@article { author = {RODRIGUEZ-MERCHAN, E. Carlos}, title = {Does Intravenous or Intraarticular Tranexamic Acid (TXA) Reduce Joint Bleeding Following Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction and Arthroscopic Meniscectomy? Can Intraarticular Use be Harmful to Chondrocytes?}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {557-559}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.50710.2513}, abstract = {Arthroscopic knee surgery to perform partial meniscectomy and anterior cruciate ligament (ACL) reconstruction is frequent and effective, although a possible complication is postoperative intra-articular bleeding. When this complication occurs, in addition to the associated pain, the patient usually requires an arthrocentesis to avoid loss of joint mobility. Sometimes this problem ends up associated with a poor result of surgery due to loss of knee mobility. Therefore, recently, the use of tranaexamic acid (TXA) has been considered in order to reduce postoperative bleeding and its potential associated complications.}, keywords = {tranexamic acid (TXA),arthroscopic anterior cruciate ligament (ACL),Bleeding,arthroscopic meniscectomy}, url = {https://abjs.mums.ac.ir/article_16458.html}, eprint = {https://abjs.mums.ac.ir/article_16458_5c3da15979a434d40206ce386125b47f.pdf} } @article { author = {Kumar, Ashok and Kadamb, Anikait and Kadamb, Krish}, title = {Mesenchymal or Maintenance Stem Cell & Understanding Their Role in Osteoarthritis of the Knee Joint: A Review Article}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {560-569}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42536.2155}, abstract = {Mesenchymal Stem Cell (MSC) therapy in osteoarthritis has been hailed as a promising treatment for osteoarthritis dueto their unlimited potential of healing and regeneration. Existing literature regarding their proper name, optimal sources,mechanisms of action, dosage, and route of administration, efficacy, and safety is debatable. This index review articlehas tried to connect these puzzling pieces of available information and brought clarity on some of these crucial issues.The author believes that Maintenance Stem Cells (MSC) may be a more suitable term than mesenchymal stem cell ormedicinal signaling cells as their origin might not be limited to mesodermal tissue. Also, they have been shown capableof self-renewal, differentiation, and maintaining a cascade of healing & possibly regeneration at the implanted site. Onlya small percentage of implanted MSC survive and rest undergo apoptosis after releasing growth factors, cytokines, andextracellular vesicles. These surviving MSC become active due to conformational changes induced by anti-environmentstimuli and undergo limited self-renewal, proliferation, and differentiation, but only a few of them might incorporate into thehost tissues. These cells generate & maintain a momentum of series of regenerative activities to improve the function ofjoint, stabilize or possibly enhance the cartilage quality. More randomized studies with long term follow-up are required tobring clarity on their ideal source, expansion, culture technique, optimum dosage, and route of administration and longtermsafety issues.Level of evidence: V}, keywords = {knee,Maintenance Stem Cell,Mesenchymal,Osteoarthritis}, url = {https://abjs.mums.ac.ir/article_16459.html}, eprint = {https://abjs.mums.ac.ir/article_16459_3a267c60e5e4b30878547611305d3180.pdf} } @article { author = {Humes, Charlie and Aguero, Stephanie and Chahla, Jorge and Foad, Abdullah}, title = {Blood Flow Restriction and Its Function in Post- Operative Anterior Cruciate Ligament Reconstruction Therapy: Expert Opinion}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {570-574}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42068.2145}, abstract = {An increasingly popular method for post-operative rehabilitation of an ACL reconstruction, as a substitute for traditionaltherapy, is blood flow restriction therapy (BFR). BFR therapy utilizes a pneumatic cuff to simulate strenuous exercisein an effort to stimulate muscle recruitment, mitigate atrophy, and promote hypertrophy in patients with load-bearinglimitations. Because this is a relatively new form of therapy, there is a lack of established literature and protocol thatis preventing widespread use of the therapy. This article will seek to confirm the value and validity of the utilization ofBFR therapy. In order to validate the utilization of BFR, an evaluation of the science underlying BFR will be discussedas well as the technique and exercises preformed during therapy. Furthermore, analysis of other BFR literature will beutilized to lend further credence to the obtained conclusions. Based on the literature, BFR therapy mitigates atrophythrough type II muscle recruitment while also stimulating hypertrophy in patients, supporting its use post-operatively.Moreover, positive results from BFR case series also lend credence to its value as a substitute for traditional therapyin patients who have weight-bearing limitations, specifically those who are recovering from anterior cruciate ligamentreconstructions.Level of evidence: V}, keywords = {ACL,Blood flow restriction,Reconstruction,Therapy}, url = {https://abjs.mums.ac.ir/article_16460.html}, eprint = {https://abjs.mums.ac.ir/article_16460_292ee78489d8d357840d87de295ca742.pdf} } @article { author = {Apfel, Allison and Lin, Charles C. and Burfeind, William and Dillon, Mark T. and Navarro, Ronald A.}, title = {Characteristics of Rotator Cuff Repairs Revised to Shoulder Arthroplasty}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {575-580}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.39006.2042}, abstract = {Background: Successful repair of a torn rotator cuff may prevent progression to rotator cuff arthropathy. However,previous studies have shown a substantial rate of failure after rotator cuff repair and characteristics of surgicallyrepaired rotator cuffs that go on to shoulder arthroplasty have not been fully elucidated. The purpose of this study wasto determine the patient characteristics and rate at which patients who underwent rotator cuff repair progressed toshoulder arthroplasty.Methods: This was a retrospective study of patients who underwent rotator cuff repair in a large, closed healthcaresystem in 2008. The EMR was queried for rotator cuff repair CPT with ICD-9 codes for rotator cuff. The resultant datasetwas then cross-referenced with a separate internal shoulder arthroplasty registry to determine which patients went ontoshoulder arthroplasty. Demographic variables, descriptors of tear pathology and repair characteristics were collectedand compared between patients who subsequently underwent shoulder arthroplasty and those that did not.Results: A total of 882 rotator cuff repair patients were included within this study. Of the initial 882 cuff repairs, therewere 12 patients (1.4%) that went on to have arthroplasty. Patients who underwent shoulder arthroplasty after rotatorcuff repair were significantly older at time of surgery and had greater comorbidity burdens. Patients who ended up withshoulder arthroplasty had the procedure an average of 4.77 ± 3.28 (SD) years after rotator cuff repair, with 11 of 12patients having a diagnosis of rotator cuff arthropathy at the time of shoulder replacement.Conclusion: In a closed system, tracking rotator cuff repairs over 9.1 years revealed a small number that went onto subsequent shoulder arthroplasty. Patients who underwent shoulder arthroplasty were significantly older and hadgreater comorbidity burdens than those who did not. Patients who underwent shoulder arthroplasty usually eitherhad shoulder arthroplasty within 1 year or after 5 years. Enhanced understanding of which patients may progress toarthroplasty may provide a better initial choice of operative intervention in those patients.Level of evidence: III}, keywords = {failure rate of rotator cuff repair,Revision,Rotator cuff repair,Shoulder Arthroplasty}, url = {https://abjs.mums.ac.ir/article_16308.html}, eprint = {https://abjs.mums.ac.ir/article_16308_1260756cec8ef8a37e75044b43ab12ae.pdf} } @article { author = {Kortlever, Joost T.P. and Tripathi, Shashwat and Ring, David and McDonald, John and Smoot, Brannan and Laverty, David}, title = {Tampa Scale for Kinesiophobia Short Form and Lower Extremity Specific Limitations}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {581-588}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.40004.2073}, abstract = {Background: We compared the amount of variation in Patient-Reported Outcomes Measurement Information SystemPhysical Function (PROMIS PF) Computer Adaptive Test (CAT) accounted for by The Tampa Scale for Kinesiophobia(TSK) and its short form (TSK-4) independent of other factors. Questionnaire coverage, reliability, and validitywere compared for both TSK and TSK-4 using mean scaled scores, internal consistency, floor and ceiling effects,interquestionnaire correlations, and collinearity with other measures as the Pain Catastrophizing Scale short form(PCS-4), PROMIS Depression CAT, and PROMIS Pain Interference (PROMIS PI) CAT.Methods: One hundred forty eight consecutive new or return patients were enrolled. Patients were seen in an outpatientsetting in several orthopaedic clinics in a large urban area. All patients completed the TSK, PROMIS PF CAT, PROMISPI CAT, PROMIS Depression CAT, and PCS-4.Results: Greater fear of movement (higher TSK) was associated with worse physical function (lower PROMIS PF CAT)and the full TSK explained more variation in physical function than the short form (TSK-4). In contrast to prior studiesPCS-4 was not independent of TSK. Flooring and ceiling effects were seen with TSK-4. Worse physical function wasassociated with older age, traumatic condition, and more symptoms of depression.Conclusion: The short form of the Tampa Scale for Kinesiophobia can be used as a brief screening measure in patientcare and research in order to identify an independent influence of kinesiophobia on lower extremity specific limitations.Additional study is needed to determine whether there is utility in screening for both TSK and PCS or if one or theother provides sufficient information about cognitive biases regarding pain to guide treatment with cognitive behavioraltherapy and related techniques.Level of evidence: II}, keywords = {Fear of Movement,Kinesiophobia,lower extremity,Physical Function,TSK-4}, url = {https://abjs.mums.ac.ir/article_16310.html}, eprint = {https://abjs.mums.ac.ir/article_16310_ed0fe938e7ca5056e48ca3a61f1dedf9.pdf} } @article { author = {Haupt, Samuel and Frima, Herman and Sommer, Christoph}, title = {Operative Treatment of Proximal Humeral Fracturedislocations Through an Anterolateral Deltoid Split Approach}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {589-597}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42728.2162}, abstract = {Background: Proximal humeral fracture-dislocations (PHFD) are a special entity in proximal humeral fracturetreatment. The aim of this study is to present our minimally invasive plate osteosynthesis (MIPO) technique throughan anterolateral deltoid split approach. In addition, we performed a retrospective cohort study analyzing the patientreported functional outcome and complications.Methods: A single center cohort study was performed. All patients operated through a deltoid split approach for PHFDbetween 2009 and 2016 were eligible for inclusion. The primary endpoint was subjective shoulder function measured withQuickDASH and subjective shoulder value (SSV). Secondary endpoints were complications and implant-related irritation.Results: 28 patients were included. The mean age was 49 (SD ± 10.3). The mean follow-up was 48 months (SD ±23.7). The mean QuickDASH score was 6.8 (SD ±7.8) and the mean SSV was 86 (SD ±14.6). Four patients had aconversion into a reversed arthroplasty (14%), one patient (4%) a shortening of secondary perforated screws, fourpatients an early re-osteosynthesis (14%), four patients (14%) developed an AVN and in one patient damage of theaxillary nerve was observed. 21 patients (75%) had their implant removed.Conclusion: Patient reported functional results after humeral head preservation and internal fixation of PHFDs throughan anterolateral deltoid spilt approach are promising. However, there is a high rate of re-operations either because ofcomplications or for implant removal. Comparing our data to literature these rates are not depending on the approach chosen.Level of evidence: IV}, keywords = {Fracture fixation,Internal,Minimally Invasive Surgical Procedures,Operative,Shoulder dislocation,Shoulder fractures,Surgical procedures}, url = {https://abjs.mums.ac.ir/article_16461.html}, eprint = {https://abjs.mums.ac.ir/article_16461_f8ab35b1883af9bc59b7d04c9a4bc6e1.pdf} } @article { author = {Abbasian, Mohammadreza and Biglari, Farsad and Sadighi, Mehrdad and Ebrahimpour, Adel}, title = {Reliability of Postoperative Radiographies in Ankle Fractures}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {598-604}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.43134.2173}, abstract = {Background: The accuracy of reduction of ankle fractures using postoperative plain radiographies (x-ray) remainswidely controversial. Some authors have demonstrated that postoperative computed tomography (CT) scan can beuseful for these patients. In current study, the efficacy of x-rays after fixation of ankle fractures was investigated basedon the CT scan findings.Methods: A total of 73 patients with ankle fractures who were subjected to open reduction internal fixation (ORIF) wereenrolled. After surgery, if the reduction was acceptable based on the x-rays according to standard measurements, thepatient was referred for CT scanning. Forty four patients were included in the study. Undesirable CT scan findingsincluding malreduction of fragments or articular surfaces, device malpositioning, missed fractures, and undetectedintra-articular fragments were documented.Results: Undesirable CT findings were seen in 25 patients (56.8%). CT scan showed acceptable reduction withoutdevice malpositioning in 19 patients. The most prevalent findings in CT images were malreduction and devicemalpositioning in 17 and 16 patients, respectively. There was no abnormal finding in CT imaging of lateral malleolarfractures. In two thirds of the injured syndesmosis, device malpositioning, and malreduction were detected in CT scan.Conclusion: Despite acceptable postoperative x-rays, a considerable number of patients with ankle fractures hadinappropriate reduction or undesirable findings in their postoperative CT scan. It seems necessary to use CT scan afterORIF of ankle fractures in order to examine the accuracy of reduction. Further validation of postoperative CT scan inankle fracture surgery should be investigated.Level of evidence: IV}, keywords = {Ankle fracture,Computed Tomography,Device malpositioning,Malreduction,Plain radiography,Syndesmosis}, url = {https://abjs.mums.ac.ir/article_16462.html}, eprint = {https://abjs.mums.ac.ir/article_16462_cbe8fad4a620b77b1f7086fbfb8d43b4.pdf} } @article { author = {Ein-Afshar, Mohammad Javad and Shahrezaee, Mostafa and Shahrezaee, Mohammad and Sharifzadeh, Seyed Reza}, title = {Biomechanical Evaluation of Temperature Rising and Applied Force in Controlled Cortical Bone Drilling: an Animal in Vitro Study}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {605-612}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.45014.2233}, abstract = {Background: The present study was conducted to quantify the relationships between bone drilling process parameters(i.e., feed rate, resting time, exit rate, and drill bit diameter) and drilling outcome parameters (i.e., thrust force andmaximum temperature).Methods: This study utilized 10-cm cortical bovine samples to evaluate the effects of four independent parameters,including drill bit diameters, six different feed rates, three various resting times, and three different exit rates on thrustforce and maximum temperature (MT). A total of 28 stainless steel orthopedic drill bits with a diameter of 2.5 and 3.2mm, as well as an orthopedic handpiece were attached to the 500N load cell and an accurate linear variable differentialtransformer to obtain forces. Moreover, two k-type thermocouples were utilized to record the temperature-time curvenear the drilling site. The data were analyzed using the two-way analysis of variance and post hoc Tukey-KramerHonest test.Results: Maximum thrust force (MTF) decreased by almost 230% as the drill bit diameter increased from 2.5 to 3.2mm in the lowest feed rate. The MTF showed a 335% increase, whereas a decrease of 69% was observed as the feedrates rose from 0.5 to 3 mm/sec. Moreover, the MT decreased to 67% with an increasing exit rate from 1 to 3 mm/sec.Furthermore, a slight increase was observed in MT when the resting time increased from 0 to 2 seconds (P>0.05).Conclusion: The desired drilling is drilling with lower thrust force and lower final temperature of bone. Increasing feedrate can cause an increase and decline in thrust force and final temperature, respectively. The highest rates of MT were0.5 and 1 mm/min, and the optimum feed rate would be 1.5 mm/min due to the averaged thrust force. Moreover, theresting time had no significant effects on the final temperature. Attentions to resting time would be useful to provide amore accurate, efficient, and uniform drill hole.Level of evidence: V}, keywords = {Controlled bone drilling,Drilling thrust force,Efficiency of drilling,Heat generation}, url = {https://abjs.mums.ac.ir/article_16463.html}, eprint = {https://abjs.mums.ac.ir/article_16463_16aae31e5a01ae78425ceab86505b2e2.pdf} } @article { author = {Shirvani Brojeni, Shahram and Hesarikia, Hamid and Rahimnia, Amirhossien and Emami Meybodi, Mohammad Kazem and Rahimnia, Alireza}, title = {Treatment of Femoral Head Osteonecrosis (Stages 2B, 3 Ficat) Through Open Direct Core Decompression by Allograft Impaction and Light Bulb Technique}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {613-619}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.49380.2452}, abstract = {Background: Femoral head avascular necrosis is the cause of paralyzing status of youth population. Initial diagnosisis the main element in treating the disease. Bone grafting and core decompression are the approved cures at the earlysteps of the disease. Hip replacement in a total manner is the common cure in the final stages. The optimal treatment inthe intermediate stages is partially disputable. We investigated several patients with femoral head osteonecrosis curedwith impacted cancellous allograft and open core decompression using the lightbulb technique.Methods: A total of 46 patients (58 hips) suffering from femoral head osteonecrosis were evaluated in this crosssectionalstudy. Patients were classified into two groups: A (stage 2B Ficat) and B (stage 3 Ficat) to be treated with theimpaction of cancellous allograft and by open core decompression. Radiographic results, demographic data, and rangeof hip joint motions were recorded. The patients were assessed through employing the Harris hip score (HHS) andvisual analogue scale (VAS) index prior to operation and over five years following surgery. We also studied radiographicalterations of femoral head.Results: The means of HHS and VAS were developed following the operation. Radiographic outcomes promoted inboth groups, however, it was better in group A. 12 (40%) and six (22%) hips (40%) in groups A and B, respectivelydisplayed developed stages following the operation. The hip ROM was enhanced with the mean of 15-20 degrees(p <0.005).Conclusion: Open core decompression combined with allograft impaction sounds to be influential in the developingsteps of femoral head necrosis and leads to joint discomfort and diminished pain improving ROM of the hip joint andmeanwhile procrastinating the worsening of the disease.Level of evidence: IV}, keywords = {Allograft,Cancellous Bone,Femur Head Necrosis,Osteonecrosis,Surgical Decompression}, url = {https://abjs.mums.ac.ir/article_16464.html}, eprint = {https://abjs.mums.ac.ir/article_16464_878f6f7921597ba4771bbfb6b5b9ccea.pdf} } @article { author = {Rezaee, Hamid and Bahadorkhan, Gholamreza and Ehsaei, Mohammadreza and Ganjeifar, Babak and Keykhosravi, Ehsan and Pishjoo, Masoud}, title = {Spinopelvic Parameters among Healthy Volunteers in Iran}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {620-624}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.40734.2106}, abstract = {Background: Recently, in approach to spinal pathologies, the whole spine should be considered as a biomechanicalunit. Studies have shown the great importance of sagittal and coronal balance and the relationship between the variousparts of spine together and pelvis. Former studies have shown a close relationship between spinopelvic parametersand sagittal balance. A complete understanding of sagittal balance basics is needed to achieve the best outcomeand avoiding future complications after treatment of spinal deformities. In this study, the normal range of spinopelvicparameters among healthy volunteers in Iran has been evaluated.Methods: This cross-sectional study was conducted on healthy volunteers in 2017. The lateral whole-spine X-ray wasobtained under the standard conditions. Two spine surgeons measured the parameters including pelvic incidence,pelvic tilt, sacral slope and lumbar lordosis.Results: In this study 100 volunteers were studied; out of whom, 41 participants were male and the mean age was47.5±11.7 years. The average pelvic incidence, pelvic tilt, and sacral slope were 51.5±10.9, 17.4±9.9, and 34.8±8.8degrees, respectively. The pelvic tilt was significantly lower in women. It was found that with increasing age, the pelvicincidence and pelvic tilt increases while lumbar lordosis decreases (p <0.05).Conclusion: This study is the first study on the normal range of spinopelvic parameters in healthy individuals in Iran..Our data showed that PT and PI-LL are significantly lower in women, while, PT, PI and PI-LL increase and LL decreasesin older ages.Level of evidence: II}, keywords = {healthy people,Normal range,Parameter,Sagittal balance,Spinopelvic}, url = {https://abjs.mums.ac.ir/article_16313.html}, eprint = {https://abjs.mums.ac.ir/article_16313_8e585908dc2fb8a6f713727758cf32a9.pdf} } @article { author = {Mehdipour, Soheil and Qoreishi, Mohamad and Keipourfard, Ali}, title = {Comparison of Clinical, Functional, and Radiological Outcomes of Total Knee Arthroplasty Using Conventional and Patient-Specific Instrumentation}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {625-632}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.41571.2124}, abstract = {Background: Recently, patient-specific instrumentation (PSI) systems have been developed in order to increase theaccuracy of component positioning during total knee arthroplasty (TKA); however, the findings of previous studies arecontroversial in this regard. In the current randomized clinical study, the outcomes of computer tomography (CT)-basedPS (patient specific)-guided TKA were compared to the results of conventional instrumentation (CVI) TKA. The guideswere designed on the basis of distal femoral and proximal tibial pin orientation of the conventional related guides.Methods: The present study was carried out on 24 TKA candidates randomly assigned to two PSI (n=12) and CVI(n=12) groups. The patients were postoperatively followed for 2 years. Then, the hip-knee-ankle angle (HKAA), femoralcomponent flexion, and orientation of components in the coronal plane were measured. In addition, the WesternOntario and McMaster Universities Osteoarthritis (WOMAC) Index and Knee Society Score (KSS) questionnaire werecompleted for all the patients.Results: The rate of the outliers of the HKAA was higher in the CVI group (41.7% and 8.3%; P=0.077); nevertheless,the difference was not significant in this regard. The rate of the outliers of other radiographic measurements andoperational time were similar in both groups. Furthermore, there was no significant difference between the two groupsin terms of the WOMAC and KSS.Conclusion: The CT-based PS-guided TKA may result in the improved postoperative mechanical alignment of the limband should be considered in complicated TKAs. However, future studies should investigate whether the results of PSITKA support the considerably higher costs of this technique.Level of evidence: II}, keywords = {mechanical alignment,patient-specific instrumentation,Total knee arthroplasty}, url = {https://abjs.mums.ac.ir/article_16314.html}, eprint = {https://abjs.mums.ac.ir/article_16314_624da6a023aad38c8131a7fc33c3f0b2.pdf} } @article { author = {Kazemian, Gholam Hossein and Khak, Mohammad and Ravarian, Behdad and Sarzaeem, Mohammad Mahdi and Okhovatpour, Mohammad Ali and Amouzadeh Omrani, Farzad}, title = {Closed K-wire Fixation for the Treatment of Perilunate Dislocation and Trans-Scaphoid Perilunate Fracture Dislocations without Ligamentous Repair: Short Term Follow-Up}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {633-640}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42341.2152}, abstract = {Background: The purpose of this study was to evaluate the treatment outcomes of perilunate dislocations (PLDs) andtransscaphoid perilunate fracture dislocations (TSPLDs) treated with operative volar approach without ligament repairor reconstruction.Methods: A total of seven patients (10 hands) were studied during 2017-2018. We fixed scaphoid fractures thorougha volar approach and 3 k-wires were inserted to stabilize the scaphoid to the adjacent bones. We evaluated patients’range of motion by VAS and grip strength, sensitivity assessment, and radiographs. Mayo and DASH scores were alsorecorded for wrist evaluation.Results: All fractures united well. The mean Mayo wrist score was 81.5. Five patients scored good and excellentresults (90-100). Excellent DASH scores (˂20) were observed in 4 patients and there was no poor DASH score (˃50).Conclusion: Treatment of PLDs and TSPLDs with k-wire and screw fixation using a volar approach and without anyligament repair or reconstruction results in minimal manipulation and has favorable short-term outcomes.Level of evidence: II}, keywords = {Bone wire,Joint Dislocations,Ligament,Lunate bone,Transscaphoid perilunate fracture dislocation}, url = {https://abjs.mums.ac.ir/article_16465.html}, eprint = {https://abjs.mums.ac.ir/article_16465_01e59c8944ee382f8cc07c40badde8b3.pdf} } @article { author = {hosseinzadeh, somayeh and barzegari, ali and Taghipour, Mohammad and Mehr Aein, Raheleh and Gholinia, Hemmat}, title = {Changes of the Patellar Tendon Moment Arm Length in Different Knee Angles: A Biomechanical in Vivo Study}, journal = {The Archives of Bone and Joint Surgery}, volume = {8}, number = {5}, pages = {641-645}, year = {2020}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42551.2158}, abstract = {Patellar tendon moment arm length (PTma) changes at different knee flexion angles have not been determined in invivo studies. We aimed to determine PTma in four different knee angles using Magnetic Resonance Imaging (MRI) topredict in vivo changes in the moment arm length from different knee angles during running.PTma was measured as the perpendicular distance from muscle–tendon line of action to the knee joint axis of rotationat 0° (full extension), 20°, 40°, and 60° flexion of knee by using MRI method. Repeated measure ANOVA method wasapplied to compare the moment arm length among four degrees of knee flexion (p <0.05). A regression analysis wasused to predict the PTma during different knee joint angles.The PTma in the four angles at 0°, 20°, 40°, and 60° of knee flexion were 42.55±4.20, 39.91±2.98, 37.73±2.87, and36.18±2.90 mm, respectively (p <0.05). The regression analysis provided an equation to predict the PTma from differentknee joint angles during running.PTma values decreased from knee extension to flexion in a linear manner. These findings have important implicationsfor estimating PTma using a regression equation model from different knee joint angles.Level of evidence: V}, keywords = {knee,MRI,Patellar tendon moment arm length,PTma}, url = {https://abjs.mums.ac.ir/article_16466.html}, eprint = {https://abjs.mums.ac.ir/article_16466_63bcd04b82182f3ad52c8d7bba224481.pdf} }