Iranian Journal of Orthopedic Surgery

Abstract One of the common complications after total knee replacement surgery is pain and instability in the patellofemoral joint, which significantly impacts patients' quality of life. Statistics show that 8–12% of revision knee replacement surgeries are due to issues related to the patellofemoral joint. A critical concern during surgery is patellar maltracking, which is frequently observed. This condition occurs when the patella does not move along its proper path, leading to functional problems and pain. Various methods have been introduced to evaluate and correct patellar maltracking. This review article addresses different aspects of this issue, including: Definition of patellofemoral maltracking, factors affecting patellar tracking, intraoperative evaluation of patellar tracking, the concept of Perfect Patellar Tracking, Surgical methods to correct patellar maltracking. This article aims to provide a comprehensive perspective on the importance of proper correction of patellar tracking to improve surgical outcomes and patients’ satisfaction.

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.