Sohrab Keyhani, MD; Seyyed Reza Sharifzadeh, MD; Mohammad Reza Abbasian, MD; Touraj Shafaghi, MD; Soheil Mehdipour, MD; Farshad Safdari, MSc
Abstract
Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before ...
Read More
Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before and after clinical trial, 56 patients with grade 4 full thickness chondral lesion (outer bridge classification) were treated by the arthroscopic mosaicplasty technique over a 4-year period at an hospital in Tehran, Iran. The mean time of follow-up was 21±4 months (16-32 months). The patients were assessed by International Knee Documentation Committee (IKDC) and Lyshom knee scoring scale (LKSS). The impact of age, site of chondral lesion (medial or lateral femoral condyle), extent of the lesion (number of plugs) and associated lesions, preoperative active levels, tourniquet time and surgery complications were studied. In 3 cases, second-look arthroscopy was performed.Results: The result of 78.6% was excellent and 21.4 good, based on IKDC. Preoperative Lysholm score was 67.1±17.6 and postoperative score increased to 93.2±6.5 (p < /em>=.0004). Clinical outcomes were better significantly in patients with associated articular lesions, lateral condyles lesions, professional athletes and younger patients, also in cases with lower plug numbers and sport injuries (p < /em>
Mahmood Karimi Mobarakeh, MD; Hooman Mohammadzadeh Eiedgahi, MD; Habibeh Ahmadipour, MD
Abstract
Background: Anterior cruciate ligament (ACL) is one of the major stabilizing ligaments of the knee. ACL reconstruction usually has high success rate. The choice of graft in ACL reconstruction has been a source of controversy. This study compares the outcome of two commonly used grafts.
Methods: Seventy ...
Read More
Background: Anterior cruciate ligament (ACL) is one of the major stabilizing ligaments of the knee. ACL reconstruction usually has high success rate. The choice of graft in ACL reconstruction has been a source of controversy. This study compares the outcome of two commonly used grafts.
Methods: Seventy patients with ACL tear among the cases referring to training hospitals of Kerman, Iran from 2013 to 2015 were studied. The patients underwent reconstruction, using, randomly, either the "four-fiber semitendinosus autograft" or tibias abterior allograft". The Lysholm, IKDC, KOOS and SF36 scores were evaluated for comparing clinical stability examination, laxity, subjective satisfaction, and return to work before and after surgery.
Results: The two groups were the same in term of age, range of motion, knee flexion, IKDC, KOOS, Lysholm scores as well as SF36. The ligament laxity did not show a significant difference either. The operative time was significantly different between two groups (p < /em><.001).
Conclusions: ACL reconstruction with tibias anterior allograft has similar clinical, functional and stability results as semitendinosous autograft in a short time follow-up; although the operation time was shorter in allograft group.
Aziz Ahmadi
Abstract
Knee osteoarthritis is one of the most important causes of disability in elderly. Increasing age is associated with increased knee osteoarthritis. The average population age is increasing. In the next 30 years, Iran will enter the club of countries with the 30% of the population aged over 65. The cost ...
Read More
Knee osteoarthritis is one of the most important causes of disability in elderly. Increasing age is associated with increased knee osteoarthritis. The average population age is increasing. In the next 30 years, Iran will enter the club of countries with the 30% of the population aged over 65. The cost of osteoarthritis treatment accounts for a significant amount of each country’s GDP. Knee osteoarthritis is caused by an imbalance between the destruction and repair of articular cartilage under the influence of several risk factors such as trauma, excessive use, and genetic predisposition. Overweight and joint disorders apply an increased load to the specific points of the knee. This overload creates a tissue response, which provides the conditions for the occurrence of osteoarthritis. No cure has been found for knee osteoarthritis so far. Although joint replacement (knee arthroplasty) at this point is the best solution, its survival and durability is not permanent. Some patients are not suitable for surgery; some are reluctant to have surgery, and finally, the cost of surgery is high. Treating knee osteoarthritis without joint replacement is another method to deal with this problem. Through extensive studies and review of medical literature, The American Academy of Orthopaedic Surgeons has prepared the Guideline for Non-Arthroplasty Treatment of Knee Osteoarthritis. This Guideline brings the promise of quality of life equal to the surgical approach. The Academy recommends its use to all orthopaedic surgeons and also calls for an assessment of the outcome studies. Nonarthroplasty treatment of knee osteoarthritis is a simple and inexpensive treatment method. The majority of patients will benefit from this treatment. We all need to set up centers to treat patients according to the academy Guideline with special interest on recording outcomes.
Seyed Amir Mahlisha Kazemi Sheshvan; Mohammad-Reza Shakeri; Behnam Panjavi; Mehrzad Mahdizadeh; Houman Alizadeh; Mohammad-Reza Shakeri; Bahador Aalami Harandi
Abstract
Background: Developmental dysplasia of the hip (DDH) is a common problem and inappropriate treatment may result in serious complications. Several techniques have been used to monitor the status of the hip after reduction. Each has its own problem so that ultrasound found a special place where the assessment ...
Read More
Background: Developmental dysplasia of the hip (DDH) is a common problem and inappropriate treatment may result in serious complications. Several techniques have been used to monitor the status of the hip after reduction. Each has its own problem so that ultrasound found a special place where the assessment is needed. The aim of this study was to determine the diagnostic value of transinguinal and transgluteal ultrasound in comparison to CT scan in the evaluation of femoral head position in acetabulum in DDH treatment in spica cast. Methods : A cross-sectional study was performed on 37 affected hips in 24 infants at the age of 9 to 36 months during one year in a teaching hospital in Tehran, Iran. After close or open reduction and applying spica cast, an opening was made over the anterior edge of the inguinal region and transinguinal and transgluteal ultrasound was performed to confirm the quality of reduction in the acetabulum. The sensitivity, specificity, positive and negative predictive values of the postoperative ultrasonography was compared with CT scan. Data analysis was done by statistical tests. Results: The rate of agreement between ultrasonography and CT scan results was 91% (p < /i>
Mahmood Bahari, MD; Hasan Rahimi, MD; Mohammad Gharedaghi, MD; Alireza Hootkani, MD
Abstract
Background: Distal radius is the most common site of fracture in older postmenopausal women, with a lifetime risk of 15%. Evidence exists for its association with osteoporosis. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine with dual energy X-ray absorptiometry. ...
Read More
Background: Distal radius is the most common site of fracture in older postmenopausal women, with a lifetime risk of 15%. Evidence exists for its association with osteoporosis. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine with dual energy X-ray absorptiometry. Low BMD of the lumbar spine or hip is a strong predictor for future vertebral deformity and hip fracture. Elderly women with distal radial fracture are not investigated for osteoporosis on a routine basis. The aim of the present study is to evaluate the relationship between distal radius fracture and the BMD of the lumbar spine, and to investigate the need for osteoporosis screening in elderly women with a distal radius fracture.Methods: A prospective study was performed in a hospital in Mashhad in 2004-2005. In 104 women (mean age, 66.9 years) with a distal radius fracture, BMD of the lumbar spine was assessed. A biosphosphonate was prescribed when osteoporosis was diagnosed, and the BMD was reassessed after 2 years of treatment.Results: A low BMD was found in 87 patients (83.65%). Osteoporosis was diagnosed in 46 (44.23%) and osteopenia in 41(39.42%) patients. Only 17 cases (16.23%) had normal bone density. The mean T-score of the lumbar spine was –2.10 (±1.06). The BMD in patients treated with bisphosphonate medication increased from T-score of -2.88 to -2.55 in 2 years (p < /em>
amin razi; Mohammad-Taghi Peivandi; Ali Birjandinejad; Ali Parsa; Sara Amel Farzad; Maryam Hosseini Hasanabady
Abstract
Orthopaedics tissues, such as bone, cartilage, and tendon, involve cells that are difficult to culture and grow in vitro for reconstruction of damaged tissues. A small number of cells called stem cells have the ability to self-renew and differentiate into connective tissue lineages, involving bone, cartilage, ...
Read More
Orthopaedics tissues, such as bone, cartilage, and tendon, involve cells that are difficult to culture and grow in vitro for reconstruction of damaged tissues. A small number of cells called stem cells have the ability to self-renew and differentiate into connective tissue lineages, involving bone, cartilage, tendon and ligaments. Recent development in stem cell research has led to an exciting effort in applying stem cells for orthopaedics tissue regeneration. This review summarizes recent findings regarding the potential clinical use of Mesenchymal Stem Cells (MSCs) in Non:union:s, Osteogenesis imperfect, Human Cartilage defects, Osteoarthritis and Rheumatoid arthritis to provide a better understanding of the issue engineering with stem cell research, as well as the potential therapeutic purpose of these cells in orthopedic surgery.
Masoome Pourmokhtari
Abstract
The history of the new nailing method dates back to Gerhard Küntscher, who introduced this concept in Germany in 1940. He believed in two general principles: Stable fixation and fixation of fractures without opening the fracture site. In the beginning, primary nails with various weaknesses were ...
Read More
The history of the new nailing method dates back to Gerhard Küntscher, who introduced this concept in Germany in 1940. He believed in two general principles: Stable fixation and fixation of fractures without opening the fracture site. In the beginning, primary nails with various weaknesses were only used in fractures of femur. Over time, effective changes were made in the design and insertion of bone nails. This article aimed to review the evolution of the design of nails and simple but significantly important principles of inserting nails in long bones. In any case, lack of adherence to these simple principles by surgeons leads to lack of desirable fixation.
Behzad Aminzadeh; Motahare Ebrahimnezhad; Mohammad H Ebrahimzadeh; Hasan Mehrad Majd; Ali Moradi
Abstract
Background: This study aimed to evaluate the relationship between changes observed in an ultrasonography before and after the surgical release of carpal tunnel syndrome (CTS).Methods: This prospective study was performed on 15 candidates of CTS surgery during 2017-2018 who underwent an ultrasonography ...
Read More
Background: This study aimed to evaluate the relationship between changes observed in an ultrasonography before and after the surgical release of carpal tunnel syndrome (CTS).Methods: This prospective study was performed on 15 candidates of CTS surgery during 2017-2018 who underwent an ultrasonography before and three months after the surgery. The structural changes in the median nerve and their correlation with the carpal tunnel were analized.Results: According to ultrasonography results, the findings related to height, diameter and cross-sectional area of the median nerve decreased in the pisiform region of carpal tunnel while they increased in the area of hamate hook (P=0.002 in pisiform and P=0.001 in hamate hook), which might be due to the elimination of nerve dysfunction in the pisiform and effective decrease of pressure on nerve in hamate hook.Conclusion: In terms of evaluation of changes in the area of the median nerve, ultrasonography of the median nerve could be an effective and accurate technique to recognize the compression and follow up the nerve status in patients with CTS after surgery.
Hamid Reza Aslani, MD; Manoochehr Ghazaleh, MD; Zohreh Zafarani, MD
Abstract
Background: The superior labral lesion causes shoulder pain, disability and severe dysfunction. These lesions can see separated or with rotator cuff tear. The pain and recurrent instability require surgical repairing. The purpose of this study was to evaluate the results of arthroscopy surgery of superior ...
Read More
Background: The superior labral lesion causes shoulder pain, disability and severe dysfunction. These lesions can see separated or with rotator cuff tear. The pain and recurrent instability require surgical repairing. The purpose of this study was to evaluate the results of arthroscopy surgery of superior labral lesion of the shoulder.Methods: In a case series study, we evaluated 29 patients (23 men, 6 women, mean age=26 years, range: 19-36 years) at a mean 31 months (12 ـ 47 months) following arthroscopic surgery of superior labral lesion of the shoulder. The outcome of treatment was evaluated with the University of California-Los Angeles Shoulder Scale (UCLA). 13 patients were involved in athletic activities, 7 of which in “overhead” sports and one contact sport. 8 patients had type I, 17 type II, 3 type III, and 1 patient type IV of slap lesions. The treatment included debridment for type I, debridment and decortication of glenoid and anchor suture in type II, debridment and excision of labral tear in type 3 and, excision and anchor suture of labral tear in type IV.Results: Surgery of the superior labral lesion resulted in satisfactory UCLA score. 19 regained their preinjury level of shoulder function. The shoulder score and the return to activity were correlated with the type of sports activity. The patients participating in overhead sports had significantly lower shoulder scores and a lower percentage of return to their preinjury level of shoulder function compared with patients who were not engaged in overhead activity.Conclusion: arthroscopic surgery of superior labral is successful in the majority of patients but less satisfactory in those doing “overhead” sports. However, the result in patient who participates not involved in overhead sports.
Mohammad Ali Hosseinian, MD; Atusa Gharib, MD; Javad Sahebi, MD; Mohsen Khandaghi, MD
Abstract
Background: Sutures and glue are the commonly used techniques in peripheral nerve repair with controversies in the results of experimental researches studying either technique. This experimental study aimed at evaluation of the axonal regeneration after end-to-side nerve repair with glue and suture ...
Read More
Background: Sutures and glue are the commonly used techniques in peripheral nerve repair with controversies in the results of experimental researches studying either technique. This experimental study aimed at evaluation of the axonal regeneration after end-to-side nerve repair with glue and suture in rats.Methods: In an experimental study, 30 male Wistar rats were divided into three groups: group 1 (n=10) were submitted to fibular nerve transection with end-to-side nerve anastomosis using sutures alone group 2 (n=10) were submitted to fibular transection with end-to side nerve anastomosis using sutures and cyanacrylate glue in the lateral surface of an intact tibial nerve and group 3 (n=10), were submitted to surgery without repair (control group). At the end of the study (after 16 weeks) period, the three groups were evaluated by "walking track", and posterior morphometrical analysis.Results: At the end of the study, the mean weight of the groups had increased. The functional tests showed difference in the walking track analysis in groups 1 and 2, with important recovery in group 2 in walking pattern, while group 3 showed no function. Histological comparison showed no statistically significant difference between group 1 and 2, regarding the count of regenerated axons in the site of nerve repair. The number of regenerated axons, however, was more in group 2. The surgical time in group 3 was shorter than groups 1 and 2.Conclusion: End-to-side nerve repair using glue presented better results than suture following transection of fibular nerve in the rat experimental model.
Kushal Parikh; Mitesh Patel; Shalin Shah; Akarsh Patel
Abstract
Background: Despite years of study, there is no consensus on the best method for treatment of intraarticular calcaneum fracture. This study aims to compare the outcome of operative versus nonoperative modality of management in intraarticular displaced calcaneum fractures over one year.Method: This is ...
Read More
Background: Despite years of study, there is no consensus on the best method for treatment of intraarticular calcaneum fracture. This study aims to compare the outcome of operative versus nonoperative modality of management in intraarticular displaced calcaneum fractures over one year.Method: This is a prospective study carried out at a tertiary care hospital over a period of 2 years: 2017 to 2018 in Surat, Gujarat, India. In this period, out of 49 fractures 25, were treated non-operatively and 24 by operative method (11 Open Reduction Internal Fixation ORIF plating, 13 Minimally Invasive Surgery – (MIS). The outcome was recorded using American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographs up to 1-year post injury. The assessment was made using Analysis of Variance (ANOVA) method.Result: Operative method of management of intraarticular calcaneal fractures had a significantly better (95% confidence) functional outcome at 3 month compared to non-operative management. However, at 6 and 12 months follow ups the difference between them become insignificant. Non-operative management, however, had more complications as compared to operative management.Conclusion: Operative modality even in experienced hands has better outcome in terms of AOFAS score and radiographically compared to non-operative method in treatment of intraarticular displaced calcaneal fractures only in first few months. At 6 and 12 months follow up, the functional outcomes become similar.
Kamaran Mozafarian; Mohammad Javad Farahani
Abstract
Background: General information about the ulnar impaction syndrome is scarty and often neglected. The ulnar styloid process and ulnar variance have important roles in this syndrome. The statistical data related to these factors is not enough in Iranian literature.This study measured ulnar styloid length ...
Read More
Background: General information about the ulnar impaction syndrome is scarty and often neglected. The ulnar styloid process and ulnar variance have important roles in this syndrome. The statistical data related to these factors is not enough in Iranian literature.This study measured ulnar styloid length and ulnar variance in a group of healthy adults.Methods: In a prospective study, the ulnar styloid length and ulnar variance were measured on the posteroanterior view on 140 of wrist radiographs in a training hospital in Shiraz-Iran. The relative length of the ulnar styloid process and the ulnar impaction potential were assessed with the styloid-capitate ratio (SCR) and ulnar styloid process index (USPI), respectively. Clinical examination of the wrists for ulnar impaction was also done. Results: The mean ulnar styloid length was 5.38±1.45 mm. The average styloid-capitate ratio (SCR) was .24±.06 and the average of ulnar styloid process index (USPI) was .34±.11. 40.71% of the radiographic views in SCR, and 56.42% in USPI were more than average. The ulnar variance showed 19.3% neutral (23% male, 10% female), 12.1% positive (11% male, 15% female) and 68.6% negative (66% male, 75% female) measurements. Conclusion: It seems a long ulnar styloid process with SCR>.24±.06 or an overall styloid length greater than 6 mm is one of the most important cause of pain in ulnar sided wrist pain in our population.
Saeid Tabatabaei; Ahmad Dashtbozorg; Ahmad Dashtbozorg
Abstract
Background: In patients with late diagnosis of DDH after open reduction of the hip joint, we can use pelvic osteotomy or varus-derotational osteotomy (VDO) of the femur to make the open reduction more stable. The goal of the present study is to report on redirection of the femoral head towards acetabulum ...
Read More
Background: In patients with late diagnosis of DDH after open reduction of the hip joint, we can use pelvic osteotomy or varus-derotational osteotomy (VDO) of the femur to make the open reduction more stable. The goal of the present study is to report on redirection of the femoral head towards acetabulum by femoral osteotomy. Methods : In this prospective study we performed only VDO in 67 hips in 46 patients (36 females, 10 males) after open reduction of the hip in cases of 18 months to 10 years of age whom Salter innominate osteotomy was needed in a hospital in Ahvaz, Iran. The patients were followed up until complete weight bearing and plate removal. Results : Concentric reduction was achieved in 67 hips. Acetabular index showed 6 degrees of reduction after 26 months. No redislocation was seen after plate removal in 61 hips (91%) but pelvic osteotomy was done in 6 hips (9%) due to redislocation or residual displasia. Ninety percent of patients were classified as group 1 or 2 in "severin" classification. Conclusions : VDO is a simple operation with low complication rate. Although more than 90% success rate was observed in these patients, in order to see possible residual dysplasia in these patients longer follow-ups are needed.
Mohammad Taghi Peyvandi, MD; Hossein Shobiri, MD, MPH; Sara Amel Farzad, MD
Abstract
Background: The likelihood of transmission of hepatitis C virus through a single skin perforation is 2.7 to 10 percent. The serologic test of “Elisa” is about 99 percent sensitive in detecting hepatitis C virus (HCV) infection. The aim of this study is to evaluate the possibility of disease transmission ...
Read More
Background: The likelihood of transmission of hepatitis C virus through a single skin perforation is 2.7 to 10 percent. The serologic test of “Elisa” is about 99 percent sensitive in detecting hepatitis C virus (HCV) infection. The aim of this study is to evaluate the possibility of disease transmission to orthopaedic surgeons or orthopaedic assistants by serologic testing of orthopaedic trauma cases for HCV.Methods: In a one year period (2005-2006), 670 patients who had been admitted to the orthopaedic trauma center of a hospital in Meshhad were tested for HCV by serologic tests with “Elisa” technique.Results: From the 670 tested patients, 22 male and 3 female who had a mean age of 38.7 had positive serology for HCV. This would mean 3.9 percent male and 2.8 percent female prevalence.Conclusions: A worrisome number of patients with orthopaedic trauma are serologically positive for hepatitis C. Protective measures are, therefore, essential for all the people who handle orthopaedic trauma.
Hamidreza Aslani, MD; Hamed Vahedi, MD
Abstract
Background: Ipsilateral fractures of tibia and femur or’ “floating knee”, commonly occur as a result of high energy trauma. It is, therefore, associated with high chance of knee injuries. This articles looks at the prevalence of intra-articular knee injury in “floating knee” when the fractures ...
Read More
Background: Ipsilateral fractures of tibia and femur or’ “floating knee”, commonly occur as a result of high energy trauma. It is, therefore, associated with high chance of knee injuries. This articles looks at the prevalence of intra-articular knee injury in “floating knee” when the fractures are extra-articular, both in tibia and femur.Methods: During a 3.5 year period of time (March 2002-Oct 2005), 61, out of total of 76 cases of “floating knees” that had extra-articular femur and tibia fractures, had no history of prior knee problems, and the fractures of both segments had been internally fixed were studied. Each knee was examined for any possible ligamentous injury, following rigid fixation of the fractures, under the same anesthesia. The findings were documented and the patients were later followed for any new findings or complaints up to nine months after the incident.Results: The mean age in these 61 cases (57 males, 4 females) was 29.3 (18-46). Lachman and Pivot tests were positive in 5 and Posterior Drawer test in 3 cases. Valgus instability in 9 and varus instability in 6 other cases were detected. After the 9-months follow-up, knee pain was the chief complaint in 19 patients, while the MRI study which was done in 16 cases was positive for meniscal damage in 13 patients.Conclusions: Concomitant knee insults are fairly common in “floating knee” injuries. A thorough knee examination, following fixation of "floating knee” fractures, while the patient is still under anesthesia is essential. Further evaluation during the course of fracture treatment for any knee complaint is also recommended.
Mohammadreza Etemadifar, MD; Mohammadhossein Jamalaldini, MD; Bahador khaleghi, MD
Abstract
Background: Pedicle screw instrumentation has many advantages for correction of adolescent idiopathic scoliosis (AIS) deformity, but screw insertion in AIS could be challenging due to distorted anatomy of pedicles and also rotation and tilt of the vertebrae. In “Free hand” technique, the ...
Read More
Background: Pedicle screw instrumentation has many advantages for correction of adolescent idiopathic scoliosis (AIS) deformity, but screw insertion in AIS could be challenging due to distorted anatomy of pedicles and also rotation and tilt of the vertebrae. In “Free hand” technique, the surgeon locates the pedicle with anatomical landmarks. The purpose of this study was to evaluate the accuracy of pedicle screw position in correction of adolescent idiopathic scoliosis in “free hand” technique.
Methods: In a prospective study, 38 consecutive AIS cases who underwent corrective surgery with free-hand technique from 2013 to 2015 in a training hospital in Isfahan-Iran, were studied. Deformity corrections were evaluated with multislice CT-scan. In terms of position, pedicle screws were devided into “excellent” and “misplacement”. Misplaced pedicles were considered as medial, lateral, inferior, superior and anterior vertebral body and the dis-placement as grades 0 to 4.
Results: A total of 720 screws were inserted. 623 screws (86.5%) were perfect and 97 (13.5%) were misplaced. In all the misplaced cases, 39 screws (40.2%) were medial and 58 (59.8%) were lateral and the deviation of screw was less than 2 mm (grade 1). There was no misplacement in the inferior or superior directions. Only one screw with 4 mm anterior misplacement associated with abdominal pain.
Conclusions: Pedicle screw insertion in adolescent idiopathic scoliosis with the “free hand” technique is a safe and reliable method with acceptable accuracy; if obviates time and radiation exposure.
Alireza Moazaz; Gholamreza Aminian; Roshanak Baghaie; Hoda Nabavi
Abstract
Background: Osteoarthritis is a physiological response to the longitudinal and repeated forces applied to the joint which is associated with an increase in energy consumption and changes in the rate of displacement of the center of pressure in these patients. The purpose of the present study was ...
Read More
Background: Osteoarthritis is a physiological response to the longitudinal and repeated forces applied to the joint which is associated with an increase in energy consumption and changes in the rate of displacement of the center of pressure in these patients. The purpose of the present study was to investigate the effect of 8 degree lateral wedge in medial compartment knee osteoarthritis energy consumption and displacement of the center of pressure in frontal plane.
Methods: The research design was quasi-experimental with a pretest - posttest. In this study, 26 patients with medial compartment knee osteoarthritis in the age (range of 40 to 60 years) were selected through available sampling. In order to measure the energy consumption the polar electro and measure displacement of the center of pressure the force plate apparatus were used. Participants were evaluated in two conditions with/without of using lateral wedge during walking.
Results: The results showed that the mean of energy consumption and the displacement of the center of pressure decreased after using the lateral wedge. The average range of energy consumption before and after using the lateral wedge was respectively 0/381, 0/318 (p< 0/001), and displacement of the center of pressure was respectively 26/99, 17/23 (p< 0/001).
Conclusion: Use therapeutic interventions such as 8 degree lateral wedge may reduce energy consumption and displacement of the center of pressure of patients with medial compartment knee osteoarthritis.
Mehrdad Yadegari; Amin Bigham-Sadegh; Sanaz Farhang; Sajad Farhangi
Abstract
AbstractBackground & Aim: Nowadays, bone grafts are used in veterinary and human orthopedic to stimulate fracture healing, accelerate joint connection, and healing of bone defects. In this study, we carried out the radiological and histopathological evaluation of the effects of nano-hydroxyapatite ...
Read More
AbstractBackground & Aim: Nowadays, bone grafts are used in veterinary and human orthopedic to stimulate fracture healing, accelerate joint connection, and healing of bone defects. In this study, we carried out the radiological and histopathological evaluation of the effects of nano-hydroxyapatite concurrent with bone marrow treatment on rabbit fracture repair.Materials and Methods: This experimental study was performed in the spring and summer of 2019 on 20 male New Zealand white rabbits (12-month-old, weight=2 kg). The samples were randomly divided into four groups, and bone segments were removed from the radius. In the first group (n=5) (control), the bone defect remained empty and no substance was injected. Meanwhile, the defects in the second, third, and fourth groups (sample size of five in each group) were filled with nano-hydroxyapatite, bone marrow, and combination of nano-hydroxyapatite and bone marrow. Radiographs of the radius in each rabbit were taken at 2nd, 4th, 6th, and 8th post-operative weeks, and bone biopsy was performed in the eighth week for histopathological assessment. In addition, the radiographs and samples were evaluated in terms of union, ossification activity, and re-forming.Results: In this study, there was a significant difference among the groups in the second, fourth, sixth, and eight weeks regarding radiographical assessments (P<0.05). However, the difference was more evident in the sixth week, when a significant difference was found between the nano-hydroxyapatite group and a combination of bone marrow and nano-hydroxyapatite group (P=0.02). In this regard, the latter had a better performance, compared to the former. In histopathological evaluation, the group of a combination of nano-hydroxyapatite and bone marrow showed higher ossification activities, compared to the control group.Conclusion: According to the results of the study, the group of a combination of nano-hydroxyapatite and bone marrow had a better function in terms of bone healing, compared to the other two groups. Therefore, it is suggested that the method be applied to larger animal samples to confirm its clinical implications.
Foot and Ankle
mohamad taghi peivandi; Farshid Bagheri; Ali Birjandi nezhad; Sara Amel Farzad; Lida Jarahi; Milad Esmail zade; Amin Razi; Reza Habibzadeh shojaie
Abstract
Introduction The use of parathyroid hormone in the management of fracture disorders is poorly documented. Aim of study was evaluation of parathyroid hormone efficacy on :union: of tibia/fibula diaphysis fractures. Materials and methods: It was a hospital-based study who conducted on patient with non-:union: ...
Read More
Introduction The use of parathyroid hormone in the management of fracture disorders is poorly documented. Aim of study was evaluation of parathyroid hormone efficacy on :union: of tibia/fibula diaphysis fractures. Materials and methods: It was a hospital-based study who conducted on patient with non-:union: or delayed-:union: fracture of tibia/fibula. At Shahid Kamyab hospital, patients with inclusion criteria, entered the study after completing the conscious consent form in both case and control groups. CBC, ESR, Ca, P, Mg, ALK-P, Cr, BUN tests were performed as baseline, then in the case group prescribe oral D-Calcium and monthly injection of parathyroid hormone for 3 months at a daily dose of 8 units and in the control group, prescribe oral D-Calcium and the expected treatment method, and those who had a specific risk factor such as digoxin tablets or kidney failure were excluded from the study. After entering the study and receiving the hormone once the month, patients evaluate with radiographic parameter. Results: Of evaluated cases, mean and standard deviation of age in the intervention group was 16.9 ± 37.7 years and in the control group was 13.8 ± 39.1 years (P = 0.73). In terms of gender in the two groups, 24 cases were male and 6 cases were female (P = 1.0). In addition in clinical findings, fracture type (P = 1.0), fracture shape (P = 0.18), fixation method (P = 0.26), radiographical result (P = 0.06) did not have a statistically significant difference between the two groups. Conclusion: We not find any positive effect of this hormon on fracture status, as clinical or para clinical evaluation.
Seyyed Morteza Kazemi; Siyavosh Hemmati Eslamlou; Arash Maleki; Reza Zandi; Mohammad Ali Jalili; Keyghobad Ashoori; Farshad Safdari
Abstract
Background: The role of increased posterior tibial slope in rupture of the anterior cruciate ligament (ACL) is controversial. The purpose of current study was to determine the effect of posterior slope on the ACL injury. Methods: In a case control study, 61 consecutive cases with ACL injury, who were ...
Read More
Background: The role of increased posterior tibial slope in rupture of the anterior cruciate ligament (ACL) is controversial. The purpose of current study was to determine the effect of posterior slope on the ACL injury. Methods: In a case control study, 61 consecutive cases with ACL injury, who were candidates for reconstruction, were compared with 61 persons with normal knees who were matched for age and sex, over a 2-year period at a teaching hospital in Tehran, Iran. The posterior tibial slope angles were measured on true lateral radiographs on all the cases. The measurement variations were analyzed between the two groups. Results: The mean posterior tibial slope was 9.4±1.8 degrees in controls and 12.3±4.4 in patients with ruptured ACL (p < .001). The incidence of tibial slope greater than 10 degrees in patients with ruptured ACL was 3.1 times greater than that of the controls. Conclusion: This study suggests that increased tibial slope angle may contribute to increased risk for ACL rupture.
Bahram Mobini, MD; Hamid Behtash, MD; Ebrahim Ameri, MD; Seyed Alireza Bassampoor, MD
Abstract
Background: Spinal stenosis is a common reason for referral to a spine center by adults. Pain and numbness in buttochs and lower limbs after a period of standing or walking are the common complaints. History, supplemented with good physical exam radiography and MRI of spine are the mainstays of diagnosis. ...
Read More
Background: Spinal stenosis is a common reason for referral to a spine center by adults. Pain and numbness in buttochs and lower limbs after a period of standing or walking are the common complaints. History, supplemented with good physical exam radiography and MRI of spine are the mainstays of diagnosis. Spinal decompression is the final step in treatment, which is not always associated with long term patients’ satisfaction.Methods: 38 patients with mean age of 56 years who had undergone posterior spinal decompression were retrospectively studied. The pre and post operative activity level and their degree of satisfaction were assessed.Results: In a 2-4 year follow-up period, 30 patients were satisfied with their operations, and no surgical complication had been experienced. In 30 patients (79%) back pain had aggravated. 3 folds improvement in standing or walking was reported by 29 cases, and 21 patients (57%) returned to their previous activity level. Conclusions: In short time, spinal decompression can effectively relieve the symptoms, but can not reduce back pain symptoms. Despite higher age range for this surgery, early complication rate is very low.
Amirreza Sadeghifar, MD; Arash Akbari, MD; Mahmood Karimi Mobarakeh, MD
Abstract
Background: Knee osteoarthritis is a common etiology of disability in older age group. There are evidences suggesting that varus or valgus deformity can be from distal of femur, proximal of tibia or because of ligamentous laxity. Osteotomy in incorrect location may create zigzag deformity and may contribute ...
Read More
Background: Knee osteoarthritis is a common etiology of disability in older age group. There are evidences suggesting that varus or valgus deformity can be from distal of femur, proximal of tibia or because of ligamentous laxity. Osteotomy in incorrect location may create zigzag deformity and may contribute to increase risk of osteoarthritis. The objective of this study was to find the correct location of deformity in genuevarum or genuevalgum.Methods: We studied 40 patients with knee deformity at a mean age of 27.4 years (19-38), prospectively. Standing 3-point view radiographs were obtained on each patient, and the limb axis was determined. The data on limb malalignment was analyzed statistically.Results: In 94.5% of cases the location of varus deformity was proximal of tibia and in 5.5% in distal of femur, the best location of osteotomy. Our study also revealed multiple factors contributing to varus deformity, i.e. distal femur in 67.5%of cases, proximal tibia deformity in 92.5% of cases and ligamentous laxity in 77.5%.Conclusions: Varus knee deformity can be from proximal tibia, distal femur or knee laxity. Before any corrective surgery one must clarify location of deformity
Bahram Moradi; Arad Fatahian; Reza Fatahian
Abstract
Background: Compression fractures of the spine are common complications of osteoporosis that lead to persistent pain, inability to perform daily activities, and a significant reduction in quality of life. Kyphoplasty and vertebroplasty are two semi-invasive treatments for this complication. Therefore, ...
Read More
Background: Compression fractures of the spine are common complications of osteoporosis that lead to persistent pain, inability to perform daily activities, and a significant reduction in quality of life. Kyphoplasty and vertebroplasty are two semi-invasive treatments for this complication. Therefore, the purpose of this research was to evaluate and compare the treatment results obtained from the use of the two mentioned methods with non-surgical medical treatment in patients with compression fracture of the spine.Methods: The cases of thoracic spine compression fracture referring to 2 teaching hospitals during a 2-years period (2015 to 2017) were retrospectively studied the results of 3 treatment methods of non-surgical, vertebroplasty and Kyphoplasty were compared by chart review and also direct questioning and examination at a minimum follow-up of one year. The evaluation of pain by VAS, and functional status Oswestry Disability Index (ODI) and SF-36 short form were completed. Results: From total of 138 cases of compression thoracic spine fracture only 96 had the inclusion criteria and were entered into the study. 42 male and 54 female patients were evaluated. The patients had a minimum of 3 months and maximum of 1 year (Mean=7.5 months) follow-up. VAS score in non-surgical group was 6.75±1.32, in vertebroplasty was 3.58±1.94 and in Kyphoplasty was 2.67±1.64. The ODI scores were: 56.82±14.4, 28±15.40, and 25.64±13.52 for non-surgical, vertebroplasty and Kyphoplasty respectively. The SF-36 scores were almost similar in all 3 treatment methods.Conclusion: The two methods of vertebroplasty and Kyphoplasty, in comparison with non-surgical treatment, had significantly reduced pain and better quality of life and ability of work. Therefore the two surgical treatments are preferred techniques for compression spine fractures.
Nasser Sarrafan, MD; Ahmad Dashtbozorg, MD; Seyed Abdolhossein Mehdinassab, MD; Afshin Azma, MD
Abstract
Background: Intetrochanteric hip fracture commonly affects over 70 years old people. While the best acceptable treatment is early fixation, the complication rate is fairly high because of patients' older age and associated age-related comorbidities. We would like to report our experience with the outcome ...
Read More
Background: Intetrochanteric hip fracture commonly affects over 70 years old people. While the best acceptable treatment is early fixation, the complication rate is fairly high because of patients' older age and associated age-related comorbidities. We would like to report our experience with the outcome of fixation of such fractures in our locality.Methods: In a descriptive study all the intertrochanteric fractures treated with compression screw-plate system during a 2 year period in two hospitals of Ahwaz were studied. 84 patients with mean age of 73.4 (range of 59 to 98 years) were assessed. 34 (40.5%) male and 50 (59.5%) female constituted the study group. Patients with a minimum of one year follow-up were evaluated.Results: The complications consisted of 8 (9.5%) varus, 8 (9.5%) shortening, 4 (4.7%) fixation "cut-out", 1 (1.1%) AVN, 13 (15.4%) wound infection and 2 (2.3%) non-:::union:::, 9 (10.7%) mortality in 24 weeks. 10 (11.9%) underwent re-operation and re-fixation. The average time to returning to pre-fracture activity was 5 months.Conclusion: Complication rate is relatively high in intetrochanteric hip fractures even after screw-plate fixation. Except for high infection rate, in our series, the overall results are similar to the other reports in the literature.
S Saravani; N Tanideh; M Fazeli; N Azarpira; E Nadimi; M Lotfi; Ayda Iraji; Sh Zareh
Abstract
Background: Osteoarthritis (OA) recognized, as degenerative arthritis. Synthetic drugs available to treat the OA have, the dangerous side effects and low efficacy. Therefore, using of herbal medicines is an important component of alternative and complementary medicine, Mesenchymal stem cells have ...
Read More
Background: Osteoarthritis (OA) recognized, as degenerative arthritis. Synthetic drugs available to treat the OA have, the dangerous side effects and low efficacy. Therefore, using of herbal medicines is an important component of alternative and complementary medicine, Mesenchymal stem cells have a special site in the treatment of diseases. drugs.Psidium guajava Leaves used as antioxidant, anti-inflammatory antinociceptive and analgesic. The goals of scientific research of this study were to the evaluate the regeneration articular cartilage effect of injection of the hydroalcoholic extract of leave of Psidium Guajava with Stem Cell into the knee joints of rats.
Methods: Firstly, ninety male rats were choosen, and collagenase type II was prepared for an intra-articular knee injection, for them to induce OA in the animal models. Then, they were divided into nine treatment groups. (N = 10): (a) Sham, (b) Control, (c) injection of hyaluronic Acid intra-articular, (d) Injections of Stem Cell intra-articular, (e) Injections of PRP, (f): Injections of the extract Psidium guajava leaves (g) Injections of the extract Psidium guajava leave with PRP, (h) Injections of the extract Psidium guajava leaves with Stem Cell (i) Injections of the extract Psidium guajava leaves with Stem Cell and PRP. After 5 months, the results were assessments by a Radiologist and Histopathologist.
Results: Radiological and histopathological findings were in which the improvement of the articular cartilage was better in the leaves with Stem Cell and PRP compared with the control group(P<0.05).
Conclusions: It seems that Psidium guajava leaves can be suggested as an effective complementary and alternative treatment for OA of the knee. Because it has a lot of polyphenol compounds.
