Arash Maleki; Firoozeh Madadi; Ramin Arjang; Firooz Madadi
Abstract
Background: Tibial torsion is a term used to describe the physiologic twist of the distal relative to the proximal articular axis of the tibial bone in the transverse plane around its longitudinal axis. This study focuses on a method of tibial torsion measurement with computerized tomography cuts. Methods: ...
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Background: Tibial torsion is a term used to describe the physiologic twist of the distal relative to the proximal articular axis of the tibial bone in the transverse plane around its longitudinal axis. This study focuses on a method of tibial torsion measurement with computerized tomography cuts. Methods: Sixty four volunteers aged over 16 years old had CT imaging of proximal and distal tibia in a teaching hospital in Tehran-Iran. The images were evaluated for leg rotation by four physicians using two different techniques in two different occasions, one month apart. In the first technique the middle of tibia and middle of fibula were used as reference points and in the second method the perpendicular axis to the line connecting the distal fibular notches on CT scans was used. The values were analyzed, and the intra and inter observer agreements for tibia torsions were assessed. Results: The inter-observer agreement in tibial torsion was .861 and .863 in the first and second methods respectively. The intra-observer reliability in both measurements techniques were .868. The two techniques also had excellent agreement in tibial torsion measurements. Conclusion: The second technique has high reliability and reproductivity in assessing tibial rotation in fibula deformity.
Firooz Madadi, MD; Mohammad Ali Okhovatpour, MD; Amir Mehrvarz Serkesheh, MD; Firoozeh Madadi; Majid Borairi, MD
Abstract
Background: The posterior of acetabular cup in total hip replacement can be affected by the central osteophytes in the acetabular fovea. We are proposing a classification of such osteophytes based on direct observation and CT scan of osteoarthritis hips.Methods: This study was composed of two sections: ...
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Background: The posterior of acetabular cup in total hip replacement can be affected by the central osteophytes in the acetabular fovea. We are proposing a classification of such osteophytes based on direct observation and CT scan of osteoarthritis hips.Methods: This study was composed of two sections: first, 276 cases with all clinical and radiographic evidence of osteoarthritis of hip–with no history of fracture or pelvic bony surgery – were studied by radiographs and CT Scans. The changes in the acetabular osteophytes were evaluated and categorized. Secondly, 57 cases of hip osteoarthirites who were undergoing hip arthroplasty received direct observation of the acetabular osteophytes and categorization of the acetabular fovea in accordance with the above classification system. The relation of primary etiology of hip osteoarthritis with the osteophyte classification was also studied.Results: According to radiographs, CT Scans and direct visualization, four types of acetabular osteophytes were identified. Type I: Normal acetabular with 5mm distance from rim to the floor type IIa: Evidence of sclerosis around fovea type IIb: Sclerosis forming a ceiling, like an umbrella over the fovea type IIc: The foveal osteophytes are almost touching in the center type III: Osteophytes have fully covered the fovea, making the acetubular look very shallow.Conclusion: Study and categorization of acetabular osteophytes with radiographs and CT scan would be a helpful pre-operative tool for more accurate reaming of the acetabular cavity and cup positioning in hip osteoarthrties.
Firooz Madadi, MD; Mohammad Reza Abbassian, MD; Fooad Rahimi, MD; Farivar Abdollahzadeh Lahiji, MD; Armin Aalami Harandi, MD; Farzam Farahmand; Tahereh Yazdanyar; Firozeh Madadi; Reza Sadeghian
Abstract
Background: Several different methods for fixation of grafts in anterior cruciate ligament (ACL) reconstruction have been used. The purpose of present study is to compare two techniques of tibial fixation in hamstring quadruple graft reconstruction. Methods: In a randomized clinical trial study, 46 ...
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Background: Several different methods for fixation of grafts in anterior cruciate ligament (ACL) reconstruction have been used. The purpose of present study is to compare two techniques of tibial fixation in hamstring quadruple graft reconstruction. Methods: In a randomized clinical trial study, 46 cases of isolated tears were reconstructed using hamstring grafts. In 24 cases the tibial fixation sites were fixed with interference screw, and in 22 patients the remnant end of graft at tibia was passed through a bony tunnel and fixed with suture to the bone. The cases were all assessed with a mean follow-up of one year with “Cincinnati knee ligament rating scale” and “KT-2000” examination.Results: The score in 22 “target group” cases was 8, and in 24 “control group” was 9. In “KT-2000” examination, 11 patients of double fixation were excellent and 11 good. In control group 4 cases had excellent and 20 good results (p < /em>=0.01).Conclusions: Double tibial fixation for ACL reconstruction with Hamstring tendon graft has a better outcome on “Symptom” evaluation and “KT-2000” instrument compared to single tibial-site fixation.
