Fardin Mirzatolouei, MD; Majid Mohseni Kabir, MD
Abstract
Background: Perfect rotational positioning of femoral component in total knee arthroplasty is mandatory for good outcome, particularly in knees with severe varus. Posterior condylar line (PCL) and transepicondylar axis TEA are the two current methods used to determine the appropriate rotational positioning ...
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Background: Perfect rotational positioning of femoral component in total knee arthroplasty is mandatory for good outcome, particularly in knees with severe varus. Posterior condylar line (PCL) and transepicondylar axis TEA are the two current methods used to determine the appropriate rotational positioning of femoral component. The aim of this study was to compare the accuracy of femoral component rotation after TKA, using either PCL or TEA reference points. Methods: In a retrospective study, 42 consecutive TKA candidates with severe varus knees were divided into two groups: In group I posterior condylar line, and in group II transepicondylar axis was considered as the primary landmark for rotational positioning. Erosion of medical femoral condylar was recorded in millimeters. One year after operation all the patients underwent CT scan and the angles between TEA and PCL of the prosthesis was meausured. The degree of knee flexion and also WOMAC scores were recorded. Results : The female gender was prominent in both groups (81% in group 1, 85.7% in group II). There was no significant femoral condylar erosion in either group. The mean Womac score in group 1 was 71.4±17.51 and 72.07±15.48 in group II (p < /i>=.9). The degree of external rotation according to condylar twisting angle was 3.35±1.74 in group 1 and 1.9±1.7 in group 2 (p < /i>=.009). Conclusions: In severe Knee-varus deformity, TEA landmark gives more external rotation position for femoral component, despite of lack of significant erosion in femoral condyle.
Amir Salari; Kamran Asadi; Ali Bahari-Khorram
Abstract
AbstractIntroduction: A delay in diagnosis and inadequate treatment of Benign bone tumors may lead to malignant transformation or damage to other internal organs with time. We decided to Survey the frequency of benign bone tumors and its related factors in patients in a ten-year period referred to Orthopaedic ...
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AbstractIntroduction: A delay in diagnosis and inadequate treatment of Benign bone tumors may lead to malignant transformation or damage to other internal organs with time. We decided to Survey the frequency of benign bone tumors and its related factors in patients in a ten-year period referred to Orthopaedic ward of Poursina Hospital, Rasht.Materials and Methods: A descriptive retrospective study was designed on bone tumors collected from medical records of 2007 – 2017 patients referred to Guilan university of medical sciences. All the demographic data were collected and analyzed.Results: The mean age of patients with benign tumors of bone in this investigation was the 43.5 ± 12.93 years. The highest percentage of patients with benign tumors of bone were males (63.9%). The highest percentage of benign tumor of bone was multiple exostosis 25% followed by osteochondroma 22.2% and then osteoid stoma by 16.7%. Using Fisher's exact test showed a statistically significant relationship between gender, age, educational level and location of the benign tumors of bone seen in this study (P=0.001).Conclusion: Exotosis and osteochondroma are the most common benign bone tumors, and are more in the lower limb in the male gender -Blood pressure and higher education level were the common associated findings.
S Ramin Zargarbashi
Abstract
Botulinum toxin is produced by clostridum botulinum bacteria , and has seven serotypes ,some of which are pharmacologically active in human.
An inactive protein is bound to this toxin , as toxin contains two distinct chains, each one with a specific characteristic . The mechanism of action is acetyle ...
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Botulinum toxin is produced by clostridum botulinum bacteria , and has seven serotypes ,some of which are pharmacologically active in human.
An inactive protein is bound to this toxin , as toxin contains two distinct chains, each one with a specific characteristic . The mechanism of action is acetyle choline inhibition at the synapses.
The general pharmacological and practical points for the use of this toxin will be discussed in this article without emphasis on its use in any specific field.
Amin Bigham-Sadegh; Saeid Lotfi; Amad Oryan; Iman Hafar
Abstract
Background: Facilitating the fracture healing process is important to increase the fracture healing speed and to decrease the time period till union. This study aimed to evaluate the effects of blood clot and doxycycline on bone healing process.Methods: Twenty mature male New Zealand white rabbits were ...
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Background: Facilitating the fracture healing process is important to increase the fracture healing speed and to decrease the time period till union. This study aimed to evaluate the effects of blood clot and doxycycline on bone healing process.Methods: Twenty mature male New Zealand white rabbits were used, in this study. A defect was created in the middle part of the radius. The rabbits were randomly distributed into 4 groups and the gaps were filled with the graft materials: blood clot, doxycycline, combination of blood clot and doxycycline and control group in which the defect was left empty. Radiographs of operated limbs were taken on 14th, 28th, 42nd and 56th postoperative days. Histologic samples were taken on the 56th day post surgery.Results: On radiographic evaluation significant difference between the groups was not observed (p>0.05). On histopathological evaluation, blood clot and doxycycline groups were superior to control group (P<0.05), also combination of blood clot and doxycycline group was superior to other ones (P<0.05). There was no evidence of graft rejection in any group.Conclusion: This study demonstrated that the combination of blood clot and doxycycline has a better function in bone healing process than other groups.
Amir Mohammad Navali, MD; Amin Moradi, MD; Abolfazl Mokhtari, MD
Abstract
Background: Post-operative pain control is an important issue in orthopaedics. Narcotics do not properly control pain and may have many complications. The non-steroidal anti-inflammatory drugs can, however, play an important role in postoperative pain management. This study evaluates the effect ...
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Background: Post-operative pain control is an important issue in orthopaedics. Narcotics do not properly control pain and may have many complications. The non-steroidal anti-inflammatory drugs can, however, play an important role in postoperative pain management. This study evaluates the effect of intra-articular Ketorolac injection on pain control after knee arthroscopy.
Methods: In a randomized double blind clinical trial study, 60 age and sex-matched patients of around 45 years of age were divided into two groups of 30. Tirthy mg of intra-articular ketorolac in one group and 30 millimeters of saline in the control group were injected at the end of arthroscopic knee surgery. The postoperative pain control and need for other pain medications were compared between the two groups.
Results: In the Ketorolac group the pain at 4 hours and 8 hours after surgery was significantly lower than the control group. At 12, and 24 hours after surgery, no significant difference in severity of pain was observed. The need for the use of opioid drugs was not significantly different between the two groups. The Sleep disturbance of 42.8% in the Ketorolac and 57.1% in the saline group was not significantly different.
Conclusions: Intra-articular ketorolac is effective in pain reduction only in the first few hours after knee arthroscopy, and does not reduce the need for other analgesics.
Ehsan Shakouri, PhD; Fatemeh Zareh, MSc; Ahmad Majd, PhD; Hossein Haghigh Hassanali Deh, MSc
Abstract
Background: Drilling of bone is used to fix the fractures with screws, wires or plates. The interaction between hole surface surface and fracture stabilization components is effective in the bonding strength of the stabilization process. During bone drilling, the temperature could increase above 47 °C ...
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Background: Drilling of bone is used to fix the fractures with screws, wires or plates. The interaction between hole surface surface and fracture stabilization components is effective in the bonding strength of the stabilization process. During bone drilling, the temperature could increase above 47 °C and cause irreversible thermal necrosis. The surface roughness can be considered as a sign of damage of the bone cells.
Methods: This study looks at the effect of rotational speed of drilling of bone on production of surface defects to determine the best processing condition for minimizing the osteonecrosis and surface defects. Seven different rotational speeds in drilling beef femur were used-in non-cooling and liquid cooling phases. In all tests the temperature was measured. After cutting samples, using hematoxylin-eosin staining were stained for detection of surface defects.
Results: The lowest heat prodution was with use of liquid cooling. The drill speed of 1500 rpm with liquid cooling showed the maximum temperature of 48.5°C without production of surface debris and defects as witnessed in stained bone segment.
Conclusions: Cooling application in bone drilling process avoids over and thus less thermal necrosis, which gives the lowest number of surface defects and highest quality wall surface hole.
jafar Soleimanpoor; Siamak Kazemi sufi; Amin Moradi
Abstract
Background:Total knee arthroplasty (TKA) is one of the most common orthopedic surgeries in the world. The use of tourniquet is recommended by some surgeons around the world. However, the evidence of its usefulness in replacing the knee is still uncertain. In the present study, we assessed the effect ...
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Background:Total knee arthroplasty (TKA) is one of the most common orthopedic surgeries in the world. The use of tourniquet is recommended by some surgeons around the world. However, the evidence of its usefulness in replacing the knee is still uncertain. In the present study, we assessed the effect of using tourniquet in reducing bleeding during and after operation and the amount of transfusion requirement in TKA surgery.Methods and Materials:Patients referred to Imam Reza and Tabriz universal hospitals for TKA surgery in case of absence of hemorrhagic diseases and non-use of anticoagulants were included in this study. In this study, 8 (25.8%) males and 23 (74.2%) females were present with an average age of 63.6 ± 7.86 with a minimum age of 52 years and a maximum age of 81 years. Patients' Randomization applied considering balanced mean age and body mass index (BMI). In the first group after the patient's preparation and induction of anesthesia, the tourniquet was considered and surgery was performed and the tourniquet was released immediately after the cement was inserted. In the second group after the patient's preparation and induction of anesthesia, tourniquet was not used until cementation and after that again deflated. All surgical procedures were performed by the same and experienced surgical team using spinal epidural anesthesia. The standard surgical procedure was considered by surgeons.Results:23 (74.2%) patients did not need blood transfusion, and 8 (25.8%) patients needed transfusion. The average duration of surgery was 75.81 ± 26.3 minutes with a minimum duration of 30 minutes and a maximum of 125 minutes. The mean preoperative HB level was 12.66 ± 1.67, which was 11.09 ± 1.62 after surgery.Conclusion:In conclusion, the use of tourniquet in patients undergoing TKA surgery reduces the duration of surgery but does not significantly affect hemoglobin maintenance after surgery. In other words, the use of tourniquet does not have an effect on reducing the need for blood transfusion.
F Biglari; A Mavaein; S Shabani; H Mahdavi Mohtasham; S M Kazemi
Abstract
Background: Clavicle fractures have various complications following open reduction and internal fixation. The main objective of this study was to investigate the prevalence of complications of Clavicle fractures following operative treatment. Also, the prevalence of infection, local dissatisfaction, ...
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Background: Clavicle fractures have various complications following open reduction and internal fixation. The main objective of this study was to investigate the prevalence of complications of Clavicle fractures following operative treatment. Also, the prevalence of infection, local dissatisfaction, non:::::union::::: and mal:::::union::::: in the Clavicle fracture after internal fixation was investigated.
Material and Methods: The study was cross-sectional. A sample of 52 patients was treated with clavicle fractures, which were treated with open resection and internal fixation. In order to determine the range of motion, strength and shoulder pain, patients were selected from Constant Shoulder Score. Radiography used to detect :::::union:::::.
Results: 12 were female and 40 were male of 52 patients. The mean score of the shoulder was 84 ± 2 (95% CI 83-84). One third of the patients used Hook. Patients complained more dysmorphic scar (96%), skin numbness (80%) and pain (73.1%). The rate of infection in patients was very low.
Conclusions: The most common complication is pain, dysmorphic scar and skin numbness that can be said to be relatively normal and can be seen in most patients. Of course, it should also be taken into account that the differences in surgical techniques, surgeries, cultural issues, gender, and age of the patients can be affected.
Bahram Mobini, MD; Ebrahim Ameri, MD; Hamid Behtash, MD; Hassan Ghandhari, MD; Mohammad Khakinahad, MD
Abstract
Background: Postural round back is a common entity with unknown etiology. Reports on the results of brace treatment are scarce. The purpose of this study was to determine the effect of bracing in different stages of treatment and also the amount of preservation of kyphosis after stopping the brace.Methods: ...
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Background: Postural round back is a common entity with unknown etiology. Reports on the results of brace treatment are scarce. The purpose of this study was to determine the effect of bracing in different stages of treatment and also the amount of preservation of kyphosis after stopping the brace.Methods: from 1991 through 2005, 165 cases (39 male, 126 female) who had a diagnosis of idiopathic postural kyphosis were treated with a Milwaukee brace. The mean age at the initiation of treatment was 13.06 years (8-16 years), at the completion of treatment was 15.06 years (11-17 years) and at the final follow-up was 17.9 years (12-25 years). The mean initial kyphosis was 59.26° (51°-74°). The patients were evaluated after an average follow-up of 34 months (6-102 months).Results: The mean angle of kyphosis was 42° (28°-68°) at completion of treatment, and 47.9° (28°-75°) at the final follow-up. Angle of kyphosis was 50° or less in 85.9% at the end of treatment and in 74.7% of patients at final follow-up. 5.9 degrees of original correction was lost in final follow-up. Two cases underwent surgery. Brace was effective in correction of kyphosis (p < /em>=.001).Conclusion: Milwaukee brace is effective in treatment of postural kyphosis. Longer period of treatment, even after maturity, is needed in more stiff deformities.
AR Rahimnia; S Haji; M Jafar Beiglo
Abstract
AbstractBackground: Reconstruction of anterior cruciate ligament (ACL) injuries using arthroscopic single-bundle method is a common procedure with a success rate of 83% to 95%. Some studies have shown that the transportal method for drilling the femoral tunnel results in a higher success rate than transtibial ...
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AbstractBackground: Reconstruction of anterior cruciate ligament (ACL) injuries using arthroscopic single-bundle method is a common procedure with a success rate of 83% to 95%. Some studies have shown that the transportal method for drilling the femoral tunnel results in a higher success rate than transtibial approach. Other studies show equal rate of success in both approaches. The aim of this study was to investigate which one of the two methods has nearest biomechanics to the original ACL and better outcome for patients.Methods: This study was a cross sectional (prospective) follow up. The clinical results of the ACL reconstruction in military patients with pure ACL rupture were evaluated and followed up. In one group 26 ACL reconstruction was done using the transportal (TP) technique and in the other group 20 ligaments were reconstructed using the transtibial (TT) method.Results: At the final follow-up, eight patients (40%) in the TT group and five cases (19.23%) in the TP group had a positive pivot test. Three patients (15%) in the TT group and nine patients (34.61%) in the TP group had a positive Lachman test. There was no statistically significant difference in the pivot test (P=0.06) and Lachman test (P=0.35) between the two groups. Mean Lysholm scores were 92.8 ± 2.5 and 93.2 ± 2.8 in the TT and the TP groups, respectively (P = 0.51). The averages of the graft angle were 68.7 ± 2.9 and 43.6 ± 4.1 in TT and the TP groups, respectively (p = 0.001). Any correlation between the graft angle and the patients’ concurrence (Lysholm score) after surgery (P>0.05) and any correlation between the graft angle and the instability testes (P>0.05) were not observed between the two groups.Conclusion: No significant clinical difference was found between the two techniques.No significant clinical differences were found between two techniques and therefore, both of them can create good results.
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.
Farivar A Lahiji, MD; Hamidreza Aslani, MD; Amir Bisadi, MD; Seyed Mahdi Hosseini Khameneh, MD; Elham Rahimian, MD; Ali Fotouhi Maleki, MD; Seyyed Rouhollah Mousavi, MD; Farshad Safdari, MSc
Abstract
Background: Some authors suggested using ultrasound
in diagnosis of carpal tunnel syndrome (CTS), however the efficacy of
ultrasound in determining the severity of disease is unclear. In current study,
we aimed to investigate the diagnostic efficacy of ultrasound in determining
the severity of ...
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Background: Some authors suggested using ultrasound
in diagnosis of carpal tunnel syndrome (CTS), however the efficacy of
ultrasound in determining the severity of disease is unclear. In current study,
we aimed to investigate the diagnostic efficacy of ultrasound in determining
the severity of CTS in comparison with NCV using measurement of cross-sectional
area of median nerve. Methods: In
a prospective study, 181 CTS suspected wrists (94 patients) were investigated.
The cross-sectional area of the median nerve was measured using ultrasound and
the severity of disease was determined based on criteria of El Miedany et al. Based on the NCV,
the patients were divided into four groups of normal, mild, moderate or severe
CTS. Finally, the mean cross-sectional area was compared between the groups and
the kappa agreement coefficient for determining the severity of disease by the two
methods was calculated. Results: The mean cross-sectional area increased
significantly with increase in disease severity (p < /i>>.001). Conclusions: Determination of cross-sectional area of
median nerve with ultrasound can be a useful tool in decision-making about
surgical intervention in carpal tunnel syndrome. However, the clinical
correlation is mandatory.
Iman Hafar; Amin Bigham-sadegh; Amin Nematollahi; Iraj Karimi; Saeid Lotfi
Abstract
Background: Acceleration of bone healing is one of the most challenging issues in orthopedic science. This study aimed to evaluate bone healing process with the application of fish bone powder and human lyophilized platelet (prepared with a novel protocol) in the rabbit animal model. Materials and Methods: ...
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Background: Acceleration of bone healing is one of the most challenging issues in orthopedic science. This study aimed to evaluate bone healing process with the application of fish bone powder and human lyophilized platelet (prepared with a novel protocol) in the rabbit animal model. Materials and Methods: This study was carried out on 20 male New Zealand white rabbits (12 month old), divided into four equal groups as control, fish bone powder, lyophilized platelet and a combination of fish bone powder and lyophilized platelet. After exposing the radius, a bone segment (10 mm) was cut from the bone, and the empty space was left empty in the control group but filled with the mentioned biomaterials in other groups. Radiographs of each rabbit were taken on the 14th, 28th, 42nd, and 56th post-operative days to evaluate bone formation, union and remodeling of the bone defect. All animals were euthanized on the 56th post-operative day for histopathological evaluation. Results: Radiological evaluation showed a significant difference between the lyophilized platelet group (P=0.02) and the control (P=0.007) and the fish bone powder (P=0.005) on 56th post-operative day, where the lyophilized platelet group was superior, compared to other groups. Moreover, the histopathological evaluation revealed a significant difference between the control group (P=0.01), the fish bone powder (P=0.03) and lyophilized platelet group (P=0.01), where treatment groups were superior, compared to the control group on 56th post-operative day. Nonetheless, there was no evidence of graft rejection in all groups.Conclusion: According to the results of the study, using lyophilized platelet could accelerate the bone healing process in rabbit and has the potential for use in medicine.
Mohsen Karami, MD; Ali Akbar Esmailiejah, MD; Maryam Sedaghatnia, MD; Ali Akbar Esmailiejah, MD; Ramin Etemadi, MD; Ahmad shafaeizadeh, MD
Abstract
Background: The use of pedicle screws in thoracic or lumbar spinal fusion and deformity correction is becoming more privalent, even in children. Improper screw insertion can produce major complications. The accuracy of the screw placement is evaluated post operatively by CT scanning in a small group ...
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Background: The use of pedicle screws in thoracic or lumbar spinal fusion and deformity correction is becoming more privalent, even in children. Improper screw insertion can produce major complications. The accuracy of the screw placement is evaluated post operatively by CT scanning in a small group of children.Methods: In a cross section study, 7 children under 5 years of age who had undergone spinal surgery, using pedicular screws were evaluated in two training hospitals in Tehran, Iran. The position of pedicular screws was determined by an expert radiologist and documented along with probable neurovascular effect.Results: Seven children with total of 42 pedicle screws were assessed. 34 screws (80%) had been placed in the desired positions. The remaining 9 screws had produced minor breakage through the cortices, mainly in narrow thoracic pedicles. There was no case of neurovascular compromise, or stability problem in the 42 screws.Conclusions: Use of peducular screw in spinal fusion of young children is a proper technique.
Hamid Reza Hosseinzadeh; Reza Zandi; Seyyed Morteza Kazemi; Seyyed Mohammad Qorashi; Sina Shahi; Farshad Safdari; Mohammad Reza Bigdeli; Siyavosh Hemmati Eslamlou; Mohammad Ali Jalili
Abstract
Background: Posterior tibial slope is the normal anteroposterior inclination of the tibia slope and plays an important role in the biomechanics of the knee and function of the cruciate ligaments. Posterior tibial slope angle varies in different populations and there is no report about its measurement ...
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Background: Posterior tibial slope is the normal anteroposterior inclination of the tibia slope and plays an important role in the biomechanics of the knee and function of the cruciate ligaments. Posterior tibial slope angle varies in different populations and there is no report about its measurement in the Iranian population. The aim of this study was to investigate the normal posterior tibial slope in a teaching hospital in Tehran-Iran. Methods: In a desreptive study, 108 knees in 70 men and 38 female patients, with no history of prior knee problem were evaluated by lateral knee rodiographs in a teaching hospital in Tehran-Iran. The average age in these cases was 38 years (23-60 years). These patients had refered because of recent knee trauma, but no fracture or intra-articular derangement had been found. The angle of tibial slope was measured in all the cases and analyzed. Results: The mean slope angle was 9.4±1.8 degrees. There was no statistical relationship between age and gender and posterior tibial slope (p≥.05). Conclusion: The normal posterior tibial slope angle in this Iranian population was different from other countries. It may be necessary to consider these differences in designing tibial and femoral components for knee arthroplasty.
Amir Salari; Ahmad –Reza Mirbolok; Mozafar Hoseininejad; Ali Karimi
Abstract
Abstract
Background: Carpal tunnel syndrome (CTS) is the most common form of localized peripheral neuropathy. CTS and cervical radiculopathy (CR) often co-occur, known as double crush syndrome (DCS).
Aim: This study aimed at determining frequency of CR in patients with CTS referred to electrodiagnosis ...
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Abstract
Background: Carpal tunnel syndrome (CTS) is the most common form of localized peripheral neuropathy. CTS and cervical radiculopathy (CR) often co-occur, known as double crush syndrome (DCS).
Aim: This study aimed at determining frequency of CR in patients with CTS referred to electrodiagnosis department of Rasht Imam Reza clinic.
Materials and Methods: This was a descriptive cross-sectional study on 117 patients with CTS referred to Imam Reza clinic. The patients’ data were recorded through a questionnaire including electrodiagnosis test results, patients’ demographic data, medical history and disease primary diagnosis and related results, electromyogram (EMG)/nerve conduction velocity (NCV) tests results. NCV test shows CTS type (unilateral and bilateral) as well as its severity, while EMG test determines co-occurrence of CR and CTS, type and severity of DCS. Finally, the data were entered into SPSS 19, and analyzed using statistical tests.
Results: Out of 117 patients with primary diagnosis of CTS, 21 patients (17.9%) were male and 96 patients (82.1%) were female, with a mean age of 46.5 years. The highest frequency (41.5%) in patients with CTS belonged to housewives. 48 (41%) patients had bilateral CTS and 69 patients (59%) suffered from unilateral one. DCS prevalence in this study was about 35%. Out of 41 patients with DCS, 25 patients (61%) had unilateral DCS with moderate severity (48.8%) and C7 radiculopathy (70.7%). Using binary logistic regression analysis (method=ENTER) showed that age and body mass index (BMI) were two variables affecting on the simultaneous development of CTS and cervical spines involvement (P<0.0001).
Conclusion: Since knowing simultaneous presence of CR and CTS in patients’ therapy is necessary, patients with CTS should be examined for DCS.
Ali Doostmohammadi; Mohammad Hossein Fathi; Amin Bigham Sadegh; Amir Hossein Tavakolizadeh; Hamed Akbarian
Abstract
Background: Bioactive bioceramics have been regarded by researchers in recent years. Bioglass and Hydroxyapatite (HA) are the examples of these bioactive bioceramics. Production and characterization of nano bioglass and HA for bone repair applications were the purpose of this study. Methods: Nano bioglass ...
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Background: Bioactive bioceramics have been regarded by researchers in recent years. Bioglass and Hydroxyapatite (HA) are the examples of these bioactive bioceramics. Production and characterization of nano bioglass and HA for bone repair applications were the purpose of this study. Methods: Nano bioglass and HA were produced and the particles shape and size were characterized by X-ray flurescence (XRF). The bioactivity of the particles of HA and nano bioglass and combination of the two were tested, by introducing them into the cavities formed in rabbit's Tibia. The incorporation and bone induction of these 3 different paricles in bone were evaluated by radiography and also histopathology of the resected specimens. Results: The characterized tests confirmed that nano bioglass and natural HA were produced with desired composition. The radiographic and histopathologic evaluation illustrated good bioactivity of nano-size bioglass, HA and HA-bioglass composite, leading to restoration of bone defects after 4 to 6 weeks. It was also observed that bioactivity of HA-bioglass composite was superior to bioglass and HA used singularly. Conclusions: The osteoconductivty of HA and osteoinductivity of bioglass combined as a composite lead to excellent bioactivity and good response in the hard bony tissue.
Mohammad Fakoor, MD; Zahed Safikhani, MD; Shiva Razi, MSc
Abstract
Background: The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in tibiofemoral alignment in young people in a region ...
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Background: The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in tibiofemoral alignment in young people in a region of Iran.Methods: A cross-sectional study on 853 children (455 girls, 398 boys) of 3 to 16 years age was performed. Tibiofemoral angles and intermalleolar distances were measured in standing position. Normal limits of tibiofemoral angles and intermalleolar distances were separately determined based on age and sex.Results: A valgus alignment was observed in all. The tibiofemoral angles in boys between ages 3 to 7 years were 7.1±0.35 and 4.97±0.36 between 8 to 16 years of age. The tibiofemoral angle in girls aged 3 to 7 years were 7.1± 0.38 and in girls of 8 to 16 years were 4.95±0.37 degrees. There was no significant difference between the tibiofemoral angle in girls and boys. The internalleolar distance in boys of 3 to 7 years old was 2.7±0.9 and in boys of 8 to 16 years were 1.4±0.86 centimeters. The intermalleolar distance was 2.6±0.88 centimeters in 3 to 7 year old girls and 2.29±0.93 centimeters in 8 to 16 year old girls. Pierson correlation coefficient showed a reverse relationship between tibiofemoral angle and intermalleolar distance.Conclusion: The tibiofemoral alignment in Iranian children is similar to that of Europe, North America and Turkey but different from Chinese children.
Amir Mohammad Navali, MD; Mehraban Mehraeen, MD
Abstract
Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more ...
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Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more than 7 years delay in ACL reconstruction.
Methods: In a cross sectional study, 43 patients (39 men, 4 women) at mean age of 38 years, who underwent ACL reconstruction with a delay of more than 7 years, were studied. The Lysholm, IKDC, Tenger and KOOS scores were evaluated before surgery and at the last follow up. The observed meniscal or chondral lesions were collected from the patients’ arthroscopic records. The mean follow-up was 34 months.
Results: The mean time interval between primary trauma and ACL reconstruction surgery was 121 months. A total of 39 cases (90/7%) had chondral lesions which include 20 cases of grade I/II and 19 cases of grade III/IV lesions. In 35 patients (81.4%) meniscal tear was observed. Only two cases (4.6%) had isolated ACL tear. A statistically significant improvement in IKDC, Lysholm, KOOS, and Tegner score was observed following surgical treatment (p < /em><.001).
Conclusions: Longstanding ACL tear leads to increase the occurrence of meniscal and cartilage injuries. Delayed ACL reconstruction in this group of patients can improve IKDC, Lysholm and KOOS knee scores and Tegner activity level.
Ali Birjandi nejad; Hamid Farzadfard; Shokofeh Farzadfard; Moslem Mokhtari fard
Abstract
Introduction: The Preferential method in Fixation of some long bone fractures consists of using intramedullary nailing. The benefit of this method lies in its better biomechanical stability, as well as preventing additional surgical trauma to the fracture site. Despite these benefits, few surgeons conduct ...
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Introduction: The Preferential method in Fixation of some long bone fractures consists of using intramedullary nailing. The benefit of this method lies in its better biomechanical stability, as well as preventing additional surgical trauma to the fracture site. Despite these benefits, few surgeons conduct this method as it is time-consuming, risky (Performing x- ray fluoroscopy) and also tedious.
Method: Seven male patients with diaphyseal femoral fractures, with an average age of 32.28, underwent closed femoral nailing surgery making use of the innovative set. The duration of operation, fracture type and fracture site were evaluated.
The innovative solution: To align the bone fragments and make the guidance stick cross the fracture site closely, the present close reduction set was designed to make crossing the guidance stick through the fracture site possible on the normal bed of operation room in a short period of time without fluoroscopy, with the least possible extra trauma and the least degree of annoyance in the reduction stage.
Results: All the patients with diaphyseal femoral fracture, without any peripheral fractures, underwent nailing surgery, while total time of the surgery was 116.57 minutes on average; and pure time of the innovative set application and passing guidance stick to the bottom of the distal canal was 21.85 minutes.
Conclusion: The results indicated that closed intramedullary nailing of femoral fractures without performing Fluoroscope, using the aforementioned innovative set is possible for the patients with utter convenience in an appropriate time period.
davood asgari
Abstract
Abstract
Background: Damage in cartilage tissue is one of the global challenges and affects a large percentage of people. Trauma or age-related degenerative disease is the main cause of osteoarthritis. The aim of this study was to evaluate the effect of intra-articular injection for bone marrow mesenchymal ...
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Abstract
Background: Damage in cartilage tissue is one of the global challenges and affects a large percentage of people. Trauma or age-related degenerative disease is the main cause of osteoarthritis. The aim of this study was to evaluate the effect of intra-articular injection for bone marrow mesenchymal stem cells and the resulting secretions in repairing the damaged cartilage of the rat knee joint.
Methods: 30 male rats that weights approximately 200 to 250 g were randomly divided into five groups of 6 rats, including healthy group (receiving physiological serum), osteoarthritis group (monosodium iodoacetate injection), mesenchymal group, mesenchymal group + receiving the same volume of cell secretions + culture medium and culture medium injection group. Four weeks later, the rats have been killed and the hip joint examined by both macroscopic and microscopic methods.
Results: The results showed that the injection of 2.5*105 cells per ml had a good effect on the repairing of cartilaginous lesions caused by the monosodium iodoacetate injection. Histological studies showed that fibrillation rate, the presence of small gaps and deep gaps (P <0.05) decreased in the mesenchymal treatment group. The level of proteoglycans in mesenchymal treatment group increased significantly (P <0.05). Also, in the treatment group with mesenchymal secretions and culture medium, changes were observed in repairing the damaged cartilage, which was not significantly different from the osteoarthritis group.
Conclusion: In this study, the restorative effect has benn confirmed for bone marrow mesenchymal stem cells and their secretions in improving histopathological lesions of rat articular cartilage.
Sedigheh Najafipour, MS; Gholamhossain Shahcheraghi, MD, FRCS(C); Mohammad Hossein Fallahzadeh, MD; Marzieh Kargar, MS
Abstract
Background: Secondary hypertension in newborns and children may occur in many conditions including trauma and extremity fractures. This study was undertaken in two hospitals of Shiraz to determine the prevalence of hypertension among children undergoing orthopedic procedures.Methods: Sixty children (34 ...
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Background: Secondary hypertension in newborns and children may occur in many conditions including trauma and extremity fractures. This study was undertaken in two hospitals of Shiraz to determine the prevalence of hypertension among children undergoing orthopedic procedures.Methods: Sixty children (34 boys, 26 girls) aging 3-14 years old were cases of 7 clubfeet, 35 femoral fractures, 5 developmental dislocation of hip, 2 poliomyelitis, 3 pelvic fracture, 3 congenital short leg, and 5 miscellaneous conditions were studied in a six month interval. Blood pressures were measured.Results: Hypertension was observed in 30 children in age groups of 3-14 years old from the second to fourth day after orthopaedic surgery, without any previous history of hypertension. Severe hypertension was demonstrated in 4 boys and 2 girls and returned to normal after changing of the traction angles and alignments of fixators. 24 cases had moderated increase in blood pressure that was normal on sixth post operative day. Femoral shaft fractures treated with skeletal traction, postsurgical casting of clubfoot deformities and leg-lengthening with external fixator were the top three causes of such findings.Conclusions: Secondary hypertension may happen among children undergoing orthopaedic procedures and needs careful monitoring.
Mohammadreza Guity, MD; Arash Sharafat Vaziri, MD
Abstract
acromioclavicular joint separation such as screw fixation, pin fixation, coracoclavicular ligaments reconstruction, tension band wiring. One of the recent methods is hook plate fixation.Methods: In a retrospective study, 81 patients with unstable distal clavicular fractures or acromioclavicular joint ...
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acromioclavicular joint separation such as screw fixation, pin fixation, coracoclavicular ligaments reconstruction, tension band wiring. One of the recent methods is hook plate fixation.Methods: In a retrospective study, 81 patients with unstable distal clavicular fractures or acromioclavicular joint separation that were treated with hook plate, were assessed. The assessment included the reliability of fixation method and its impression on subacromial space. Clinical results were charted due to constant score system.Results: All the distal clavicular fractures were solidly united. In the last follow-up, the mean of constant score were 93.6 of 100. We had mild pain during range of motion in 16 patients (19.7%) although they had full range of motion, in 2 cases we had recurrent separation of joint that was revised in 3 weeks after primary operation.Conclusions: Hook plate fixation is a good method for unstable distal clavicular fractures and acromioclavicular joint separation, but we must inform the patient for expectable complications and plate removal necessity.
Mohammad Ali Erfani, MD; Hormoz Nouraei, MD; Seyed Amir Reza Mesbahi, MD; Fatemeh Toubaei, MD
Abstract
Background: The aim of this study was an assessment of patients with adolescent idiopathic scoliosis (AIS) treated by short anterior fusion of the thoracolumbar/lumbar curve.Methods: In a retrospective study, 12 consecutive patients with Lenke 5 type AIS treated by short segment anterior spinal fusion ...
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Background: The aim of this study was an assessment of patients with adolescent idiopathic scoliosis (AIS) treated by short anterior fusion of the thoracolumbar/lumbar curve.Methods: In a retrospective study, 12 consecutive patients with Lenke 5 type AIS treated by short segment anterior spinal fusion during 2002-2005, were evaluated. The Cobb angles of major and minor curves, upper and lower end instrumented vertebrae angulation, disc angulation below the lower end instrumented vertebrae, apical vertebral angulation and translation, sagittal Cobb angles were assessed preoperatively, 4 days post operatively and at the last follow-up. Patients' satisfaction was assessed by SRS-30 questionnaire.Results: The correction of main curve cobb angle was 66.7%. The unfused thoracic curve improved to 50.2% that was comparable with flexibility data. In the major curve, there were an improvement of 92% in the apical vertebral rotation, 74% apical vertebral translation, 75% upper end instrumented vertebra angulation, 79% lower end instrumented vertebra angulation, and 92% correction of disc angulation below the lower instrumented vertebra. There were no significant changes in thoracic kyphosis or lumbar lordosis. The average SRS-30 at the last follow-up was 116 points.Conclusion: We conclude that short segment anterior selective fusion with anterior instrumentation of the thoraco lumbar/ lumbar curve in Lenke 5 scoliosis with a thoracic curve bending to 25º or less, results in a satisfactory correction and a well balanced spine.
Abstract
Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: ...
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Background: The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval.Methods: In a randomized clinical trial study, 71 patients with an average age of 29 years were treated for ACL between 2008 and 2009. Forty six patients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. In the last year of follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.Results: At 36 month follow-up, 34 patients in BPTB and and 28 in ST group, had good-to-excellent IKDC score (p < /em>≥.05).Lachman test was graded normal, for 23 while patients in BPTB and / in ST group, (p < /em>=.043) normal pivot-shift test was present in, 29 and 15 patients, respectively (p < /em>=.038). There was no significant difference in terms of thigh circumference knee effusion, range of motion or pain. The complications rate was also similar.Conclusions: These results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level, and knee function.
