Sohrab Keyhani, MD; Arash Sherafat Vaziri, MD; Mohammad Hossein Nabian, MD
Abstract
Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus ...
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Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus from 2007 to 2011 in 3 centers in Tehran-Iran. Only 40 patients were studied with an average followe-up of 32.4 months (24-48 months). The patients were evaluated by International Knee Documentation Committee (IKDC), Lysholm and Tegner scoring systems subjectively, and by objective Lachman and McMurray tests. Results: 34 patients were operated for ACL reconstruction and 6 for ACL and PCL reconstruction and lateral meniscus tears were repaired simultaneously. On the final follow-up, all the patients had firm end-points tested by Lachman. None reported popping or clicking. The mean IKDC score was 75.25 (range: 54-92), the mean Lysholm score was 94.4 (excellent) in 22 patients and the mean Tegner score was 7.15. From the 16 patients who were professional soccer players, 14 were still playing competitively at the time of follow-up. Conclusions: The midterm results of lateral meniscus repair - at root or para-root level - in association with ACL or / and PCL reconstruction, are acceptable.
Azin Zargham; Karim Leilnahari; Soheil Mehdipoor; Elnaz Nouri; Sohrab Keihani
Abstract
Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized ...
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Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized knee model. Methods: A computer-knee modle was constructed. Then "single bundle" and "double bundle" ACL reconstruction was performed. The knee stability and ligament tension were tested in 3 different settings: 1) At 30° knee flexion under isolated postero-anterior load, valgus and rotational torque was applied, 2) In weight-bearing flexion range (from extension to 70° of flexion) an anterior load of 134 Newton was applied, 3) Knee model was loaded by a non-contact pivot farce to produce ACL rupture. Results: The results showed no significant difference between "single bundle" and "double bundle" under isolated loading. The second and third model, however, showed 4 times greater tension on the ligament in "single bundle". The "single bundle" in the second technique of testing (weight bearing) showed at most 7 mm more displacement compared with "double bundle". In the third testing technique "double bundle" was stronger than "single bundle" in valgus torque resistance. The internal rotation stability was also more in "double bundle". Conclusion: Functional stability of knee model of ACL reconstruction with a "double bundle" graft is superior to a "single bundle" graft.
Mahmood Karimi Mobarakeh; Mohsen Mardani Kivi; Sohrab Keyhani; Hadi Safaee
Abstract
Background: High tibia osteotomy remains an acceptable method for prevention of medial comportment knee osteoarthritis. The conventional technique is a closing wedge osteotomy. We planned to study short-term results of a medial open wedge high tibia osteotomy using T-Buttress plate and a metal wedge. ...
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Background: High tibia osteotomy remains an acceptable method for prevention of medial comportment knee osteoarthritis. The conventional technique is a closing wedge osteotomy. We planned to study short-term results of a medial open wedge high tibia osteotomy using T-Buttress plate and a metal wedge. Methods: In this case series study, 60 patients (76 knees, 27 male and 33 female) underwent an open wedge high tibia osteotomy surgery using a T-Buttress plate and a metal wedge in a in a teaching hospital in Kerman-Iran. Patients were assessed clinically and radiographically including Modified Hospital for Special Surgery Knee Scoring System (HSSKS), anatomical and mechanical limb alignment, Insall-Salvati patellar height index and proximal tibia posterior slope angle. Results: The mean tibia-femoral angle changed from -6.8 to +4.33 degrees. 26(43.3%) patients needed iliac cancellous graft. The mean metal wedge size was 11.07 mm (8-15 mm). The mean Modified HSSKS promoted from 75.5 to 98.73. The observed complications were: fracture in five, intraarticular screw penetration in four (one in proximal tibia-fibular joint), infection in two and under-correction in one patient. There was no non-:::union:::, proneal nerve injury, over-correction, plate failure, deep vein thrombosis and bone graft donor site complication. The mean posterior tibia slope changed from 8.05±1.95 to 8.68±1.54 degrees and patellar height index changed from 1.06 to .97. Conclusion: This procedure is a safe and reliable technique and lessened the need for an autograft. Significant improvement in score of Modified HSSKS was seen post operatively.
Farivar A Lahiji; Reza Zandi; Sohrab Keyhani; Farshad Safdari; Arash Maleki; Seyyed Reza Aghapour; Salman Azarsina
Abstract
Background: Kienbock disease resulting from avascular necrosis of lunate bone leads to pain and disability in young active patients. Radial shortening is one of the treatment methods in this disease. In this study, we evaluated the mid-term results of treatment of Kienbock using radial shortening. Methods: ...
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Background: Kienbock disease resulting from avascular necrosis of lunate bone leads to pain and disability in young active patients. Radial shortening is one of the treatment methods in this disease. In this study, we evaluated the mid-term results of treatment of Kienbock using radial shortening. Methods: In a retrospective study, 9 males and 6 females with Kienbock disease with average age of 28.6±9.37 years who had undergone radial shortening, were examined in a teaching hospital in Tehran-Iran. There were 2 patients in stage II, 5 in IIIa and 8 in step IIIb of Lichman’s class. In a mean follow-up of 5±2.44 years, these 15 cases were evaluated for wrist motion and gap strength and also with quick-DASH score. The radiograph Stahl index and carpal height ratio were also assessed. Results: Pain and range of motion improved and grip strength was favorable in 13 patients. Quick-DASH score was 8.5±.84 in patients with stage II, 12.72±5.09 in stage IIIa, and 27.57±18.87 in stage IIIb. Stahl index and carpal height ratio were the same in patients with stage II, but significantly decreased in other patients. Kienbock disease progressed in 2 cases. Conclusion: Radial shortening can relief clinical symptoms, even in stage III and IIIb of Kienback diseases, although the disease X-ray show radiographic worsening.
Sohrab Keyhani, MD; Seyyed Reza Sharifzadeh, MD; Mohammad Reza Abbasian, MD; Touraj Shafaghi, MD; Soheil Mehdipour, MD; Farshad Safdari, MSc
Abstract
Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before ...
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Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before and after clinical trial, 56 patients with grade 4 full thickness chondral lesion (outer bridge classification) were treated by the arthroscopic mosaicplasty technique over a 4-year period at an hospital in Tehran, Iran. The mean time of follow-up was 21±4 months (16-32 months). The patients were assessed by International Knee Documentation Committee (IKDC) and Lyshom knee scoring scale (LKSS). The impact of age, site of chondral lesion (medial or lateral femoral condyle), extent of the lesion (number of plugs) and associated lesions, preoperative active levels, tourniquet time and surgery complications were studied. In 3 cases, second-look arthroscopy was performed.Results: The result of 78.6% was excellent and 21.4 good, based on IKDC. Preoperative Lysholm score was 67.1±17.6 and postoperative score increased to 93.2±6.5 (p < /em>=.0004). Clinical outcomes were better significantly in patients with associated articular lesions, lateral condyles lesions, professional athletes and younger patients, also in cases with lower plug numbers and sport injuries (p < /em>
Ali Akbar Esmailijah, MD; Seyyed Mohammad Jazaeri, MD; Seyyed Mehdi Hosseini Khameneh, MD; Firooz Madadi, MD; Sohrab Keihani, MD; Keyghobad Ashoori, MD; Pooran Hakimi, MD; Reza Zandi, MD; Mehdi Rahimi, MD; Farshad Safdari, MSc
Abstract
Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial ...
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Background: Incorrect tunneling is one of the concerns in arthroscopic anterior cruciate ligament reconstruction. The purpose of the current study was to determine the incidence of the correct femoral and tibial tunnel positions.Materials: In a cross-sectional study, the CT image positions of the tibial and femoral tunnels in 40 patients that had undergone arthroscopic ACL reconstruction using single-bundle hamstring tendon were studied. The parameters that were evaluated were: tibial tunnel position in axial and sagittal cuts, femoral tunnel position in axial cut, appropriate thickness of the posterior cortex at the intercondylar notch, and femoral exit point.Results: The correct position of the tibial and femoral tunnels, appropriate thickness of the posterior cortex at the intercondylar notch, and the correct position of the "femoral exit point" were respectively recognized in 60%, 52.5%, 70%, and 67.5%. In total, the correct position of the femoral and tibial tunnels was seen on 37.5% of patients. These parameters were compared with known standard anatomic positions.Conclusion: Although the incidence of correct tibial and femoral tunnel positioning in ACL reconstruction, when viewed separately, was acceptable when looked at as one tunnel was not satisfactory. More precise attention and expertise seem necessary for the operating orthopaedic surgeons.
Sohrab Keyhani, MD; Reza Zandi, MD; Hamid Reza Seyyed Hosseinzadeh, MD; Mohammad Ali Okhovatpour, MD; Mahdi Rahimi, MD; Reza Minaee Noshahr, MD
Abstract
Isolated fracture of the lesser tuberosity of humerus is rare. In this study we report one case of isolated fracture of lesser tuberosity, that was diagnosed acutely and was treated with open reduction and internal fixation.
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Isolated fracture of the lesser tuberosity of humerus is rare. In this study we report one case of isolated fracture of lesser tuberosity, that was diagnosed acutely and was treated with open reduction and internal fixation.
Soheil Mehdipour, MD; Sohrab Keihani, MD; Seyed Mohammad Jazayeri, MD; Mohammad Reza Abbasian, MD
Abstract
Background: Treatment of recurrent shoulder dislocation with open technique has a long successful history in orthopaedic surgery. Arthroscopic repair, however, has a much shorter history especially in Iran. This is a short-term follow-up study of such an operation in Iran.Methods: Forty patients (39 ...
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Background: Treatment of recurrent shoulder dislocation with open technique has a long successful history in orthopaedic surgery. Arthroscopic repair, however, has a much shorter history especially in Iran. This is a short-term follow-up study of such an operation in Iran.Methods: Forty patients (39 males, 1 female) with recurrent anterior shoulder dislocation who had undergone arthroscopic stabilization over a two-year period were evaluated in a retrospective study. The cases had a mean age of 25.3 years, and had 15.5 months (6-30 months) average follow-up. The assessment scores were “The University of California-Los Angeles” (UCLA), “Rowe” and “American Shoulder and Elbow Society Scores” (ASES).Results: Mean Rowe score was 95.5 (77-100) with excellent scores in 32 patients, good in 4, fair in 3 and poor in one. Mean UCLA score was 33.3 (25-35), with good and excellent results in all but 4 cases. ASES was 2-3 in 3 patients, and the rest being painless and without any symptoms. Thirty six patients returned to their previous levels of activity, and achieved good results the results were fair in 3, and poor in one patient who had recurrent instability.Conclusions: Short-term results of arthroscopic repair of anterior shoulder instability are encouraging.
