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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Knee arthroplasty,Genu varum,Genu valgum,Hindfoot alignment
- چکیده:
- چکیده انگلیسی: Background: The maintenance of deformity in the ankle and hindfoot after correction of knee deformity following knee
arthroplasty may cause abnormal tension in the knee and patient dissatisfaction. The aim of this study was to determine
the effect of knee arthroplasty on the hindfoot alignment in patients with severe genu varum and valgum.
Methods: A total of 84 patients with primary osteoarthritis, were enrolled in the study. The knee deformity was measured
using a long leg film before surgery. The long axial radiographic view of hindfoot was taken in the standing position for
all patients, before and six months after surgery. Comparisons were made on changes in the hindfoot angles measured
before and after surgery.
Results: A total of 84 patients with mean age of 62.28 ± 7.77 years, 77 (92%) and seven patients (eight percent)
had knee varus and valgus deformity, respectively. In the knee varus group, the mean preoperative hindfoot angle
was + 5.32 ± 6.12 ° (valgus) which was changed to - 0.25 ± 4.91 ° (varus) in the postoperative phase. In the knee
valgus group, the mean pre and postoperative hindfoot angles were - 7.71 ± 7.06° (varus) and - 2.14 ± 5.92 ° (varus),
respectively. The mean preoperative hindfoot angle in severe and very severe varus knee groups were + 5.45 ± 3.30
and + 5.28 ± 6.86 °, respectively. These angles were changed to + 0.21± 5.17 and -1.60 ± 3.89° six months after
surgery, respectively. The mean preoperative hindfoot angle in severe and very severe valgus knee deformity groups
were - 7.00 ± 4.69 and -8.66 ± 10.69 °, respectively. These angles were changed to - 2.00 ± 5.71 and - 2.33 ± 7.50
°after surgery, respectively. There was no significant difference between patients with severe and very severe deformity
in terms of pre and post-operative hindfoot angle.
Conclusion: The hindfoot alignment is significantly corrected after knee arthroplasty. The severity of knee deformity
does not correlate with the severity of the hindfoot deformity before and after surgery.
Level of evidence: I- انتشار مقاله: 10-05-1397
- نویسندگان: Hosseinali Hadi,Mahmood Jabal Amoli,Abolfazl Bagherifard,Ahmadreza Behrouzi,Fatemeh Safi,Amir Azimi,Mahtab Ghanbari,Gholamreza Azarnia Samarin
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Anterior Cruciate Ligament,Knee arthroplasty,Femoral intercondylar notch
- چکیده:
- چکیده انگلیسی: Background: The presence of cruciate ligaments is very important for normal knee kinematics. Knee arthroplasty
prostheses, in which these ligaments are maintained, have better kinematics. The aim of the present study was to
investigate the association between femoral intercondylar notch (FIN) narrowing in radiography and clinical and
histopathologic integrity of anterior cruciate ligament (ACL) in patients undergoing knee replacement surgery.
Methods: FIN index was measured in tunnel view radiography of the knees of 102 candidates of knee replacement
surgery. The anatomical status of ACL was also examined during total knee arthroplasty (TKA). ACL was removed and
sent for histopathologic examination to assess its degeneration rate. The association between the FIN index and the
clinical and histopathological health of ACL was investigated.
Results: Among 102 patients with mean age of 69.73 ± 7.81 years , 39 patients (38.32%) had no or torn ACL, 31
patients (30.39%) had weak ACL, and 32 (31.37%) had normal ACL. There was a significant association between age
and clinical status of ACL during surgery (P=0.017). There was a significant difference in FIN and ACL health status
during surgery between the two groups with an index of more and less than 0.252 (P=0.019 and P=0.019, respectively).
There was no significant difference in the mean total degeneration score (TDS) of ACL between the two groups with FIN
more and less than 0.252 (P=0.816).
Conclusion: There was a significant difference between the age and FIN narrowing (less than 0.252) as well as ACL
clinical status during surgery. FIN narrowing had no significant effect on the severity of ACL degeneration and there was
no significant difference in the severity of degenerative histopathologic changes between healthy and attenuated ACLs.
This indicates that if ACL exists, although apparently attenuated, it has the histologic characteristic of a healthy ligament.
Level of evidence: II- انتشار مقاله: 10-05-1397
- نویسندگان: Hosseinali Hadi,Ali Rahbari,Mahmood Jabalameli,Abolfazl BagheriFard,Ahmadreza Behrouzi,Fatemeh Safi,Zahra Rezaei,Gholamreza Azarnia Samarin,Amir Azimi
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Outcome,complication,Multiligament knee injury,reconstruction surgery
- چکیده:
- چکیده انگلیسی: Background: Multiligament knee injury (MLKI) is a complex orthopedic injury leading to the tear of at least two of
the major knee ligaments. However, there is no consensus on the optimal management of this debilitating condition.
Regarding this, the present study was performed to evaluate the outcomes of single-stage multiligament reconstruction
surgery in patients with MLKI.
Methods: This retrospective study was conducted on 41 consecutive MLKI patients who underwent surgical
reconstruction. Objective evaluation of the outcome included active extension and flexion. Furthermore, the subjective
evaluation of the outcome was accomplished using the Lysholm scoring scale and International Knee Documentation
Committee (IKDC) form in Persian. Postoperative complications were also recorded for all patients.
Results: The mean age of the participants was 31.95±7.82 years. In addition, the mean follow-up period and the
mean time interval between the injury and surgery were recorded as 36.9±17.8 and 11.5±8.9 months, respectively. The
mean Lysholm and IKDC scores were obtained as 86.9±11.5 and 70±18.7, respectively. The mean Lysholm and IKDC
scores were not statistically different between the patients who underwent surgery less than 6 months after the injury
and those subjected to reconstruction 6 months postinjury (P=0.07 and P=0.3, respectively). Seven patients showed
postoperative restricted range of motion, which was resolved with physiotherapy. The only surgical complication was
popliteal artery injury.
Conclusion: As the findings indicated, the single-stage reconstruction of MLKI provided an acceptable outcome.
However, several aspects of this reconstruction, such as the timing of the surgery, still remain to be resolved in future
investigations.
Level of evidence: IV- انتشار مقاله: 13-03-1397
- نویسندگان: Abolfazl BagheriFard,Mahmoud Jabalameli,Salman Ghaffari,Jafar Rezazadeh,Majid Abedi,Masoud Mirkazemi,Javad Aghamohamadi,Afshin Hesabi,Mehdi Mohammadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Anterior Cruciate Ligament,hip extension,isokinetic testing
- چکیده:
- چکیده انگلیسی: Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament
(ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sports
that need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in this
area, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using different
types of grafts.
Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compare
isokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in group
A (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendon
allograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D
(only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- and
six-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases)
and non-operated (controls) limbs.
Results: There was a significant increase in hip extension force between three and six month intervals in all four
groups and in both operated (case) and non-operated (control) limbs (P<0.05, 95% CI). However, there was more
increase in case limbs in comparison to control limbs. There was no significant difference in hip extension strength
among all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests.
Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one or
both hamstrings had no deleterious effect on hip extension force.
Level of evidence: III- انتشار مقاله: 15-02-1397
- نویسندگان: Hosseinali Hadi,Abolfazl Bagherifar,Fereshte Tayebi,Majid Ansari,Ali Shahsavaripour,Iman Qomashi,Mahmoud Jabalameli
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Registry,knee,Hip,Arthroplasty,Total joint replacement
- چکیده:
- چکیده انگلیسی: Joint replacement is currently on the rise with a high community burden. A registry was designed to evaluate the costs,
possible complications, and rate of revisions as well as finding the most effective techniques, risk factors associated
with poor results, indications for revision surgeries, and also demographic evaluation of patients undergoing joint
replacement surgery in Iran.
Level of evidence: V- انتشار مقاله: 19-03-1397
- نویسندگان: Arvin Najafi,Abolfazl Bagherifard,Mohammad H. Kaseb,Seyed Mohamadjavad Mortazavi,Pejman Mansouri
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Anterior Cruciate Ligament,Knee arthroplasty,Femoral intercondylar notch
- چکیده:
- چکیده انگلیسی: Background: The presence of cruciate ligaments is very important for normal knee kinematics. Knee arthroplasty
prostheses, in which these ligaments are maintained, have better kinematics. The aim of the present study was to
investigate the association between femoral intercondylar notch (FIN) narrowing in radiography and clinical and
histopathologic integrity of anterior cruciate ligament (ACL) in patients undergoing knee replacement surgery.
Methods: FIN index was measured in tunnel view radiography of the knees of 102 candidates of knee replacement
surgery. The anatomical status of ACL was also examined during total knee arthroplasty (TKA). ACL was removed and
sent for histopathologic examination to assess its degeneration rate. The association between the FIN index and the
clinical and histopathological health of ACL was investigated.
Results: Among 102 patients with mean age of 69.73 ± 7.81 years , 39 patients (38.32%) had no or torn ACL, 31
patients (30.39%) had weak ACL, and 32 (31.37%) had normal ACL. There was a significant association between age
and clinical status of ACL during surgery (P=0.017). There was a significant difference in FIN and ACL health status
during surgery between the two groups with an index of more and less than 0.252 (P=0.019 and P=0.019, respectively).
There was no significant difference in the mean total degeneration score (TDS) of ACL between the two groups with FIN
more and less than 0.252 (P=0.816).
Conclusion: There was a significant difference between the age and FIN narrowing (less than 0.252) as well as ACL
clinical status during surgery. FIN narrowing had no significant effect on the severity of ACL degeneration and there was
no significant difference in the severity of degenerative histopathologic changes between healthy and attenuated ACLs.
This indicates that if ACL exists, although apparently attenuated, it has the histologic characteristic of a healthy ligament.
Level of evidence: II- انتشار مقاله: 10-05-1397
- نویسندگان: Hosseinali Hadi,Ali Rahbari,Mahmood Jabalameli,Abolfazl BagheriFard,Ahmadreza Behrouzi,Fatemeh Safi,Zahra Rezaei,Gholamreza Azarnia Samarin,Amir Azimi
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Outcome,complication,Multiligament knee injury,reconstruction surgery
- چکیده:
- چکیده انگلیسی: Background: Multiligament knee injury (MLKI) is a complex orthopedic injury leading to the tear of at least two of
the major knee ligaments. However, there is no consensus on the optimal management of this debilitating condition.
Regarding this, the present study was performed to evaluate the outcomes of single-stage multiligament reconstruction
surgery in patients with MLKI.
Methods: This retrospective study was conducted on 41 consecutive MLKI patients who underwent surgical
reconstruction. Objective evaluation of the outcome included active extension and flexion. Furthermore, the subjective
evaluation of the outcome was accomplished using the Lysholm scoring scale and International Knee Documentation
Committee (IKDC) form in Persian. Postoperative complications were also recorded for all patients.
Results: The mean age of the participants was 31.95±7.82 years. In addition, the mean follow-up period and the
mean time interval between the injury and surgery were recorded as 36.9±17.8 and 11.5±8.9 months, respectively. The
mean Lysholm and IKDC scores were obtained as 86.9±11.5 and 70±18.7, respectively. The mean Lysholm and IKDC
scores were not statistically different between the patients who underwent surgery less than 6 months after the injury
and those subjected to reconstruction 6 months postinjury (P=0.07 and P=0.3, respectively). Seven patients showed
postoperative restricted range of motion, which was resolved with physiotherapy. The only surgical complication was
popliteal artery injury.
Conclusion: As the findings indicated, the single-stage reconstruction of MLKI provided an acceptable outcome.
However, several aspects of this reconstruction, such as the timing of the surgery, still remain to be resolved in future
investigations.
Level of evidence: IV- انتشار مقاله: 13-03-1397
- نویسندگان: Abolfazl BagheriFard,Mahmoud Jabalameli,Salman Ghaffari,Jafar Rezazadeh,Majid Abedi,Masoud Mirkazemi,Javad Aghamohamadi,Afshin Hesabi,Mehdi Mohammadpour
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Anterior Cruciate Ligament,hip extension,isokinetic testing
- چکیده:
- چکیده انگلیسی: Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament
(ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sports
that need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in this
area, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using different
types of grafts.
Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compare
isokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in group
A (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendon
allograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D
(only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- and
six-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases)
and non-operated (controls) limbs.
Results: There was a significant increase in hip extension force between three and six month intervals in all four
groups and in both operated (case) and non-operated (control) limbs (P<0.05, 95% CI). However, there was more
increase in case limbs in comparison to control limbs. There was no significant difference in hip extension strength
among all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests.
Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one or
both hamstrings had no deleterious effect on hip extension force.
Level of evidence: III- انتشار مقاله: 15-02-1397
- نویسندگان: Hosseinali Hadi,Abolfazl Bagherifar,Fereshte Tayebi,Majid Ansari,Ali Shahsavaripour,Iman Qomashi,Mahmoud Jabalameli
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Registry,knee,Hip,Arthroplasty,Total joint replacement
- چکیده:
- چکیده انگلیسی: Joint replacement is currently on the rise with a high community burden. A registry was designed to evaluate the costs,
possible complications, and rate of revisions as well as finding the most effective techniques, risk factors associated
with poor results, indications for revision surgeries, and also demographic evaluation of patients undergoing joint
replacement surgery in Iran.
Level of evidence: V- انتشار مقاله: 19-03-1397
- نویسندگان: Arvin Najafi,Abolfazl Bagherifard,Mohammad H. Kaseb,Seyed Mohamadjavad Mortazavi,Pejman Mansouri
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Recurrence,Sacrum,Giant Cell Tumor,Intralesional curettage
- چکیده:
- چکیده انگلیسی: There are still some debates regarding the best treatment of Giant Cell Tumor (GCT) of the sacrum. Since GCT of this location is rare, therapeutic strategies are mainly based on the treatment of GCT in other anatomic locations. The objective of this study was to evaluate the oncologic and clinical results of surgical management of sacral GCT with and without local adjuvant therapy. Medical records of 19 patients diagnosed with GCT of the sacrum, were retrospectively reviewed. Sixteen patients were treated by intralesional curettage and three patients with marginal resection. Musculoskeletal tumor society (MSTS) score was used for the evaluation of functional outcome. Prolonged pain was the most common complication after treatment. Mean Pre and post-operative pain based on visual analogue scale (VAS) was 6.1 ± 1.99 and 3.05 ± 1.64, respectively. Postoperative neurologic deficit appeared in six patients. In addition, infection occurred in five patients. One case of spinopelvic instability was also observed after surgery. At average follow up of 158.5 ± 95.9 months (25 to 316 months), recurrence was seen in eight (42.7%) out of seventeen patients treated by intralesional curettage. The size of the tumor significantly correlated with the tumor recurrence (r=0.654, P=0.001). Mean MSTS score was 74.7 ± 16.78. Those patients, in whom sacral nerve roots remained intact before and after surgery, had better functional outcome. Preservation of sacral nerve roots is associated with better functional outcome and less pain. Although an acceptable surgical outcome was observed in our cohort, the problem of local recurrence still warrants further investigations for better local control of the tumor.
- انتشار مقاله: 27-10-1395
- نویسندگان: Khodamorad Jamshidi,Abolfazl Bagherifard,Alireza Mirzaei,Mehrdad Bahrabadi
- مشاهده