Iranian Journal of Orthopedic Surgery

Abstract Introduction: Anterior cruciate ligament (ACL) rupture disrupts knee stability and increases the risk of subsequent meniscal injury and degenerative joint disease. (ACL) reconstruction is one of the most common orthopedic surgeries. This study was conducted with the aim of investigating the effect of pre-operative and post-operative physiotherapy of ACL reconstruction with hamstring autograft on the success rate of surgery based on the eight parameters of Lysholm knee scoring scale (LKS) one year after the operation.
Method: In this descriptive-analytical study 140 patients underwent ACL reconstruction surgery with hamstring autograft after cruciate ligament rupture in Imam Khomeini Hospital of Ahvaz between 2020 and 2024. The relationship between the number of pre-operative and post-operative physiotherapy sessions and the starting time of post-operative physiotherapy with (LKS) one year after the operation was analyzed using SPSS version 22 software.
Results: In this study 112 men and 28 women were examined. There was no significant relationship between the (LKS) score and the number of pre-operative and post-operative physiotherapy sessions, but the (LKS) score was higher in patients who had 1 to 10 pre-operative physiotherapy sessions and in patients who had less than 10 post-operative physiotherapy sessions. Also the patients who started their physiotherapy in the first week after the operation had much better results.
Conclusion: Although the number of physiotherapy sessions before and after the operation of ACL reconstruction with hamstring autograft does not have a clear effect on the results of the operation but the patients who did physiotherapy before the operation compared to the patients who had no experience of physiotherapy before the operation and also patients who started their physiotherapy sooner after the operation had better results.

Abstract Abstract
Introduction: This study aimed to find a statistical relationship between clinical and functional findings based on the Lysholm scoring scale in the success rate of surgery and patient satisfaction with the arthroscopic reconstruction of the anterior cruciate ligament (ACL).
Method: This prospective and cross-sectional study was performed on 38 patients (42 knees) aged 17 to 45 years who underwent anterior cruciate ligament (ACL) reconstruction during 2018-2019 due to ACL rupture at Imam Khomeini Hospital in Ahvaz.6 and 12 months after surgery, clinical trials of "anterior drawer" and "Lachman test" were performed, and the standard Lysholm questionnaire for patients was completed. Then, the compatibility of the test results with the results of the Lysholm questionnaire and MRI was assessed.
Results: In the diagnosis of ACL rupture, 6 months after surgery, the highest sensitivity was related to the anterior drawer and Lysholm scale tests, and the highest specificity was related to the Lachman test. Also, the highest positive predictive value was related to the Lachman test and the highest negative predictive value was related to the anterior drawer and Lysholm scale tests. 12 months after surgery, the highest sensitivity was related to the Lysholm scale and the highest specificity was related to the Lachman test. The highest positive predictive value was for the Lachman test and the highest negative predictive value was for the Lysholm scale. In the first 6 months, graft failure was observed in 13.6% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 28.95%. In the second 6 months, graft failure was observed in 7.14% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 19.05%.
Conclusion: Since in some cases, such as excessive knee diameter due to obesity or swelling, the examination may be limited and citation of clinical test results may be erroneous, it is recommended that in addition to mechanical tests such as the Lachman test and the anterior drawer test, standard questionnaires such as Lysholm be used to more accurately assess the success of surgery and treatment, as well as to help identify more accurate lesions.
 

Abstract Abstract
Introduction: This study aimed to investigate the risk factors and the effectiveness of calcium and vitamin D intake in controlling the progression of osteoporosis.
Methods: This was a retrospective medical records study of the patients with osteoporosis, assessed from 2014 to 2018 in the bone density measurement center of Imam Khomeini Hospital in Ahvaz. Patients with a T-score of less than -2.5 and patients with at least two repeat tests in their medical records were included. After collecting patient information, the correlation between osteoporosis and  positive or negative  history of underlying disease or family history was evaluated. The effectiveness of calcium and vitamin D in controlling the progression of osteoporosis in those patients was also assessed.
Results: 16% of patients had a positive family history and 51% of patients had an underlying disease that was not significantly associated with osteoporosis. Decreased bone density in the spine area and femoral neck was significantly lower in people without basal calcium deficiency disease (P = 0.04). Changes in bone density between patients with and without underlying disease receiving calcium-D supplementation were significantly different (P = 0.02) so that in people with underlying disease, the decrease in bone density was significantly higher. There was no significant difference in changes in bone density in the spine and femoral neck between patients with and without the underlying disease who had not received calcium-D supplementation (P = 0.64).
Conclusion: Based on the results of the present study, there was no significant correlation between low densitometry measurements and osteoporosis in those with underlying problems like old age, nutritional factors, lifestyle and inactivity, smoking, menopause in women and low testosterone levels in men. It is important to pay attention to other risk factors in this population of patients. Calcium-D supplementation had shown a meaningful efficacy in patients without underlying disease, but this efficacy was not observed in patients with underlying disease.