Iranian Journal of Orthopedic Surgery

Abstract Introduction
Malnutrition is an underestimated problem in the general hospitalized population. Although most physicians are aware of the risk of malnutrition, half of malnourished patients are not identified during their hospitalization. The aim of this study was to investigate the prevalence of malnutrition in traffic injured trauma patients referred to Kashani Hospital affiliated to Isfahan University of Medical Sciences.
Methods
Sixty patients were selected by simple random sampling from injured trauma patients. Required variables such as age, sex, height, weight, albumin, lymphocytes were extracted and recorded by asking the patient or the patient's file. In addition, malnutrition of patients was assessed using SGA (Subjective global assessment - Diagnosing Malnutrition) questionnaire.
Results
About 28% of traumatic patients admitted to Kashani Hospital were assessed as having proper nutritional status. However, about 72% of patients with mild to severe malnutrition were classified. Also, the nutritional status of patients was not significantly different between men and women (P-value = 0.838).
Discussion
In this study, 26.7% of patients (95% CI: 15.0-38.3) had mild to moderate malnutrition and 45% of patients (95% CI: 31.7-56.7) had severe malnutrition. Serum albumin was statistically significantly associated with malnutrition (P-value, 0.004).
Conclusion
To improve treatment outcomes and reduce hospitalization costs, nutritional screening and identification of patients in need of nutritional therapy, especially in patients with severe trauma, is emphasized.

Abstract Abstract

Title: Factors associated with longer hospitalization in patients undergoing total hip arthroplasty
Introduction: Total hip arthroplasty is one of the most successful and cost-benefit interventions in health care. The present study was designed and performed to determine the factors affecting the long-term survival of patients after total hip arthroplasty.
Material and Methods: In this retrospective cross-sectional study, 100 patients who underwent hip arthroplasty from September 2017 to March 2019 were included in the study. Patients who underwent hip arthroplasty reoperation or bilateral hip arthroplasty surgery were excluded from the study.
Results: The mean duration of hospitalization was 5.91± 1.8 days. The mean age of patients in the study was 56.37± 14.79 years and the mean duration of surgery was 2.76 ± 0.36 hours. There was no significant relationship between length of hospital stay and age and duration of surgery. Women made up 42.0% of the study population and 46.0% of patients had a history of at least one underlying disease. There was no significant difference between men and women (5.88 vs. 5.93 days) and individuals with and without underlying disease (5.88 vs. 5.93 days) in of length of hospital stay. Individuals who received blood during surgery had significantly longer hospital stays (6.63 vs. 5.57 days). Also, the type of anesthesia (general 5.76 days and spinal 6.22 days) and the type of surgery (emergency 6.48 days and elective 5.79 days) had no effect on the duration of hospitalization.
Conclusion: The results of this study showed that blood transfusion is associated with increased length of hospital stay in patients. There was no significant relationship between length of hospital stay and gender, age, past medical history, type of anesthesia, type of surgery and duration of surgery.

Abstract Abstract
Background: Considering the high prevalence of anterior cruciate ligament (ACL) injuries, several attempts have been made to repair the ligament to bring it closer to the natural anatomy. Using autografts such as the semi tandinousus and gracilis tendons (double-strand method) is the common surgical method to reconstruct ACL. However, to reconstruct ACL, using an autograft of quadrupled semitendinosus grafts (single-strand method) may have the same results and fewer complications than the first technique. Yet, there is not enough evidence in this regard. In this study, the results of using the two autografts to reconstruct ACL were compared.
Methods: Patients with ACL tear were enrolled in the study and divided into two groups (undergoing double-strand or single-strand graft surgery). After operation, all patients were assessed by using clinical examinations and Iysholm questionnaire. The results were compared between two groups.
Results: Twenty nine patients under 30 years were enrolled in the study; 19 patients in the single- strand (n = 19) and 20 patients in the double strand groups (n = 20). There was no significant difference between two groups in terms of height, weight, body mass index (BMI), complications, and scores of Iysholm and pivot shift tests.
Conclusion: There were not significant difference between the two groups in terms of height, weight, BMI, complications and activity. Therefore, depending on the patient's condition and the length and diameter of the graft, one or both of the methods can be selected to reconstruct ACL.
Keywords: Anterior cruciate ligament; Autologous Transplantation; Autograftings

Abstract Background/objective: Tendon allografts are valuable tools for reconstructing tendon tissues in several anatomical sites, when autograft or tendon transfer is not available or feasible. For the aim of introducing an ideal tendon graft, in the following investigation, a specific allograft tendon was processed and characterized.
Methods: Tendon allograft obtained from hallucis longus and digitorum longus tendon named Double Tendon (DT) was evaluated regarding its structural stability as well as in-vitro biological compatibility. On this basis, a clinical trial including 20 male patients aged between 30-40 years was performed via designing a questionnaire and asking the surgeons to evaluate the predefined qualifications (such as stabilization, repairability, handling, sizing, etc.) of DT during and post-surgery in a 1-year follow-up on a 4-stage ranking (excellent, very good, good, and fail).
Results and discussion: According to performed evaluations, this product was capable of tensile load bearing to the ultimate extent of 7.33 ± 0.87 MPa, which is acceptable for a tendon substitute concerning the literature. Regarding the cytocompatibility results, the cellular viability on DT with 98.13 ± 0.18 % was not significantly lower than the cell viability of the control sample. Also, based on the statistical analysis, the surgeons reported satisfaction with DT’s structural attributes and clinical effectiveness since no “fail” was observed in any parameters. Additionally, there were no instances of inflammation, infection, or rejection reported following DT transplantation.
Conclusion: Herein, the DT was introduced as safe and efficient substitute for the aim of tendon tissue repair.

Abstract In this study, the biomechanical behavior of individuals before and after laminoplasty surgery has been compared with the aim of measuring the ability of finite element modeling in facilitating technologies for diagnosis, treatment and prevention of cervical spine injuries and also determine its role in improving the standardization of surgery and reducing complications in patients. The main goal of this research is to extract the personalized parametric finite element model of patients so that it can be used to predict the biomechanics of the cervical spine of patients after laminoplasty. In this sense, first, a personalized geometric parametric model is created based on 16 anatomical parameters that are extracted from the patient's radiographic images. In this research, Mimics 2012 software was used to gather 2D CT images and convert them into point clouds and make initial corrections of point clouds. The software used for modification, leveling and finally creating 3D models was Geomagic Studio 2012. After modeling all the tissues of the neck, the model was entered into the Abaqus 2012 finite element software, and in this software, the process of simulation and analysis of the cervical spine took place. Therefore, in the current research, an attempt was made to create a geometric model in the modeling of volumetric tissues as well as in the modeling of ligaments and muscles with very high accuracy, in order to create a suitable platform for future studies on the properties of materials and the behavior of tissues, away from the fear of geometric model problems.