients (120 male, 26 female) with a mean age of 35 years who had clinical symptoms of knee meniscus injury and were candidates for arthroscopic evaluation entered the study in a teaching hospital in Guilan-Iran. "Axial loading Mc Murray – ALMM" test was performed in all the cases just before doing arthroscopic evaluation of the knees. The accuracy, sensitivity, specificity, positive and negative predictive values of the ALMM in relation to the later arthroscopic findings were analyzed. Results: From the 146 patients, 92 had evidence of meniscus tear on ALMM testing. The arthroscopy was, however, positive in 82 patients. In the remaining 54 cases with negative ALMM test, 38 patients had meniscus tear at arthroscopy. 56% of tears were seen in medial meniscus, 75% of which were in posterior horn. The ALMM test had 67.1% accuracy, 68.3% sensitivity, 61.5% specificity, 89.1% predictive positive value and 29.6% negative predictive value. Conclusion: Positive "Axial loading Mc Murray" for knee meniscus injury is expected to show meniscal tear in 89% of cases
