mohammad fakor; mohammad sakiani; maryam hadad shoshtari; mohammad ghasem hanafi
Abstract
AbstractBackground: Postoperative Deep Vein Thrombosis (DVT), a subtype of Venous Thromboembolism (VTE), is a significant preventable cause of morbidity and mortality worldwide. VTE is estimated to occur at a rate of one per 1,000 people per year, with DVT accounting for approximately two-thirds of these ...
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AbstractBackground: Postoperative Deep Vein Thrombosis (DVT), a subtype of Venous Thromboembolism (VTE), is a significant preventable cause of morbidity and mortality worldwide. VTE is estimated to occur at a rate of one per 1,000 people per year, with DVT accounting for approximately two-thirds of these events. DVT continues to be a common complication of knee arthroscopy. The purpose of this study is to determine the prevalence of DVT in patients who have undergone arthroscopic knee surgery.Methods: Patients over the age of 18 years who underwent arthroscopic knee surgery in a teaching hospital were evaluated for VTE clinically and via lower limb Doppler ultrasonography prior to, three days after, and four weeks after surgery. The incidence of DVT was determined and associated with risk factors such as age, sex, duration of immobility, and duration of surgery. Afterward, statistical analysis was performed on the data.Results: The prevalence of DVT was 3.1% in 318 patients undergone knee arthroscopy with a mean age of 34.31 years. The mean duration of surgery was 96.30 minutes across all patients. In 96.9% of patients, there was no evidence of DVT. Additionally, there was no significant association between DVT prevalence and gender, age, surgery type, duration of surgery, or presence of edema in patients (p = 0.551). The patients' mean duration of absolute rest was 61.89 hours. Absolute rest time was significantly longer in patients with positive DVT than in patients with negative DVT (p = 0.001).Conclusion: While knee arthroscopy can be performed as an outpatient procedure, the risk of postoperative DVT is unknown. The incidence of DVT following arthroscopic knee surgery was 3.1% in this study, a necessary precondition for perioperative thromboprophylaxis.
Mohammad Fakour; SH Mousavi; S Hatami
Abstract
Abstract
Background: Total knee arthroplasty (TKA) is widely used as an effective treatment for end-stage osteoarthritis and other knee diseases to relieve pain and improve quality of life. While the benefits of TKA are reduced pain and an improved function there are also risks, such as hemorrhage, ...
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Abstract
Background: Total knee arthroplasty (TKA) is widely used as an effective treatment for end-stage osteoarthritis and other knee diseases to relieve pain and improve quality of life. While the benefits of TKA are reduced pain and an improved function there are also risks, such as hemorrhage, thromboembolic events, infection and the need for additional surgical procedures. Tranexamic acid (TXA) is effective in reduction of hemorrhage after such major surgical procedure. Abundant literature confirms that intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) reduces blood loss in total knee arthroplasty (TKA).
Methods and Material:The study is a retrospective cross-sectional study of 152 male and female patients aged 45 to 85 years who underwent Total knee replacement. They were divided into two groups.72 patients received tranexamic acid during the operation and 80 patients did not.
Hemoglobin, transfused packed cell, hospital time, Visual analogue pain scale, Knee range of motion and cardiovascular accident were determined and compared between the two groups.
Results: Comparing the result of hemoglobin drop, post op hemoglobin, transfused packed cell and hospital stay time showed significant difference between experimental and control group when pre op hemoglobin, range of motion, VAS score for pain measurement and cardiovascular effects were not significantly different.
Conclusions: We found that the administration of tranexamic acid can reduce the complications of knee replacement surgery due to bleeding, as well as decreasing the need for blood transfusion. In addition, the administration of tranexamic acid can reduce the length of hospital stay after knee replacement surgery; that in turn significantly reduces the cost of hospitalization.
Mohammad Fakoor; Hanoon Sadoni; Payam Mohammad Hosseini; Saeed Bastan
Abstract
AbstractIntroduction: This study aimed to find a statistical relationship between clinical and functional findings based on the Lysholm scoring scale in the success rate of surgery and patient satisfaction with the arthroscopic reconstruction of the anterior cruciate ligament (ACL).Method: This prospective ...
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AbstractIntroduction: This study aimed to find a statistical relationship between clinical and functional findings based on the Lysholm scoring scale in the success rate of surgery and patient satisfaction with the arthroscopic reconstruction of the anterior cruciate ligament (ACL).Method: This prospective and cross-sectional study was performed on 38 patients (42 knees) aged 17 to 45 years who underwent anterior cruciate ligament (ACL) reconstruction during 2018-2019 due to ACL rupture at Imam Khomeini Hospital in Ahvaz.6 and 12 months after surgery, clinical trials of "anterior drawer" and "Lachman test" were performed, and the standard Lysholm questionnaire for patients was completed. Then, the compatibility of the test results with the results of the Lysholm questionnaire and MRI was assessed.Results: In the diagnosis of ACL rupture, 6 months after surgery, the highest sensitivity was related to the anterior drawer and Lysholm scale tests, and the highest specificity was related to the Lachman test. Also, the highest positive predictive value was related to the Lachman test and the highest negative predictive value was related to the anterior drawer and Lysholm scale tests. 12 months after surgery, the highest sensitivity was related to the Lysholm scale and the highest specificity was related to the Lachman test. The highest positive predictive value was for the Lachman test and the highest negative predictive value was for the Lysholm scale. In the first 6 months, graft failure was observed in 13.6% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 28.95%. In the second 6 months, graft failure was observed in 7.14% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 19.05%.Conclusion: Since in some cases, such as excessive knee diameter due to obesity or swelling, the examination may be limited and citation of clinical test results may be erroneous, it is recommended that in addition to mechanical tests such as the Lachman test and the anterior drawer test, standard questionnaires such as Lysholm be used to more accurately assess the success of surgery and treatment, as well as to help identify more accurate lesions.
mohammad fakoor; s shahnam mousavi; Ali bahaari
Abstract
AbstractBackground: Medial open wedge high tibial osteotomy (MOWHTO) is effective for the treatment of medial compartment osteoarthritis of the knee. Several studies report that it produces patella baja and increases patellofemoral contact pressure in the patellofemoral joint. Pressure distribution due ...
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AbstractBackground: Medial open wedge high tibial osteotomy (MOWHTO) is effective for the treatment of medial compartment osteoarthritis of the knee. Several studies report that it produces patella baja and increases patellofemoral contact pressure in the patellofemoral joint. Pressure distribution due to underlying varus deformity has a major influence on the onset and development of osteoarthritis in the knee joint. This study is reporting on the effect of MOWHTO on patello-femoral joint.Methods: The present study was a retrospective case series study on the patients with symptomatic osteoarthritis of medial compartment of knee with varus deformity requiring correction, referring in a 2 year period to a teaching hospital. At the last follow-up, assessment of the patellar changes based on Insall and Blackburn indices, and mechanical axis deviation (MAD) measurements was done.Results: A total of 49 knees were recruited. 52.6% of patients were male. The mean age of patients was 26.55±5.876 years and the mean body mass index was 25.05±2.903 kg/m2. No knee needed revision surgery, no intra-articular fracture occured in any patient after surgery.The mean score of VAS[1] increased significantly after surgery (P <0.05). Patellar changes before and after surgery were not statistically significant based on radiographic indices. The mean pre-operative MAD of (−8.90° ± 3.07°) improved to (0.2° ± 2.780°) post-operative value.Conclusion: Based on the above results, proper correction in MAD was obtained and no significant change in patellofemoral joint biomechanics was seen.Keywords: Tibia, patellofemoral joint, Osteotomy, Biomechanics, mechanical axis
M Fakor; P Mohammad Hosseini; Arman Shahriayari; E Sabz alipour
Abstract
AbstractIntroduction: This study aimed to investigate the risk factors and the effectiveness of calcium and vitamin D intake in controlling the progression of osteoporosis.Methods: This was a retrospective medical records study of the patients with osteoporosis, assessed from 2014 to 2018 in the bone ...
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AbstractIntroduction: This study aimed to investigate the risk factors and the effectiveness of calcium and vitamin D intake in controlling the progression of osteoporosis.Methods: This was a retrospective medical records study of the patients with osteoporosis, assessed from 2014 to 2018 in the bone density measurement center of Imam Khomeini Hospital in Ahvaz. Patients with a T-score of less than -2.5 and patients with at least two repeat tests in their medical records were included. After collecting patient information, the correlation between osteoporosis and positive or negative history of underlying disease or family history was evaluated. The effectiveness of calcium and vitamin D in controlling the progression of osteoporosis in those patients was also assessed.Results: 16% of patients had a positive family history and 51% of patients had an underlying disease that was not significantly associated with osteoporosis. Decreased bone density in the spine area and femoral neck was significantly lower in people without basal calcium deficiency disease (P = 0.04). Changes in bone density between patients with and without underlying disease receiving calcium-D supplementation were significantly different (P = 0.02) so that in people with underlying disease, the decrease in bone density was significantly higher. There was no significant difference in changes in bone density in the spine and femoral neck between patients with and without the underlying disease who had not received calcium-D supplementation (P = 0.64).Conclusion: Based on the results of the present study, there was no significant correlation between low densitometry measurements and osteoporosis in those with underlying problems like old age, nutritional factors, lifestyle and inactivity, smoking, menopause in women and low testosterone levels in men. It is important to pay attention to other risk factors in this population of patients. Calcium-D supplementation had shown a meaningful efficacy in patients without underlying disease, but this efficacy was not observed in patients with underlying disease.
Mohammad Fakor; S Shahnam Mousavi; Payam Mohammad Hosseini; Mohsen Saeidi Garaghani
Abstract
Background: Anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. Considering the high rate of ACL ruptures, especially in athletes, reconstruction of this ligament is of paramount importance. The present study aimed to compare the level of function improvement ...
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Background: Anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. Considering the high rate of ACL ruptures, especially in athletes, reconstruction of this ligament is of paramount importance. The present study aimed to compare the level of function improvement and satisfaction of patients with ACL reconstruction by two-stranded and four-stranded hamstring autografts (HAs) with the diameter above six millimeters.
Methods: In total, 60 patients with ACL ruptures, who referred to healthcare centers in a four-year period (2013-2017) and underwent arthroscopic ACL reconstruction via two-stranded and four-stranded HAs, were called to the clinic to assess their satisfaction with the surgery, time to return to unrestricted sports and work activities, the number of postoperative physiotherapy sessions, postoperative complications, range of motion of the injured knee after the surgery, and Lysholm score. Moreover, data analysis was performed using independent sample t-test.
Results: In this study, both groups were homogenous in terms of the evaluated parameters. In addition, the four-stranded and two-stranded HA groups had excellent and good grades, respectively, and their mean Lysholm scores were 91.05 and 88.98, respectively. While significantly different lysholm scores were obtained by the groups, no significant difference was observed between the research groups with regard to a slight numerical difference between the two means (P=0.585).
Conclusion: According to the results of the study, no significant difference was observed in the functional and clinical outcomes of the participants, thereby confirming the equal effectiveness of the two-stranded and four-stranded HAs in arthroscopic ACL reconstruction. It seems that both surgery methods, provided that the graft diameter is equal to or above six millimeters, will have a similar success rate with close acceptable results.
S Shahnam Mousavi; S Saeid Tabatabaei; Mohammad Fakor; Hanoon Sadooni; Majid Menati
Abstract
Abstract
Background: Hip fracture in the elderly is associated with a high mortality rate, imposing considerable burden to healthcare system. This study aimed to evaluate the functional score of Harris Hip Score (HHS) in elderly patients with intertrochanteric fracture treated by bipolar hemiarthroplasty.
Methods: ...
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Abstract
Background: Hip fracture in the elderly is associated with a high mortality rate, imposing considerable burden to healthcare system. This study aimed to evaluate the functional score of Harris Hip Score (HHS) in elderly patients with intertrochanteric fracture treated by bipolar hemiarthroplasty.
Methods: This study was conducted on 40 patients (mean age of 78.21 years) with unstable intertrochanteric fracture after surgery using cemented bipolar hemiarthroplasty. The cases were assessed in terms of radiographic and clinical evaluation. Harris Hip Score (HHS) questionnaire was filled for all the patients.
Results: Four patients had incomplete follow-ups and 5 patients had deceased. The HHS score was excellent for 6, good for 14, fair for 7, and poor for 4 patients. The mean HHS was 85.12 (good).
Conclusion: Performing surgery with cemented bipolar hemiarthroplasty in older patients with unstable intertrochanteric fracture would lead to acceptable clinical and functional results with earlier ambulation, and HHS score of 85.12 .
