Hamid Namazi; Fatemeh Dehghani Nazhvani
Abstract
Osteoarthritis is a chronic systemic disease that can involve any joint in the body, but more often lower limb bearing joints and hand joints. The prevalence of this disease in humans increases with age and obesity. Biomechanical and biological changes that occur after knee injuries are involved in the ...
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Osteoarthritis is a chronic systemic disease that can involve any joint in the body, but more often lower limb bearing joints and hand joints. The prevalence of this disease in humans increases with age and obesity. Biomechanical and biological changes that occur after knee injuries are involved in the development of post-traumatic osteoarthritis and, as a degenerative joint disease, cause irreversible hyaline cartilage destruction; which reduces the quality of life by causing permanent pain and joint dysfunction.
In order to better understand how osteoarthritis progresses, it needs to be modeled in animals; especially in the early stages of the disease, as well as the evaluation of the effects of new drugs and therapies. These models can be spontaneous or inductive. Spontaneous osteoarthritis can occur naturally in genetically engineered strains of rats. Intra-articular injection of chemicals such as mono-iodiacetate can also induce osteoarthritis. Today, many surgical modelings are also used to induce osteoarthritis, all of which indicate joint instability to cause the disease. Guinea pigs are commonly used for research on articular cartilage and are common models for studying the reconstruction process of focal cartilage defects. The development of experimental conditions inducing osteoarthritis is similar to the natural course of the disease in human due to joint instability and the final gross pathology is exactly the same.
The recent used methods to modeling osteoarthritis include the removal of lateral meniscus and anterior cruciate ligament transection, which appear to reduce inflammation and only create a mild joint instability; that way not only creates repeatable lesions in the model, but also the same kind as the lesions of osteoarthritis in humans. This method allows for the evaluation of cartilage degeneration by radiography, histology and molecular analysis.
Babak Siavashi
Abstract
Abstract
Introduction: In some special situations during the revision total hip arthroplasty with well fixed, well oriented acetabular cementless cup, orthopedic surgeons may prefer to retain the well-fixed cementless cup. The aim of this study was to report the follow-up of some cases treated with ...
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Abstract
Introduction: In some special situations during the revision total hip arthroplasty with well fixed, well oriented acetabular cementless cup, orthopedic surgeons may prefer to retain the well-fixed cementless cup. The aim of this study was to report the follow-up of some cases treated with such a technique during a 10-year period.
Methods: During 2004-2014, all cases of revision total hip surgery performed in Sina Hospital, Tehran, Iran were evaluated. 14 of 82 cases (16.5%) had cemented polyethylene liner in cementless metal shell. The demographic data, reasons for use of such revision technique result was evaluated by Harris Hip Score.
Results: The most common reason was osteolysis (64%), and the most common cause was impaired locking mechanism (65%). There were few complications (one osteolysis and one infection). In five cases (36%) constrained liner was added and in 10 cases (72%) allograft was needed. The final Harris Hip Scores was good or excellent in 78%. Only one dislocation was seen.
Conclusion: Cemented cup in cementless shell can be used in revision hip arthroplasty in well-fixed Acetabular shell situations with acceptable outcom.
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.
A Mavian; F Biglari; S Shabani; H Mahdavi Mohtasham; S M Kazemi
Abstract
Background: The outcome of ankle fractures treatment is great importance. The purpose of the present study was to investigate the outcome of ankle fractures treatment by open reduction method and internal fixation.
Material and Methods: The method of study was cross-sectional. A total of 169 patients ...
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Background: The outcome of ankle fractures treatment is great importance. The purpose of the present study was to investigate the outcome of ankle fractures treatment by open reduction method and internal fixation.
Material and Methods: The method of study was cross-sectional. A total of 169 patients with ankle fracture who underwent open surgical and internal fixation surgery were the statistical sample. Patients were evaluated by a Clinical rating system for the ankle and hindfoot and eventually gave them a point from 100.
Results: Of the 169 samples, 53 were female and 116 were male. The average a Clinical rating system for the ankle and hindfoot was 51 (95% CI 49-53). The most common fractures type was bimalleoalr fracture. The majority of patients suffering from daily dysfunction and pain, their gait pattern was also changed.
Conclusions: According to the results and available studies, the results of surgical treatment of ankle fractures were not optimal and further investigation and finding more appropriate intervention methods were needed in order to obtain the desired results. To achieve optimal surgical outcome, it is recommended that the time interval between injury and surgery should not exceed 4 days.
M Shayestehazar; M Shayestehazar; MH Karimi nasab; S Ghafari; M Razavi pour; M Mahmoudi; E Moayed Abedi
Abstract
Backgrounds: Various studies have been conducted on the local and systemic effects of orthopedic hardware. This study aimed to evaluate the pathologic reactions to orthopedic hardware (nail and plate) in patients.
Methods: In this descriptive study, the pathologic reactions of 15 patients (12 males ...
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Backgrounds: Various studies have been conducted on the local and systemic effects of orthopedic hardware. This study aimed to evaluate the pathologic reactions to orthopedic hardware (nail and plate) in patients.
Methods: In this descriptive study, the pathologic reactions of 15 patients (12 males and 3 females) with a mean age of 37.41 years, who underwent orthopaedic hardware removal surgery in two Hospitals in Sari, Iran, were assessed through observation, laboratory tissue evaluation, and a questionnaire.
Results: In this research, no allergic reaction was observed in the patients after the insertion of hardware. In this regard, 6.66% of patients reported infection after insertion of hardware, and there was one case of non:::union:::. Furthermore, no systematic complication was observed in any of the patients. The majority of patients had moderate tissue inflammation at the hardware site, and there was no evidence of malignancy in any of the pathology samples.
Conclusion: According to the results of the research, a moderate level of tissue inflammation might be observed at the site of orthopedic hardware placement.
S M Kazemi; MR Abbasian; M Karimzadeh; F Safdari; H Mahdavi Mohtasham
Abstract
Background: Distal femoral intra-articular fractures (DFIAF) can be very challenging. Although, satisfactory outcomes have been reported, however, there are several complications interfering the patients after treatment. In current retrospective study, the outcomes of treating DFIAF with ...
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Background: Distal femoral intra-articular fractures (DFIAF) can be very challenging. Although, satisfactory outcomes have been reported, however, there are several complications interfering the patients after treatment. In current retrospective study, the outcomes of treating DFIAF with open reduction internal fixation (ORIF) using locking plates (LCP) were investigated.
Material and Methods: There were 51 patients enrolled. In last visit, Lysholm score was completed for all of the patients. Pain intensity and satisfaction were measured using visual analogue scale (VAS). Degenerative changes were assessed on plain x-rays. Bilateral knee range of motion was measured and compared. The patients were followed for 17.4±7.2 months.
Results: Fractures were united in all of the patients. Degenerative changes were found in 15 patients (29.4%). The pain intensity was 2.7±1.3. Nineteen patients required to use analgesics (37.2%). VAS for satisfaction averaged 7.7±1.1. The Lysholm score averaged 81.8±8.3. The range of knee motion was significantly limited inn operated side compared to the healthy one (116.6±12.4 Vs 125.3±7.3; p<0.001).
Conclusions: Treatment of DFIAF using ORIF can be associated with complete fracture healing. However, the incidence of degenerative changes and consequent complications such as pain and loss of ROM are considerably concerning.
Kamran Badizadeh
Abstract
Abstract
Adequate control of postoperative Pain following Hip and knee arthroplasty can be challenging Task. Previous studies have shown that over 50% of Patients undergoing surgery, report Postoperative pain as a major concern. TKA patients complain of more pain than THA patients. Consequences of ...
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Abstract
Adequate control of postoperative Pain following Hip and knee arthroplasty can be challenging Task. Previous studies have shown that over 50% of Patients undergoing surgery, report Postoperative pain as a major concern. TKA patients complain of more pain than THA patients. Consequences of uncontrolled pain can lead to myocardial Ischemia and Infarction, pulmonary infections, paralytic Ileus, Urinary retention, thromboembolism, impaired immune function as well as anxiety and chronic postsurgical pain. Inadequate control of pain may result in patient dissatisfaction, impaired patient rehabilitation, and prolonged hospitalization. Functional recovery and return of muscle strength dependant on the ability of these patients to comply with rehabilitation, and pain control can provide the above mentioned requirements especially for knee Arthroplasty patients(4).
