MJ Emami; Amirreza Vosoughi; Ali Hakimi nejad
Abstract
Background: Mitchell osteotomy is one of first metatarsal distal corrective osteotomies for hallux valgus deformity. The purpose of this study was to evaluate the outcome of Mitchellosteotomy.
Methods: Eighteen patients underwent Mitchell corrective osteotomy using screw fixation for hallux valgus ...
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Background: Mitchell osteotomy is one of first metatarsal distal corrective osteotomies for hallux valgus deformity. The purpose of this study was to evaluate the outcome of Mitchellosteotomy.
Methods: Eighteen patients underwent Mitchell corrective osteotomy using screw fixation for hallux valgus deformities from 2011 to 2015 were included. Clinical outcome was assessed using American Orthopedic Foot and Ankle Score, Hallux metatarsophalangeal-interphalangeal scale, (AOFAS Hallux), visual analogue score, and changes in hallux valgus and intermetatarsal angles based on standard weight-bearing radiographs, at least one year after surgery.
Results: About 95 % of patients were completely satisfied. Mean of AOFAS score was 86.7 at final follow-up. The mean of changes in intermetatarsal and hallux valgus angles were 5.6 ± 3.1 and 17.0 ± 5.2 respectively. Pain of the cases based on visual analogue score decreased from 5.8 ± 0.8 preoperatively to 1.3 ± 1.2 postoperatively. There were no deep infections, non::union:: or osteonecrosis of first metatarsal head.
Conclusion: Mitchell corrective osteotomy with screw fixation could bea simple and effective procedure to correct hallux valgus deformity with high levels of patient satisfaction.
Niloofar Namazi, MD; Fereydoon Mojtahed Jaberi, MD; Sara Pakbaz, MD; Amir-Reza Vosooghi, MD; Mehrad Mojtahed Jaberi, MD
Abstract
Background: Destruction of pain receptors around patella by electrocauterization is commonly used during total knee arthroplasty. Its effect on cartilage was the goal of this survey.Methods: In a clinical trail study, 20 rabbits, divided into two equality sized groups (experimental-control) and experimental ...
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Background: Destruction of pain receptors around patella by electrocauterization is commonly used during total knee arthroplasty. Its effect on cartilage was the goal of this survey.Methods: In a clinical trail study, 20 rabbits, divided into two equality sized groups (experimental-control) and experimental group underwent surgery via medial parapatellar arthrotomy of the knee joint. Electrocauterization denervation at a depth of 1 mm and a distance of 3 mm from border of patella performed in the cases animals. No patellar denervation was done in the control group. Range of motion of joint, macroscopic evaluation using modified outerbridge score, and histopathologic scoring were assessed after twelve weeks. Results: Finally, nine cases and eight control animals were included due to death of three animals. Full range of motion was seen in all rabbits. Statistically significant difference in outerbridge score (p < /em>=.002), cellularity (p < /em>=.016), loss of matrix (p < /em>=.004), and clustering of chondrocytes (p < /em>=.008) were obtained.Conclusions: Cartilage destruction may be the result of electrocauterization of patellar rim. So, routine electrocauterization should be discouraged.
Mohammad Jafar Emami; Fereidoon Mojtahed Jaberi; Negar Azarpira; Amir Reza Vosoughi; Nader Tanideh, DVM, MPH, PhD
Abstract
Background: Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopaedics. This study investigated the effect of bevacizumab on intra-articular fibrosis in a rabbit animal model.Methods: Arthrofibrosis was induced in right stifle joint of thirty ...
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Background: Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopaedics. This study investigated the effect of bevacizumab on intra-articular fibrosis in a rabbit animal model.Methods: Arthrofibrosis was induced in right stifle joint of thirty male white rabbits by removing the cortical bone of femoral condyle in medial gutter under general anesthesia. The rabbits were randomly divided into three equal groups. The control group received intra-articular injection of saline the "one-injection" group received a single dose of bevacizumab (2.5 mg/kg), and the" two-injection" group received two intra-articular injections on the day of operation and 14 days later. Forty five days after the surgery, the animals were sacrificed. The severity of fibrosis was assessed by range of motion of the stifles, macroscopic adhesion score, and histopathologic variables.Results: Although no statistical difference was seen between the control group and the "one-injection" group in terms of range of motion and macroscopic evaluation, the histopathologic variables in prevention of arthrofibrosis, except for the granulation tissue, were significantly better in the "one-injection" group. The "two-injection" group in comparison to the "one-injection" group was better not only in range of motion evaluation (p < /em>=.001) and visual adhesion score (p < /em>=.012), but also in most of the histopathologic variables, except for the cell count and granulation tissue.Conclusions: Two injections of bevacizumab for prevention of arthrofibrosis resulted in better outcome than single injection.
Kamran Mozaffarian; Amir Reza Vosoughi; Arya Hedjazi; Mohammad Zarenezhad; Mehdi Khadem Nazmi
Abstract
Background: Traditional treatment of unstable fifth carpometacarpal joint injuries is closed reduction and pinning. The aim of this study was to determine the safest corridor for pinning of fifth carpometacarpal joint to prevent the iatrogenic injury to the ulnar nerve and tendons . Methods: In the ...
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Background: Traditional treatment of unstable fifth carpometacarpal joint injuries is closed reduction and pinning. The aim of this study was to determine the safest corridor for pinning of fifth carpometacarpal joint to prevent the iatrogenic injury to the ulnar nerve and tendons . Methods: In the first phase of study, three fresh cadaver samples were dissected and the safest directions of kirschner wire insertion in coronal and sagittal planes were determined to the base of the fifth metacarpal. The second phase evaluated the accuracy of data obtained in previous phase. Therefore k-wires were inserted in combination of maximum angles in different planes determined previously. After taking X-rays, the ulnar nerve branches and tendons were explored to detect any possible damage. In the third phase, four fresh carpometacarpal joints were fixed with directions outside the range of defined angl es. Results: The safe direction determined in the first phase was 20° to 30° coronal plane angle in regard to body of the fifth metacarpal bone and between 10° volar to dorsal to 20° dorsal to volar angle in sagittal plane. Insertion of k-wires in the second phase could fix the fifth carpometacarpal joint firmly. All inserted k-wires outside the defined range resulted in injuries to nerve or tendons or infirm fixation Conclusions: The safest corridor for pinning the unstable fifth carpometacarpal injuries is two centimeters distal to the joint with 20° to 30° in coronal plane and from 10° volar to dorsal to 20° dorsal to volar direction in sagittal plane.
Ahmad Ensafdaran, MD; Amir Reza Vosoughi, MD; Mohammad Reza Ensafdaran, MD; Hamid Reza Ensafdaran, MD; Amir Reza Vosoughi, MD
Abstract
Background: Meniscal injury is a major cause of functional impairment of the knee. Total meniscectomy was the treatment of choice for many years, but long-term results were not satisfactory. Nowadays, minimal partial meniscectomy performed arthroscopically, or meniscal repair when practically, have become ...
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Background: Meniscal injury is a major cause of functional impairment of the knee. Total meniscectomy was the treatment of choice for many years, but long-term results were not satisfactory. Nowadays, minimal partial meniscectomy performed arthroscopically, or meniscal repair when practically, have become the standard choice.Methods: One hundred and ten patients with stable knee and history of pain, giving way, and locking, which their MRI showed only medial meniscus tear, were selected for partial meniscectomy. Evaluation included a patient radiological evaluation by Fairbanks classification for operated and non-operated knee, physical examination and Lysholm score before and 6, 18, 36 months after operation.Results: Only 87 patients (78 men, 9 women) were available for follow-up. Mean age for men was 27.8 years (18-53 years) and for women 36.9 years (22-50 years). Meniscus tear was bucket handle in 54%, flap in 10.4%, radial in 8%, and complex in 27.6% of cases. Mean Lysholm score was 48.4 (range: 41-55) before operation which increased to 80.87 (range: 73-85), 90.6 (range: 78-95), and 90.87 (range: 68-95) 6, 18, and 36 months after operation, respectively (p < /em>
Ahmad Ensafdaran, MD; Amir Reza Vosoughi, MD; Mohammad Reza Ensafdaran, MD; Amir Reza Vosoughi, MD
Abstract
Background: Osteoarthritis is common especially in over 50 years of age patients. There are several non–surgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, ...
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Background: Osteoarthritis is common especially in over 50 years of age patients. There are several non–surgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, osteotomy of tibia and arthroscopic débridement. Careful selection of patients in particular, for arthroscopic débridement is a very important point.Methods: In a prospective study, 88 patients with mean age of 55.28 (55-63 years) with knee osteoarthritis who had failed non-surgical treatments were selected for arthroscopic débridement. Radiographic inclusion criteria were presence of 3-4 millimeters of joint space, less than 10 degrees flexion contracture and varus/valgus malalignment, and at least 100 degrees of flexion. The treatment results were assessed annually in 3 successive years, using Lysholm knee Scale. Seventy-four patients (43 females, 31 males) had complete follow-up and are reported here.Results: The pre operative Lysholm score of 37.2 (range: 26-55) increased to 81.9 (range: 70-90) in first year, to 82.9 (range: 70-95) by the second year and to 78.5 (60-90) in the third year (p < /em>
