F Biglari; A Mavaein; S Shabani; H Mahdavi Mohtasham; S M Kazemi
Abstract
Background: Clavicle fractures have various complications following open reduction and internal fixation. The main objective of this study was to investigate the prevalence of complications of Clavicle fractures following operative treatment. Also, the prevalence of infection, local dissatisfaction, ...
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Background: Clavicle fractures have various complications following open reduction and internal fixation. The main objective of this study was to investigate the prevalence of complications of Clavicle fractures following operative treatment. Also, the prevalence of infection, local dissatisfaction, non:::::union::::: and mal:::::union::::: in the Clavicle fracture after internal fixation was investigated.
Material and Methods: The study was cross-sectional. A sample of 52 patients was treated with clavicle fractures, which were treated with open resection and internal fixation. In order to determine the range of motion, strength and shoulder pain, patients were selected from Constant Shoulder Score. Radiography used to detect :::::union:::::.
Results: 12 were female and 40 were male of 52 patients. The mean score of the shoulder was 84 ± 2 (95% CI 83-84). One third of the patients used Hook. Patients complained more dysmorphic scar (96%), skin numbness (80%) and pain (73.1%). The rate of infection in patients was very low.
Conclusions: The most common complication is pain, dysmorphic scar and skin numbness that can be said to be relatively normal and can be seen in most patients. Of course, it should also be taken into account that the differences in surgical techniques, surgeries, cultural issues, gender, and age of the patients can be affected.
T Asgari; A AliAhmadi; H Mahdavi Mohtasham; SM Kazemi
Abstract
total Knee arthroplasty is an effective and cost-reducing therapeutic approach, which is very useful in relieving pain and improving the performance of patients with advanced knee arthritis, but there are some factors that may lead to the failure of this surgery. From that which patients need for ...
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total Knee arthroplasty is an effective and cost-reducing therapeutic approach, which is very useful in relieving pain and improving the performance of patients with advanced knee arthritis, but there are some factors that may lead to the failure of this surgery. From that which patients need for re-surgical repair, the most common causes of knee replacement are included as infection, poor mechanized joint replacement, implant failure, or frailty of implant. Infection is the most common cause of the main cause Knee replacement surgery. The main goal in this study is to explore new procedures to reduce implant-induced defects and also increase the implants life in knee arthroplasty surgery.
Methodology:
search was carried out in PubMed, science direct and magazine of materials for identification of published articles and studies on infections caused by bone implants. 76 articles were reviewed from 2003 to 2016 and 50 articles of them were cited in the text.
Results: From the 50 papers cited in this study, 41 articles examined the effects of non-antibiotics on infections of bone implants. 5 papers have been reviewed carefully for non-antibiotic treatments and their effects on bone tissue in vitro and 4 are related to combination of these agents with antibiotics and subsequent increase in their efficacy after surgery.
Conclusion:
Using of non-antibiotic agents to preventing cause infections after knee surgery intended to preventing biofilm formation in this area is one of the methods suggested to prevent antibiotic resistance against antibiotics.
Today, in these surgeries, polyethylmetacrylate cements are commonly used filled with antibiotics such as vancomycin and gentamicin, which unaccustomedly may be exposed by bacteria and biofilms, and ultimately lead to acute infections. Our overview is exploring the technologies that can improve the performance of orthopedic implants, which may reduce the severity of knee joint infections. The results of these reports also have revealed that the combination of technology and different types of infections at the same time, can promote microbial infection Cause.
S Morteza Kazemi; Shahin Salehi; S Mohamad Qoreishi; Mehrshad Poursaeid Esfahani; Mohammad Hassbi; Jila Sharghi; Farshad Safdari
Abstract
Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been
reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence
of hip dysplasia in a group of normal Iranians evaluated by measuring ...
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Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been
reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence
of hip dysplasia in a group of normal Iranians evaluated by measuring the morphologic parameters of acetabulum on
radiographs.
Materials and Method: 586 hips (293 person) were enrolled in this study. On anteroposterior hip radiographs,
the following 5 parameters were measured: Central edge angle (CEA), acetabular angle (AA), acetabular depth (AD),
acetabular roof obliquity (ARO) and roof angle (RA). The normal and abnormal values were obtained in different
sexes and compared with the known normal values in orthopaedic literature. Furthermore, the correlation between
the above measurements was investigated.
Results: Based on CEA, 15 (2.6%) of hips were dysplastic:-0.7% definite and 1.9% mild. 19 hips (3.2%) were
dysplastic when using AA values. AD and RA were significantly higher in males. Except for lack of correlation
between AA and AD, the other parameters -in particular, CEA and AA- were closely correlated. CEA, AA, ARO and
RA were significantly different between dysplastic and non-dysplastic hips.
Conclusion: Definite or mild dysplasia was recognized in 0.7% and 1.9% of the “normal” population that was
studied. Since CEA was the same between males and females and was correlated with all other morphologic
parameters, it seems that CEA is a useful measurement to evaluate presence of hip dysplasia.
Seyyed Morteza KazemiSeyyed Morteza Kazemi; Seyyed Mohammad Qoreishi; Mahdi Bahari Mehrabani; Farshad Safdari
Abstract
Background: It has been suggested that double-level osteotomy can prevent the occurrence of joint line obliquity, as one of the complications following high tibial osteotomy. In this study, we compared the preoperative distal femoral and proximal tibial obliquity in patients with primary genu varum with ...
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Background: It has been suggested that double-level osteotomy can prevent the occurrence of joint line obliquity, as one of the complications following high tibial osteotomy. In this study, we compared the preoperative distal femoral and proximal tibial obliquity in patients with primary genu varum with a group of normal subjects.
Methods: 75 patients with primary genu varum and 75 normal persons, contributed to a case-control study. The medial distal femoral mechanical angle (MDFMA), medial proximal tibial mechanical angle (MPTMA) and joint diversion angle (JDA) were measured and compared between the two groups. The percentage of patients with >3 degrees in both distal of femur and proximal of tibia were determined.
Results: The mean of MDFMA and MPTMA was significantly lower and the mean of JDA was significantly higher in genu varum group compared to normal group (p < /em>3 degrees.
Conclusions: The alignment of distal femur and proximal tibia is significantly different in patients with primary genu varum and normal controls. Abnormal alignment of joint line is a common finding in both primary genu varum and normal people but more commonly in the cases of genu varum. As double level osteotomy may be required in many patients with genu varum, it is important to investigate distal of femur alignment before high tibial osteotomy
Mohsen Mardani-Kivi; Seyyed Morteza Kazemi; Keyvan Hashemi Motlagh; Khashayar Saheb Ekhtiari
Abstract
Brown tumor is an osteolytic lesion caused by excessive production of parathyroid hormone. We present a 20 year old man with symptoms of severe muscle weakness and multiple fractures of shoulder and hip that the Brown tumor was observed in most of his bones.
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Brown tumor is an osteolytic lesion caused by excessive production of parathyroid hormone. We present a 20 year old man with symptoms of severe muscle weakness and multiple fractures of shoulder and hip that the Brown tumor was observed in most of his bones.
Seyyed Massoud Hashemi; Mehrdad Taheri; Farivar A Lahiji; Seyyed Morteza Kazemi; Farshad Safdari
Abstract
Background: ''Suprascapular nerve block'' is a well known technique for treating chronic shoulder pain. Ultrasonography-guided nerve block is a new technique hoping to decrease the complications of inadvertent injection of drug into the vessels or nerve sheet by increasing the accuracy and efficacy of ...
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Background: ''Suprascapular nerve block'' is a well known technique for treating chronic shoulder pain. Ultrasonography-guided nerve block is a new technique hoping to decrease the complications of inadvertent injection of drug into the vessels or nerve sheet by increasing the accuracy and efficacy of the injections. Methods: In a trial clinical study, 50 Patients suffering from chronic shoulder pain were divided randomly into two groups. In the first group, nerve block was applied under the ultrasonograpy guide and in the second group using direct anatomic landmarks (Moore technique). Pain score was assessed using a visual analog scale (VAS) and shoulder function was evaluated by constant shoulder score (CSS) before the injection and after the block. The patients' satisfaction rate and efficacy were also evaluated and compared between the two groups. Results: There was no statistically significant difference between the two groups in pain or shoulder functional scores before the procedure (p≥.05). One week after the nerve block, the first group revealed significantly improvement in pain score p=.035). Although shoulder function improved in both groups, the difference was not significant. (p≥.05). One month later, pain and shoulder functional scores showed better improvement in group one compared to group two (p=.000). No complication occurred in either group. Conclusion: Ultrasonography-guided suprascapular nerve block has better outcome in pain score and shoulder function compared with ''blindly'' blocking the nerve.
Hamid Reza Hosseinzadeh; Reza Zandi; Seyyed Morteza Kazemi; Seyyed Mohammad Qorashi; Sina Shahi; Farshad Safdari; Mohammad Reza Bigdeli; Siyavosh Hemmati Eslamlou; Mohammad Ali Jalili
Abstract
Background: Posterior tibial slope is the normal anteroposterior inclination of the tibia slope and plays an important role in the biomechanics of the knee and function of the cruciate ligaments. Posterior tibial slope angle varies in different populations and there is no report about its measurement ...
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Background: Posterior tibial slope is the normal anteroposterior inclination of the tibia slope and plays an important role in the biomechanics of the knee and function of the cruciate ligaments. Posterior tibial slope angle varies in different populations and there is no report about its measurement in the Iranian population. The aim of this study was to investigate the normal posterior tibial slope in a teaching hospital in Tehran-Iran. Methods: In a desreptive study, 108 knees in 70 men and 38 female patients, with no history of prior knee problem were evaluated by lateral knee rodiographs in a teaching hospital in Tehran-Iran. The average age in these cases was 38 years (23-60 years). These patients had refered because of recent knee trauma, but no fracture or intra-articular derangement had been found. The angle of tibial slope was measured in all the cases and analyzed. Results: The mean slope angle was 9.4±1.8 degrees. There was no statistical relationship between age and gender and posterior tibial slope (p≥.05). Conclusion: The normal posterior tibial slope angle in this Iranian population was different from other countries. It may be necessary to consider these differences in designing tibial and femoral components for knee arthroplasty.
Mohammad Reza Farahanchi Baradaran; Seyyed Morteza Kazemi; Seyyed Mehdi Hosseini Khameneh; Seyyed Mohammad Jazaeri; Firooz Madadi; Keyghobad Ashoori; Katayoon Kazemi; Reza Zandi; Farshad Safdari
Abstract
Background: Arthroscopic reconstruction of the anterior cruciate ligament is one the most common orthopaedic surgeries. There are scattered reports about the beneficial effects of post operative cox2-inhibitors administration on knee motion. The purpose of the current study was to determine the effects ...
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Background: Arthroscopic reconstruction of the anterior cruciate ligament is one the most common orthopaedic surgeries. There are scattered reports about the beneficial effects of post operative cox2-inhibitors administration on knee motion. The purpose of the current study was to determine the effects of cox-2 inhibitor on pain, range of motion and weight bearing after arthroscopic reconstruction of the anterior cruciate ligament. Methods: In this clinical trial, 70 patients who underwent arthroscopic reconstruction of the anterior cruciate ligament were assessed in a teaching hospital in Tehran-Iran. They were divided into case (cox2-inhibitor) and control groups. Postoperatively, pain, inflammation, range of motion and ability for full weight bearing were measured. Results: The mean of pain at the postoperative day 3 was 5.3±1.04 (visual analogs scale of 0 to 10) in the control and 3.3±0.71 in the case group. 29.6% of the patients in the control group and 82.8% in the case group were able to flex the knee more than 90° one week postoperatively. In the first week, all of the patients in the case group and only 28.6% in the control group were able to walk without any assistive device. The post operative knee circumstances were 2.73±0.59 and l.61±0.92 centimeters smaller respectively in case and control groups. Statistical analysis showed significant differences between the two groups, in the above measurements. Conclusion: Cox-2 inhibitor is effective in relieving pain reducing the inflammation, and accelerating the rehabilitation program after arthroscopic reconstruction of the anterior cruciate ligament.
Mohammad Reza Farahanchi Baradaran, MD; Mehrnoush Hassas Yeganeh, MD; Mohammad Reza Bigdeli, MD; Syavash Hemmati Eslamloo, MD; Farshad Safdari, MS; Reza Zandi, MD; Hamid Reza Seyyed Hosseinzadeh, MD; Seyyed Morteza Kazemi, MD; Alireza Eajazi, MD; Laleh Daftari Besheli, MD
Abstract
Background: Hip fracture in older population is frequent and often costly. The patients, however, do not commonly regain their pre-fracture activity levels. We are reporting the outcome of surgery in intertrochanteric hip fractures during a ten-year period.Methods: This is a retrospective study of the ...
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Background: Hip fracture in older population is frequent and often costly. The patients, however, do not commonly regain their pre-fracture activity levels. We are reporting the outcome of surgery in intertrochanteric hip fractures during a ten-year period.Methods: This is a retrospective study of the intertrochanteric hip fractures treated from 1994 to 2004 in one teaching hospital of Tehran-Iran. The cases were called in for a full hip examination, evaluation of their activity levels and also measurement of Harris Hip Scores (HHS), as well as radiographic assessment.Results: 293 patients, comprised of 194 males (66.2%) and 99 females (33.9%), with a mean age of 65±6.67 years were studied. The cases had a one-year of follow-up. 252 (86%) cases had obtained :::union:::. Acceptable ligament was observed in 158 (54%) cases. Harris Hip Scores over 60 points was seen in 222 (75.8%). Only 90 patients had returned to their pre-operative activity level.Conclusion: Patients with intertrochanteric hip fracture do not often return to pre-fracture activity of daily living.
Hamid Reza Seyyed Hosseinzadeh, MD; Ali Akbar Esmaieliejah MD; Seyyed Reza Aghapoor, MD; Reza Zandi, MD; Mohmmad Reza Bigdeli, MD; Ali Aidenlo, MD; Jaafar Tavakolian, MD; Ali Akbar Esmaieliejah MD; Seyyed Morteza Kazemi, MD
Abstract
Background: Dislocation of total hip arthroplasty may happen for different reasons. Abnormal acetabular orientation is a common reason for such occurance. We would like to report the effect of acetabular inclination on incidence of dislocation.Methods: In a cross-sectional study all cases of total hip ...
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Background: Dislocation of total hip arthroplasty may happen for different reasons. Abnormal acetabular orientation is a common reason for such occurance. We would like to report the effect of acetabular inclination on incidence of dislocation.Methods: In a cross-sectional study all cases of total hip arthroplasty performed in a 2-yaer interval in one educational hospital in Tehran, were followed and assessed for possible dislocation in a 18.1 months (3-25 months) of follow-up. The inclination angles of acetabular components were measured, and the relationship of dislocation with gender, age and this angle was evaluated.Results: 132 cases entered the study. 4 patients (3%) encountered dislocation and all 4 had inclination angles of over 50 degrees. Gerder did not seem to play an important role. Older age, however, was probably contributing to risk of dislocation.Conclusion: Inclination angle of over 50 degree in acetabular component position is one of the factors making it more likely for the hip arthroplasty to dislocate.
Seyyed Morteza Kazemi, MD; Reza Minaei, MD; Mohammad Ali Okhovatpoor, MD; Ramin Farhang Zanganeh, MD; Mohammad Reza Bigdeli, MD; Seyed Reza Aghapour, MD
Abstract
Background: The role of a mobile-bearing knee arthroplasty is still not clear. This study was designed to compare the mobile and fixed-bearing prosthesis.Methods: In 30 knees a fixed-bearing and in 38 knees a mobile-bearing prosthesis was used. The results were compared using the "Knee Society Scoring ...
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Background: The role of a mobile-bearing knee arthroplasty is still not clear. This study was designed to compare the mobile and fixed-bearing prosthesis.Methods: In 30 knees a fixed-bearing and in 38 knees a mobile-bearing prosthesis was used. The results were compared using the "Knee Society Scoring System".Results: The mobile-bearing group of patients had an average age of 65 and 34 months average follow-up. The fixed-bearing group had an average age of 69 years and a mean follow-up of 30 months. The average knee score, functional score and overall score in the mobile-bearing group rose from 29, 45, 73 to 64, 67, 128 and in the fixed-bearing group from 31.7, 34, 65.9 to 68, 57, 125 prospectively. The difference between two groups was not significant statistically.Conclusion: Although in both groups the average knee scores increased after the operation, there were, however, no significant difference between knee scores in the two types in short-term, and no preference between two types of prosthesis.
Seyyed Morteza Kazemi, MD; Seyed Mehdi Hosseini Khameneh, MD; Siavash Hemati Islamloo, MD; Ramin Farhang Zanganeh, MD; Mohammad Reza Bigdeli, MD; Seyyed Mohammad Ghoreishi, MD
Abstract
Background: Prior to 1980 decade, surgical ideas and facts were mainly based on the individual surgeon’s experience and the collective judgment of groups of surgeons. In the 1980’s the concept of “Evidence Based Medicine” became popular suggesting that all surgical practices must be based on ...
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Background: Prior to 1980 decade, surgical ideas and facts were mainly based on the individual surgeon’s experience and the collective judgment of groups of surgeons. In the 1980’s the concept of “Evidence Based Medicine” became popular suggesting that all surgical practices must be based on evidence and not experience. According to the widespread publication of medical articles nowadays, the question often arises about the dependability and strength of the evidence. We are reporting the level of evidence (LOE) of articles published in the Journal of the Iranian Orthopaedic Association between 1995 and 2008. Methods: All the articles published in the Iranian Journal of Orthopaedic Surgery (1995-2008) were studied separately by 5 groups of physicians. The level of evidence rating system was based on the Journal of Bone and Joint Surgery, which classifies articles into therapeutic, prognostic, diagnostic and economic subgroups. The articles are subsequently divided into five levels in accordance with the defined levels of evidence.Results: Over half of the articles (54%) were therapeutic, 9% diagnostic, 35% prognostic and 2% economic. Overall 2% were placed as level I, 8% level II, 5% level III, 84% level IV and 1% level V.Conclusion: Therapeutic and prognostic articles and evidence level IV were the most common types observable in the articles published in the Iranian Journal of Orthopaedic Surgery. Furthermore, level I to III articles in this journal had increased over 3.5 times between 1995 and 2008.
Seyyed Morteza Kazemi, MD; Reza Minaee, MD; Ramin Farhang Zanganeh, MD
Abstract
In recent decades there has been a boom in medical publication all across the world. There are numerous medical journals whose articles tend to form the basis of the art and science of medicine. Along with this widespread upward trend, ethics of conducting and publishing medical research have undergone ...
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In recent decades there has been a boom in medical publication all across the world. There are numerous medical journals whose articles tend to form the basis of the art and science of medicine. Along with this widespread upward trend, ethics of conducting and publishing medical research have undergone natural evolution. This article intends to review some of the existing publication related to the standards of medical and scientific research and publishing articles in medical journals. Paying meticulous attention to these standards guarantees credibility and originality of medical articles and the publishing journals.
Sohrab Keihani, MD; Ali Akbar Esmaieliejah, MD; Mohammad Reza Abbassian, MD; Seyyed Morteza Kazemi, MD; Ali Akbar Esmaieliejah, MD; Hamid Reza Seyed Hosseinzadeh, MD; Amer Sadeghi, MD
Abstract
Background: Medial opening-wedge valgus high tibial osteotomy has gained popularity. However, the reported complication rate is high. The technique has been modified to remedy the problems of patellar descent and alteration in angle of the inclination of the tibial plateau and delayed :::union:::. Our ...
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Background: Medial opening-wedge valgus high tibial osteotomy has gained popularity. However, the reported complication rate is high. The technique has been modified to remedy the problems of patellar descent and alteration in angle of the inclination of the tibial plateau and delayed :::union:::. Our aim is to compare the modified retrotubercle opening-wedge osteotomy with the conventional technique.Methods: In a clinical trial study, 72 consecutive patients with varus knees who were candidates for high tibial valgus osteotomy were, randomly treated with either conventional medial opening-wedge upper tibial osteotomies (34 patients) or retrotubercle opening-wedge osteotomies (38 patients) from Feb 2006 to Feb 2008. These matched cases were evaluated for patellar height and upper tibial slope as well as tibial inclination measurements. The intra and inter-observer reliability of the radiographic measures were also assessed before surgery and in a mean follow up of 13 months (10-21 months).Results: In retrotubercle open-wedge osteotomies no surgical change in patellar length or any patellar infra was seen. The tibial plateau inclination also showed no significant change from the pre-operative values. On the other hand, the conventional medial open-wedge technique showed significant reduction in patellar height as well as increase in tibial plateau inclination as compared to pre-operative values.Conclusion: In high tibial valgus osteotomies for genu varum retrotubercle medial open-wedge osteotomy negates the ill-effect of conventional open-wedge osteotomy in producing patella infra or increased tibial plateau slope or change in Q-angle of quadriceps mechanism.
Seyyed Morteza Kazemi, MD; Reza Minaei, MD; Ramin Zanganeh, MD; Mohammad Reza Miniator Sajadi, MD; Mohammad Ali Okhovatpoor, MD
Abstract
Background: Change in the position of the patella in relation to the tibiofemoral joint (PB/PPB) is an important but often neglected complication of total knee arthroplasty. Such change may result in pain and decreased knee range of motion after surgery. The aim of this study is to measure the incidence ...
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Background: Change in the position of the patella in relation to the tibiofemoral joint (PB/PPB) is an important but often neglected complication of total knee arthroplasty. Such change may result in pain and decreased knee range of motion after surgery. The aim of this study is to measure the incidence of patella baja and pseudo-patella baja after total knee arthroplasty. Methods: In a retrospective study, 60 patients (49 women, 11 men) who had knee arthroplasty between 1992 and 2002 at Akhtar teaching Hospital in Tehran were studied for patellar problem. At the time of the study, patients were at least one year and at most eleven years from their operation. All measurements were made by a single person. All the patients received posterior cruciate ligament retaining prosthesis knees through a medial parapatellar arthrotomy. The average age at the time of the study was 62.5 years and the average follow-up was 27.5 months. The Knee Society Scoring System was used to score the knees. Patients' radiographs were examined using the Insall Salvati and Blackburne Peel methods. Results: Pseudo-patella baja was found in 15 (25%) patients while simultaneous baja and Pseudo-patella baja in 2 (3%) patients. While patella baja or Pseudo-patella baja were associated with more incidence of knee pain or limitation of motion, no relation was seen with final knee society scores.Conclusion: Patella baja or Pseudo-patella baja after knee arthroplasty may cause pain or limitation in knee range of motion. Attention to proper bone cuts and patellar tracking during surgery is suggested.
Firooz Madadi, MD; Seyed Morteza Kazemi, MD; Armin Aalami Harandi, MD; Mohammad Reza Abbassian, MD; Farivar Abdollahzadeh Lahiji, MD; Hamid Hossienzadeh, MD; Fooad Rahimi, MD
Abstract
Background: Avascular necrosis (AVN) of femoral head, with resultant joint destruction, is a common disabling disease of fourth and fifth decades of life. Metal-on-metal resurfacing is a relatively newer treatment modality for this disease. The aim of this study is to compare the result of resurfacing ...
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Background: Avascular necrosis (AVN) of femoral head, with resultant joint destruction, is a common disabling disease of fourth and fifth decades of life. Metal-on-metal resurfacing is a relatively newer treatment modality for this disease. The aim of this study is to compare the result of resurfacing for osteonecrosis with that of resurfacing for other causes.Methods: Twenty eight patients with stage III or IV (Ficat & Arlet) osteonecrosis who underwent metal-on- metal hip resurfacing were compared with 24 cases of grade IV or V (Croft’s) osteoarthritis (OA) who had undergone the same kind of arthroplasty during a 2 year period in Akhtar hospital in Tehran. These cases were matched in terms of gender and age, and were assessed by Harris hip score with 41(±22) months follow-up.Results: The AVN cases had 30.86 (±7.5) and OA cases 47.88 (±12.6) years at surgery. Three patients from each of the above groups had sustained complications of either femoral neck or acetabular cup fracture and had required revision surgery. The average Harris hip score was 94(±7.2) in AVN and 91.2(±9.4) in OA group. The collective hip range of motion was 216(±6.2) in AVN and 196±(5.6) in AO patients.Conclusions: Metal-on-metal hip resurfacing gives similar satisfactory results in avascular necrosis and in osteoarthritis of hip joint in short-term, with no statistically significant difference.
Sohrab Keyhani, MD; Ali Akbar Esmaieliejah, MD; Mehran Soleimanha, MD; Ali Akbar Esmaieliejah, MD; Seyed Morteza Kazemi, MD; Mohammad Reza Abbassian, MD; Reza Rokni, MD
Abstract
Background: The purpose of this study was to evaluate the short-term outcomes after one-stage arthroscopic reconstruction in chronic multiligamentous knee injuries.Methods: In a prospective study, 15 men with chronic multiligamentous knee injuries underwent one-stage reconstruction with autogenous semitendinosus ...
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Background: The purpose of this study was to evaluate the short-term outcomes after one-stage arthroscopic reconstruction in chronic multiligamentous knee injuries.Methods: In a prospective study, 15 men with chronic multiligamentous knee injuries underwent one-stage reconstruction with autogenous semitendinosus and gracilis grafts for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Any associated other ligamentous injuries were repaired by Achilles tendon allografts. The results were assessed by IKDC, and Lysholm score and ligament integrity by MRI with a mean follow-up of 9 (4-19) months. Clinical examination, regular radiography and a subjective questionnaire completed the evaluation procedures. Results: With a mean age of 23 (18-35) years, the final IKDC score was normal (grade A) in 1, nearly normal (grade B) in 10, abnormal (grade C) in 3 and grossly abnormal (grade D) in 1 patient. The mean subjective IKDC score was 83±14. The preoperative Lysholm score of 62±13 become 94±5 in follow-up.Conclusions: Multiple ligament injuries of knee can be successfully treated arthroscopically with autologous hamstring tendon graft, and if necessary, additional of Achilles tendon allograft.
Seyed Morteza Kazemi, MD; Hamidreza Hosseinzadeh, MD; Armin Aalami Harandi, MD; Faraz Ranjpour, MD Ranjpour, MD
Abstract
Methods: In a case series study, cases of osteonecrosis in Akhtar hospital in Tehran with history of temgesic and norgesic abuse were identified in a 2 year period. The hospital charts of 11 cases with such characteristics were evaluated.Results: Eleven cases with mean age of 37.72±5.55 years comprised ...
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Methods: In a case series study, cases of osteonecrosis in Akhtar hospital in Tehran with history of temgesic and norgesic abuse were identified in a 2 year period. The hospital charts of 11 cases with such characteristics were evaluated.Results: Eleven cases with mean age of 37.72±5.55 years comprised the study group. Five cases had used norgesic, 5 temgesic and 1 patient had used both of those agents. The average drug dosage was 4.36±2.29 vials per day for an average of 4.9±2.9 months. Onset of symptoms was 11.36±2.76 months after drug usage on average. Three cases had skin stria and 7 patients had localized obesity, both suggesting steroid effect. Bilateral involvement of bone ends was observed in all, while 3 cases had more than two joints affected.Conclusions: Norgesic and temgesic cause osteonecrosis with severe joint destruction. Raising the awareness of general public and physicians towards such a devastating complication is warranted.
