Iranian Journal of Orthopedic Surgery

Abstract Abstract
Total Knee Arthroplasty (TKA) is a surgery performed to treat patients with advanced knee osteoarthritis. Currently, about 95.3% of knee arthroplasties are performed using the cemented technique. Since the introduction of Polymethylmethacrylate (PMMA) cement, it has played a primary role in arthroplasty. Cementless fixation may lead to better survival rates in selected patients, while cemented TKA is believed to have lower infection rates. With the increasing number of TKAs, improving cementing techniques is essential to reduce primary TKA failure and avoid revision surgeries. A narrative review was conducted by searching the MEDLINE database from 2000 to 2024 to investigate the most appropriate cementing techniques in knee replacement. Recent studies have identified several factors affecting the results of cement placement in TKA, such as cement penetration depth, cementing technique, and cement viscosity. Preparing the bone surfaces before cementing is essential to ensure adequate cement penetration. Bone surfaces must be thoroughly dried before cementing. For optimal cement penetration, sclerotic surfaces should undergo drilling. Poor cementing technique is associated with loosening of the prosthesis leading to early or late joint replacement failure. Therefore, it is essential to use an accurate cementing method at the time of TKA to avoid aseptic loosening and, early failure of TKA.

Abstract Abstract
Corticosteroids are widely used medications with increasing prevalence in clinical practice. In autoimmune and rheumatological diseases, the use of corticosteroids in both pulsed and long-term manners is very common. Due to the COVID-19 pandemic, their consumption increased. However, long-term use is associated with several adverse effects on the musculoskeletal system, including osteoporosis, an elevated risk of fracture, avascular necrosis, hypocalcemia, hypovitaminosis D, and impaired bone growth in children. Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis. Several factors, such as age, time of use, family history of osteoporosis, previous fractures, and calcium intake, contribute to its prevalence. Corticosteroids exert their effects by disrupting the balance between the activity of osteoblasts and osteoclasts. These medications also disturb the calcium metabolism by altering intestinal calcium absorption and renal calcium excretion. To minimize these side effects, corticosteroid therapy should be limited whenever possible. Also, supplementing with calcium and vitamin D, incorporating breaks of at least three months between corticosteroid courses, and considering alternative therapies, especially in pediatric patients, can help mitigate the potential risks.

Abstract Introduction: Knee pain is one of the most common musculoskeletal complaints in children and adolescents. There are relatively wide differential diagnoses for knee monoarthritis in children. One of the causes of knee pain and swelling is the discoid meniscus which as the most common congenital anomaly of the knee, can have a wide range of symptoms such as pain, swelling, limited range of motion, and mechanical symptoms including clicking, snapping, popping, and locking of the knee. Therefore, it is necessary to accurately understand this disease and distinguish it from other diseases that show these symptoms. The purpose of this study is to introduce a disease with chronic knee pain and swelling with the diagnosis of discoid meniscus to show that a strong clinical view is necessary to be able to diagnose this disease in children, especially in cases that occur at a younger age.
Case presentation : The patient is a 6-year-old girl who presented with pain, swelling, and limited range of motion in the left knee since 4 years ago, and during this period, she was treated with the diagnosis of Juvenile Rheumatoid arthritis(JRA). Due to the lack of response to treatment and after more examination and consultation with the knee surgeon, the discoid meniscus was diagnosed as her real disease discoid meniscus was diagnosed as his real disease. The patient underwent arthroscopic saucerization and lateral meniscus repair.
conclusion: According to this study, discoid meniscus should be considered as an important, rare differential diagnosis in children presenting with knee pain and swelling.