Mehran Soleymanha; Sohrab Keyhani; Maryam Mousavi; Zahra Mehrpouya
Abstract
Background: The anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgeries on the adult knee. Auto grafts are essential for providing knee stability while minimizing donor site morbidity. The peroneus longus tendon may be an alternative auto graft for ACL reconstruction. This ...
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Background: The anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgeries on the adult knee. Auto grafts are essential for providing knee stability while minimizing donor site morbidity. The peroneus longus tendon may be an alternative auto graft for ACL reconstruction. This study aimed to evaluate the short-term clinical outcomes and donor site morbidity of ACL reconstruction using the peroneus longus tendon.Methods: This cross-sectional study was conducted on patients with an ACL tear, who underwent arthroscopic reconstruction using the peroneal longus tendon. The knee functional outcomes were investigated based on the Lysholm and IKDC scores at preoperative and end of at least one year after the procedure. The follow-up period was at least one year, and the graft diameter was measured intra-operatively. In addition, the American Orthopaedic Foot and Ankle Score (AOFAS), the Foot & Ankle Disability Index (FADI), and ankle range of motion were applied to evaluate ankle donor site morbidities.Results: A total of 50 patients (47 men and three women) were followed up for at least one year with a mean age of 24.2 years (17 to 50 years old). The mean follow-up time was 19 months (12-24 months). The mean diameter of the peroneal longus auto graft was 8.22 ± 0.5 mm (7-9 mm). The AOFAS, FADI and ankle range of motion indicated no obvious ankle joint dysfunction.Conclusion: According to the results, arthroscopic anterior cruciate ligament reconstruction with the peroneal longus tendon is be a safe and effective auto graft source.
Knee
Mehran Soleymanha; Sohrab Keyhani; Kamran Asadi; Amin Moradi
Abstract
Background: The tourniquet commonly uses in knee replacement surgery, but there is no consensus on the release time of the tourniquet. The aim of this study was the evaluation of tourniquet release time, on postoperative hemoglobin level in knee arthroplasty patients. Material and Methods: During one ...
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Background: The tourniquet commonly uses in knee replacement surgery, but there is no consensus on the release time of the tourniquet. The aim of this study was the evaluation of tourniquet release time, on postoperative hemoglobin level in knee arthroplasty patients. Material and Methods: During one year, patients undergoing complete knee arthroplasty were randomly divided into two groups according to the inclusion criteria, the early release tourniquet group (opening tourniquet after cementation) and the late release tourniquet group (opening tourniquet after wound dressing). Hemoglobin levels were measured and compared at preoperative, 24 hours and one week after surgery. Also, Duration of surgery, blood transfusion requirements and early wound complications were evaluated in two groups.Results: The mean duration of surgery was 82 ± 11.2 minutes in the early release group and 73 ± 14 minutes in the late release group (P <0.001). Decrease of hemoglobin level at 24 hours and one week after surgery was 1.8±0.82 and 1.1±0.71 respectively in the first group, and 1.4 ±0.94 and 0.6 ±0.82 in the second group. In this study, the requirements for blood transfusion was more in the early release of the tourniquet group (4 cases in the first group and 2 cases in the second group), but this difference was not significant.Conclusion: Late tourniquet release after wound dressing can reduce surgery time and reduction of hemoglobin level in total knee arthroplasty.
Sohrab Keihani, MD; Ali Akbar Esmaieliejah, MD; Mohammad Reza Abbassian, MD; Seyyed Morteza Kazemi, MD; Ali Akbar Esmaieliejah, MD; Hamid Reza Seyed Hosseinzadeh, MD; Amer Sadeghi, MD
Abstract
Background: Medial opening-wedge valgus high tibial osteotomy has gained popularity. However, the reported complication rate is high. The technique has been modified to remedy the problems of patellar descent and alteration in angle of the inclination of the tibial plateau and delayed :::union:::. Our ...
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Background: Medial opening-wedge valgus high tibial osteotomy has gained popularity. However, the reported complication rate is high. The technique has been modified to remedy the problems of patellar descent and alteration in angle of the inclination of the tibial plateau and delayed :::union:::. Our aim is to compare the modified retrotubercle opening-wedge osteotomy with the conventional technique.Methods: In a clinical trial study, 72 consecutive patients with varus knees who were candidates for high tibial valgus osteotomy were, randomly treated with either conventional medial opening-wedge upper tibial osteotomies (34 patients) or retrotubercle opening-wedge osteotomies (38 patients) from Feb 2006 to Feb 2008. These matched cases were evaluated for patellar height and upper tibial slope as well as tibial inclination measurements. The intra and inter-observer reliability of the radiographic measures were also assessed before surgery and in a mean follow up of 13 months (10-21 months).Results: In retrotubercle open-wedge osteotomies no surgical change in patellar length or any patellar infra was seen. The tibial plateau inclination also showed no significant change from the pre-operative values. On the other hand, the conventional medial open-wedge technique showed significant reduction in patellar height as well as increase in tibial plateau inclination as compared to pre-operative values.Conclusion: In high tibial valgus osteotomies for genu varum retrotubercle medial open-wedge osteotomy negates the ill-effect of conventional open-wedge osteotomy in producing patella infra or increased tibial plateau slope or change in Q-angle of quadriceps mechanism.
Sohrab Keyhani, MD; Ali Akbar Esmaieliejah, MD; Mehran Soleimanha, MD; Ali Akbar Esmaieliejah, MD; Seyed Morteza Kazemi, MD; Mohammad Reza Abbassian, MD; Reza Rokni, MD
Abstract
Background: The purpose of this study was to evaluate the short-term outcomes after one-stage arthroscopic reconstruction in chronic multiligamentous knee injuries.Methods: In a prospective study, 15 men with chronic multiligamentous knee injuries underwent one-stage reconstruction with autogenous semitendinosus ...
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Background: The purpose of this study was to evaluate the short-term outcomes after one-stage arthroscopic reconstruction in chronic multiligamentous knee injuries.Methods: In a prospective study, 15 men with chronic multiligamentous knee injuries underwent one-stage reconstruction with autogenous semitendinosus and gracilis grafts for anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Any associated other ligamentous injuries were repaired by Achilles tendon allografts. The results were assessed by IKDC, and Lysholm score and ligament integrity by MRI with a mean follow-up of 9 (4-19) months. Clinical examination, regular radiography and a subjective questionnaire completed the evaluation procedures. Results: With a mean age of 23 (18-35) years, the final IKDC score was normal (grade A) in 1, nearly normal (grade B) in 10, abnormal (grade C) in 3 and grossly abnormal (grade D) in 1 patient. The mean subjective IKDC score was 83±14. The preoperative Lysholm score of 62±13 become 94±5 in follow-up.Conclusions: Multiple ligament injuries of knee can be successfully treated arthroscopically with autologous hamstring tendon graft, and if necessary, additional of Achilles tendon allograft.
