Abstract
Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: ...
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Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: In a randomized clinical trial study, 71 patients with an average age of 29 years were treated for ACL between 2008 and 2009. Forty six patients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. In the last year of follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.Results: At 36 month follow-up, 34 patients in BPTB and and 28 in ST group, had good-to-excellent IKDC score (p < /em>≥.05).Lachman test was graded normal, for 23 while patients in BPTB and / in ST group, (p < /em>=.043) normal pivot-shift test was present in, 29 and 15 patients, respectively (p < /em>=.038). There was no significant difference in terms of thigh circumference knee effusion, range of motion or pain. The complications rate was also similar.Conclusions: These results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level, and knee function.
Mohammad Mahdi Sarzaeem; Gholamhossein Kazemian; Gholamhossein Kazemian; Mohammad Emami; Alireza Manafi Rasi,; Mohammad Emami; Arash Ghaffari; Salim Khani
Abstract
Background: One of the common complications following total knee arthroplasty (TKA) is excessive post operative blood loss. Tranexamic acid (TXA), an antifibrinolytic drug, is commonly used to control post-operative blood loss. However, the ideal route of administration is not yet quite clear. In this ...
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Background: One of the common complications following total knee arthroplasty (TKA) is excessive post operative blood loss. Tranexamic acid (TXA), an antifibrinolytic drug, is commonly used to control post-operative blood loss. However, the ideal route of administration is not yet quite clear. In this study, the different administration routes of TXA for blood loss control after TKA will be evaluated. Methods: In a clinical trial study, 200 patients who were scheduled for knee arthroplasty were randomly divided into 4 groups. In group 1, TXA (500 mg mixed in 100 cc of saline) was administered intravenously at the time of wound closure. In group 2, the knee joint cavity was irrigated and soaked for 5 minutes with 3 g of TXA in 100 cc of saline just before wound suturing. In group 3, immediately after wound closure, 1.5 g of TXA in 100 cc of saline was injected into the knee through the drain. Group 4 (control group) received no TXA , but the drain was clamped completely for an hour. The amount of blood loss and transfusion, and changes in hemoglobin levels were documented accordingly. Results: The mean post-operative blood loss in the groups 1 to 4 were respectively 476.8±114.8, 743.2±116.5, 173.9±60.5, and 860.5±152.2 ml (p < /i>
Gholamhossein Kazemian; Gholamhossein Kazemian; Reza Tavakoli Darestani; Alireza Manafi Rasi; Mohammad Mahdi Sarzaeem; Ramin Farhang Zanganeh; Arash Ghaffari; Farshad Safdari
Abstract
Osteosarcoma is the most common malignant tumor of bone in young people. We report a case of recurrent post-radiation osteogenic sarcoma in the clavicle of a 28-year-old man with a history of Hodgkin’s lymphoma.
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Osteosarcoma is the most common malignant tumor of bone in young people. We report a case of recurrent post-radiation osteogenic sarcoma in the clavicle of a 28-year-old man with a history of Hodgkin’s lymphoma.
Gholamhossein Kazemian; Gholamhossein Kazemian; Reza Tavakoli Darestani; Mohammad Emami Tehrani Moghaddam; Alireza Manafi Rasi; Behrouz Asghari; Ali Nemati; Farshad Safdari
Abstract
Two patients with iatrogenic femoral neck fracture following intramedullary fixation of the diaphyseal fractures are reported. This is a rare complication of intramedullary nailing (IMN), has poor prognosis and is preventable. It seems that choosing the piriformis fossa as the entry point, increased ...
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Two patients with iatrogenic femoral neck fracture following intramedullary fixation of the diaphyseal fractures are reported. This is a rare complication of intramedullary nailing (IMN), has poor prognosis and is preventable. It seems that choosing the piriformis fossa as the entry point, increased neck-shaft angle (coxa valga) and excessive nail insertion increased the risk of the iatrogenic neck fracture.
Alireza Manafi Rasi; Gholamhossein Kazemian; Gholamhossein Kazemian; Amir Hossein Fallahi; Mohammad Mahdi Bagherian Lemraski,; Ali Nemati; Farshad Safdari
Abstract
Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty ...
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Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty five patients with stable fractures of the foot or ankle or ankle sprains contributed in this cross-sectional study. The level of D-dimer was determined between 7-14 days post-casting. If the level of D-dimer was higher than 0.2 µg/mL, the result of the test was considered positive and patient was referred for further examination for DVT using doppler ultrasonography. The role of risk factors in the development of DVT was evaluated. Results: There were 46 patients with at least one DVT risk factor. The D-dimer test was positive in 21 patients (22.1%). Based on the doppler ultrasonography, 3 patients developed DVT. There was a statistically significant relation between the presence of multiple risk factors (≥3) and increased risk of DVT development (p=.01). Conclusion: DVT is not a common complication in below knee casting and routine thromboprophylaxis is not necessary in patients with less than 3 risk factors.
Mohammad Mahdi Sarzaeem; Mohammad Emami; Mohammad Emami; Gholamhossein Kazemian; Gholamhossein Kazemian; Alireza Manafi Rasi; Mohammad Mahdi Bagherian Lemraski; Farshad Safdari
Abstract
Background: Large defects in chronic Achilles tendon ruptures are difficult to rapair. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic large gaps in Achilles tendon ruture using free semitendinosus interposition tendon grafting. Methods: ...
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Background: Large defects in chronic Achilles tendon ruptures are difficult to rapair. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic large gaps in Achilles tendon ruture using free semitendinosus interposition tendon grafting. Methods: In a case series study, eleven male patients with mean age of 30±4 years and average defect size of 8.31±1.96 cm in their old Achilles tendon underwent reconstruction during 6 years in a teaching hospital in Theran-Iran. Ipsilateral semitendinosus free tendon graft was used for reconstruction. The cases were evaluated by Ankle-Hindfoot Scale of American Orthopaedic Foot and Ankle Society (AOFAS), and the Achilles Tendon Rupture Score (ATRS) to with a mean follow-up of 25.36±3.3 months. Results: The pre-operative AOFAS and ATRS of 70.4±5.3 and 31.7±5.7 preoperatively improved to 91.8±4.8 and 88.7±4.2 values. The ankle dorsiflexion showed a significant decline – postoperative value of 13.5±4.2 degrees compared to preoperative of 17.2±3.9 degrees (p=.04). All the cases except a professional athlete, returned to their previous activities. Conclusion: This technique offers good clinical and functional results in patients with large defects and is associated with no donnersite morbidity. We recommend this technique for the reconstruction of the chronic at ruptures in patients with over 6 cm defects.
Seyed Mohammad Jazayeri, MD; Gholamhossein Kazemian, MD; Gholamhossein Kazemian, MD; Farivar Abdollahzadeh Lahiji, MD; Hamid Hesarikia, MD
