Armin Nikzad, BSc; Farid Abbaszade, MSc; Zahra Saghaei, MSc; Soheil Mehdipoor, MD; Firooz Madadi, MD; Morad Karimpoor, PhD
Abstract
Background: Total knee arthroplasty is an accepted method for treatment of osteoarthritis of the knee. Measuring the distal femoral rotation is one of the most important problems in such operations. In the conventional 2D method, measuring the angle is based on CT scan images but these methods usually ...
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Background: Total knee arthroplasty is an accepted method for treatment of osteoarthritis of the knee. Measuring the distal femoral rotation is one of the most important problems in such operations. In the conventional 2D method, measuring the angle is based on CT scan images but these methods usually contain errors. In this study, the three-dimensional measurement of the aforementioned angle was investigated.
Methods: In this research, using CT scans and 3D modeling, 3D lower extremity models of 40 patients were extracted. The rotation of distal femur was measured for plane perpendicular to the anatomical and the plane of mechanical axis of femur. Four axes were drawn on these planes using anatomical landmarks: posterior condylar line (PCL), anatomical and surgical transepicondylar line (ATEA+STEA), and the Whiteside line (WL).
Results: The mean difference of these measurements on the plane perpendicular to the mechanical axis of the femur, between PCL and WL, STEA, ATEA was 3.41, -1.31, 5.53; and angles on the plane perpendicular to the anatomical axis of femur were -0.74, -1.26, and 5.67, respectively. In addition, Bland-Altman diagram was plotted between every two measurements and no relationship found, except for STEA and ATEA.
Conclusions: The measurements between PCL, ATE, and STEA are not affected by the plane on which these measurements are carried out on, except for the 4 degrees difference present in WL axis. With a greater sample size and proper grouping, some relationship might be found between the aforementioned axes.
Firooz Madadi; Mahdi Bahari Mehrabani; Mohammad Ali Jalili; Farshad Safdari, MSc
Abstract
Background: The knowledge about acetabular version and angle changes in different conditions is important. The normal acetabular version may be different in various populations. We would like to report measurement of this value in a small sample of Iranains with non-orthopaedic conditions. Methods: One ...
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Background: The knowledge about acetabular version and angle changes in different conditions is important. The normal acetabular version may be different in various populations. We would like to report measurement of this value in a small sample of Iranains with non-orthopaedic conditions. Methods: One coronal pelvic CT film of 81 patients (54 male, 27 female) who had undergone CT scanning for non-orthopaedic reasons was examined in a retrospective cross-sectional study. The acetabular versions were measured and compared for different genders and different age decades. The patients were aged 41.5±14.1 years. Results: The acetabular version was 17.7±3.4 degrees (range: 8 to 32 degrees). There was no significant relationship between acetabular version and age or gender in this sample. Conclusions: The acetabular version in this Iranian group ranged from 17.4 to 19.4 degrees with 95% confidential intervals.
Keyghobad Ashouri; Ali Akbar Esmailijah; Farivar A Lahiji; Ali Akbar Esmailijah; Seyed Mehdi Hoseini Khameneh; Firooz Madadi; Farivar Bagheri; Mehdi Rahimi; Reza Zandi; Farshad Safdari
Abstract
Background: The prevalence of palmaris longus agenesis (PLA) has been variously reported to be from 1.5% to 64% in different ethnic groups. Finding the state of PLA among Iranian people was the aim of this study. Methods: 1008 participants were included in this descriptive study during a 6-month period ...
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Background: The prevalence of palmaris longus agenesis (PLA) has been variously reported to be from 1.5% to 64% in different ethnic groups. Finding the state of PLA among Iranian people was the aim of this study. Methods: 1008 participants were included in this descriptive study during a 6-month period in a teaching hospital in Tehran-Iran. The Schaeffer test was used to detect the presence or absence of palmaris longus. The role of gender and handedness was also assessed in PLA. Results: The prevalence of PLA was estimated at 22.8% - 10.2% agenesis on the right side, 5.9% on left side and 6.7% on both sides. The relationship between PLA and gender didn’t appear to be significant. Right handedness was seen in 90.9% of cases with PLA and 72.5% of those without PLA (p=.000, OR=3.8). Conclusion: The prevalence of PLA in Iranian people studied, were comparable to the average Caucasian values in the literature.
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.
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.
Firooz Madadi, MD; Jaafar Tavakolian, MD; Arash Maleki, MD; Mehdi Rahimi, MD; Reza Zandi, MD; Mohammad Reza Bigdeli, MD
Abstract
Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior ...
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Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior cruciate ligament reconstruction.Methods: In a clinical trial study, 120 patients that were candidates for ACL reconstraution were randomly divided into 3 groups of 40 individuals. The femoral fixations were by the three methods of "Aperfix", "Rigidfix" or "Endobutton". The cases were re-examined 12 months after surgery and evaluated by Lysholm score as well as with KT-1000 machine. The results were compered together for the three above methods.Results: The Lysholm score showed improvement from pre-operative values in all three techniques: From 63.21±18.59 to 90.64±9.47 in "Endobutton" group, from 65.72±18.74 to 96.22±5.35 in "Aperfix" and from 69.21±17.45 to 90.64±9.47 in the "Rigifix" group. There were 6 failures in "Endobutton", 4 in "Rigidfix" and one in "Aperfix" group. The anterior displacement tibia was 3.96±1.58 millimeters in "Endobutton", 4.28±1.48 in "Rigidfix", and 4.03±1.79 millimeters in "Aperfix" group. There was no significant difference in the operating time in the 3 groups.Conclusion: Regarding the instant stability of the graft, the "Aperfix" method seemed stranger. Further investigations with larger number of cases and longer duration of follow up are recommended.
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 Abbasian, MD; Farivar Abdollahzadeh Lahiji, MD; Reza Zandi, MD
Abstract
Congenital Knee fusion - whether as an isolated lesion or in association with other anomalies – is a relatively rare condition. This is a report of such a case without growth plate around the fused knee, who underwent leg equalization procedure.
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Congenital Knee fusion - whether as an isolated lesion or in association with other anomalies – is a relatively rare condition. This is a report of such a case without growth plate around the fused knee, who underwent leg equalization procedure.
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.
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.
