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.
Mahzad Javid, MD; Gholamhossain Shahcheraghi, MD, FRCS (C); Farivar A Lahiji, MD; Aziz Ahmadi, MD; Afshin Farhadi, MD; Gholam Ali Akasheh, MD
Abstract
Background: To find the patterns and common mechanisms of motor-vehicle related pediatric trauma in a metropolitan city (Tehran-Iran), to guide the health planners of the city in proper planning and resource application and distribution.Methods: A pilot study was started in three major pediatric-trauma ...
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Background: To find the patterns and common mechanisms of motor-vehicle related pediatric trauma in a metropolitan city (Tehran-Iran), to guide the health planners of the city in proper planning and resource application and distribution.Methods: A pilot study was started in three major pediatric-trauma referral centers in Tehran by the Iranian Orthopaedic Association. All the cases below age 14 who visited the emergency department of those three hospitals, with body trauma resulting from a vehicle-related accident were studied. Cases were collected on a 24-hours basis in one month of each four seasons of the last year. The data collection was done by contracted physicians with the use of a detailed questionnaire.Results: From a total of 318 children that visited the emergency departments because of motor–vehicle related accident, 287 patients had trauma to various parts of the body (215 male 72 females), 151 cases had only musculoskeletal trauma and 31 others had sustained no significant injury of any kind. Multiple trauma was seen in 33.6% of the cases.52.8% of accidents happened in spring & summer, 21/7% in autumn, and 25/5% in winter season. The place of accidents were usually on the streets (70%), followed by small allies (17/5%), then major roads (12/5%). 65% of the accidents had happened at night and 35% during the day. The injuries were from motorcycles hitting pedestrians in 33.7% and, car–pedestrian accidents in 31.9%. The musculoskeletal injuries included fracture of tibia and fibula (62 cases), femoral fracture (25 cases), forearm (18 cases) and humerus (11 cases) in order of frequency. 24% of patients were transferred by ambulance and the rest by their family members or by- standing people. Conclusions: Children become disabled far too frequently in the city, from lack of proper training, proper enforcement of traffic rules by the children and the drivers. An appropriate measure of safety in the crowded metropolitan city of Tehran is essential, and this report can be a guide for the other major cities of the third world.