Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Crash in Publication Ethics in 2016 in a Glance: Avoid Paper Retraction
1
1
EN
Mohammad H.
Ebrahimzadeh
0000-0000-0000-0000
Orthopedic
Research Center, Mashhad University of Medical Sciences,
Mashhad, Iran
abjs@mums.ac.ir
Amir Reza
Kachooei
Orthopedic
Research Center, Mashhad University of Medical Sciences,
Mashhad, Iran
akachooei@partners.org
10.22038/abjs.2017.8171
<br /><span style="font-size: small; font-family: Cambria,Cambria;"><span style="font-size: small; font-family: Cambria,Cambria;"><span style="font-family: Verdana;">O</span>n November 1</span></span><sup><span style="font-size: xx-small; font-family: Cambria,Cambria;"><span style="font-size: xx-small; font-family: Cambria,Cambria;">st </span></span></sup><br /> <sup><span style="font-size: small; font-family: Cambria,Cambria;">2016, Springer Nature announced that Springer and BioMed Central are retracting 58 articles published by Iran-based authors across seven journals. The decision was made after thorough investigation following receiving allegations of plagiarism, peer review, and authorship manipulation in an effort to mislead the review system (1, 2). Not all papers were involved with all of the above issues, but each showed the evidence of at least one of these issues. At this time, we are not able to comment on the involvement of each individual author, but this has already added a black sheath to his or her records....</span></sup>
Publication Ethics
https://abjs.mums.ac.ir/article_8171.html
https://abjs.mums.ac.ir/article_8171_09ff235fb680482bf88a66a60d814526.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
How do Orthopedic Surgeons Address Psychological Aspects of Illness?
2
9
EN
Ana-Maria
Vranceanu
0000-0003-3994-6488
Department of Psychiatry, Behavioral Medicine Service,
Massachusetts General Hospital, Harvard Medical School,
Boston, USA
avranceanu@mgh.harvard.edu
Reinier B.
Beks
Department of Orthopaedic Surgery, Hand and Upper
Extremity Service, Massachusetts General Hospital, Harvard
Medical School, USA
rbeks@partners.org
Thierry G.
Guitton
Department of Orthopaedic Surgery, Academic Medical
Center, University of Amsterdam, Amsterdam, the
Netherlands
tguitton@partners.org
Stein J.
Janssen
0000-0003-3939-7765
Department of Orthopaedic Surgery, Hand and Upper
Extremity Service, Massachusetts General Hospital, Harvard
Medical School, USA
sjanssen@partners.org
David
Ring
0000-0002-6506-4879
Department of Orthopaedic Surgery, Hand and Upper
Extremity Service, Massachusetts General Hospital, Harvard
Medical School, USA
david.ring@austin.utexas.edu
10.22038/abjs.2016.7916
<br /> <strong><span style="font-size: xx-small;">Background: </span></strong><br /> <span style="font-size: xx-small; font-family: Arial,Arial;">Orthopaedic surgeons have a pivotal role in transitioning the care of orthopedic patients from a biomedical to a biopsychosocial model. In an effort to foster this transition, we designed a study aimed to determine surgeons’ attitudes and practice of noticing, screening, discussing psychological illness with patients, as well as making referrals to address psychosocial issues in patients in need. Additionally, we asked surgeons to rank order potential barriers to and reasons for referrals to psychosocial treatment. </span><br /> <br /> Methods:<br /> <strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">Orthopaedic surgeons members of the Science and Variation Group and Ankle Platform (N =350) completed demographics, and a 4-part survey assessing the degree to which surgeons notice, assess, screen and refer for psychological treatments, as well ranked ordered barriers to engaging in these processes. </span></span></span></strong><br /> Results:<br /> <strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">As a group surgeons were neutral to referral for psychological treatment and formal screening of psychological factors, and somewhat likely to notice and discuss psychological factors. Surgeons were more likely to refer for psychological treatment if they engaged in research, or if they reside in South America as opposed to North America. The highest ranked barriers to screening, noticing, discussing and referring for psychological treatment were lack of time, stigma and feeling uncomfortable. </span></span></span></strong><br /> Conclusion:<br /> <strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">Overall surgeons are likely to notice and discuss psychological factors, but less likely to formally screen or refer for psychological treatment. Transition to biopsychosocial models should focus on problem solving these barriers by teaching surgeons communication skills to increase comfort with discussing psychoemotional factors associated </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">with orthopedic problems. The use of empathic communication can be very helpful in normalizing the difficulty of coping </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">with an orthopedic condition, and may facilitate referral. </span></span></span></strong>
Biopsychosocial model,Psychological treatment,Referral,Surgeons
https://abjs.mums.ac.ir/article_7916.html
https://abjs.mums.ac.ir/article_7916_c1eee221942eedadf0bc2048c3776bc9.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Qualitative Evaluation of Digital Hand X-rays is Not a Reliable Method to Assess Bone Mineral Density
10
13
EN
AndrewJ.
Miller
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
andrewmiller28@gmail.com
Christopher
Jones
0000-0003-1478-488x
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
cmj224@gmail.com
Frederick
Liss
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
fred.liss@rothmaninstitute.com
Jack
Abboudi
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
j.abboudi@mac.com
William
Kirkpatrick
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
william.kirkpatrick@rothmaninstitute.com
Pedro
Beredjiklian
0000-0001-7625-6270
Department of Orthopaedics, Thomas Jefferson University
Hospital, Philadelphia, USA
pedro.beredjiklian@rothmaninstitute.com
10.22038/abjs.2016.7868
<strong>Object:</strong> The gold standard for evaluating bone mineral density is dual energy x-ray absorptiometry (DEXA). Prior studies have shown poor reliability using analog wrist X-rays in diagnosing osteoporosis. Our goal was to investigate if there was improved diagnostic value to visual assessment of digital hand X-rays in osteoporosis screening. We hypothesized that similar to analog counterparts, digital hand X-rays have poor correlation and reliability in determining bone mineral density (BMD) relative to DEXA.<br /><strong>Methods: </strong>We prospectively evaluated female patients older than 65 years who presented to our hand clinic with digital hand and wrist X-rays as part of their evaluation over six months. Patients who had a fracture and were without DEXA scans within the past two years were excluded. Five fellowship-trained hand surgeons, blinded to DEXA T-scores, evaluated the x-rays over two assessments separated by four weeks and classified them as osteoporotic, osteopenic, or normal BMD. Accuracy relative to DEXA T-score, interobserver and intraobserver rates were calculated.<br /><strong>Results: </strong>Thirty four patients met the inclusion criteria and a total of 340 x-rays reviews were performed. The assessments were correct in 169 cases (49%) as compared to the DEXA T-scores. A mean weighted kappa coefficient of agreement between observers was 0.29 (range 0.02-0.41) reflecting a fair agreement. The first and second assessment for all five physicians was 0.46 (range 0.19-0.78) reflecting a moderate agreement. Grouping osteoporosis and osteopenia together compared to normal, the accuracy, interobserver and intraobserver rates increased to 63%, 0.42 and 0.54 respectively.<br /><strong>Conclusion</strong>: Abnormally low BMD is a common occurrence in patients treated for upper extremity disorders. There is poor accuracy relative to DEXA scan and only fair agreement in diagnosing osteoporosis using visual assessments of digital x-rays.
DEXA scan,Digital x-ray,Osteoporosis,Qualitative assessment
https://abjs.mums.ac.ir/article_7868.html
https://abjs.mums.ac.ir/article_7868_a3b63022fc2875afaf14eb0e001b61b7.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Preliminary Results of a Consecutive Series of Large & Massive Rotator Cuff Tears Treated with Arthroscopic Rotator Cuff Repairs Augmented with Extracellular Matrix
14
21
EN
Paolo
Consigliere
0000-0003-4282-1539
Rowley Bristow Orthopaedic Unit, Ashford and St Peter’s
Hospitals NHS FT, Chertsey, Surrey, UK
paoloconsigliere@gmail.com
Ioannis
Polyzois
Rowley Bristow Orthopaedic Unit, Ashford and St Peter’s
Hospitals NHS FT, Chertsey, Surrey, UK
ioannis.polyzois@asph.nhs.uk
Tanaya
Sarkhel
Rowley Bristow Orthopaedic Unit, Ashford and St Peter’s
Hospitals NHS FT, Chertsey, Surrey, UK
tanaya.sarkhel@asph.nhs.uk
Rohit
Gupta
Rowley Bristow Orthopaedic Unit, Ashford and St Peter’s
Hospitals NHS FT, Chertsey, Surrey, UK
rohit.gupta@asph.nhs.uk
Ofer
Levy
The Reading Shoulder Unit, Royal Berkshire NHS
Foundation Trust, Berkshire, UK
oferlevy@readingshoulderunit.com
A Ali
Narvani
0000-0001-9000-4504
Rowley Bristow Orthopaedic Unit, Ashford and St Peter’s
Hospitals NHS FT, Chertsey, Surrey, UK
alinarvani@shoulder-elbowsurgery.com
10.22038/abjs.2016.7932
<br /><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Recurrence rate of rotator cuff tears is still high despite the improvements of surgical techniques, materials used and a better knowledge of the healing process of the rotator cuff tendons. Large to massive rotator cuff tears are particularly associated with a high failure rate, especially in elderly. </span></span><br />Augmentation of rotator cuff repairs with extracellular matrix or synthetic patches has gained popularity in recent years with the aim of reducing failure.The aim of this study was to investigate the outcome of rotator cuff repairs augmented with denatured extracellular matrix in a series of patients who underwent arthroscopic rotator cuff repair for large to massive tears.<br /><span style="font-size: xx-small;"><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Ten consecutive patients, undergoing arthroscopic rotator cuff repair with extracellular matrix augment for large and massive tears, were prospectively enrolled into this single surgeon study. All repairs were performed arthroscopically with a double row technique augmented with extracellular matrix. </span></span><br />Oxford Shoulder Score, Constant Score and pain visual analogue scale (VAS) were used to monitor the shoulder function and outcome pre-operatively and at three, six and 12-month follow-up. Minimum follow up was tree months. Mean follow up was 7 months.<br /><span style="font-size: xx-small;"><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Mean Constant score improved from 53 (SD=4) pre-operatively to 75 (SD=11) at final follow up. Mean Oxford score also increased from 30 (SD=8) pre-operatively to 47 (SD=10) at the final follow up. The visual analogue scale (VAS) improved from seven out of 10 (SD=2) preoperatively to 0.6 (SD=0.8) at final follow up. Additionally, there was significant improvement at three months mark in Constant score. </span></span><br /><span style="font-size: xx-small;"><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Arthroscopic repair and augmentation of large and massive rotator cuff tears with extracellular matrix patch has good early outcome. </span></span>
Augmentation,Double-row technique,Extracellular matrix,Owl technique,Patch,Rotator cuff repair,Rotator cuff tear,Scaffold,Tendinopathy
https://abjs.mums.ac.ir/article_7932.html
https://abjs.mums.ac.ir/article_7932_38d9db50c5eec256356c5466bf2cba82.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Relationship between Bone Mineral Density and Serum Vitamin D with Low Energy Hip and Distal Radius Fractures: A Case-Control Study
22
27
EN
Mohammad Ali
Tahririan
0000-0003-2122-1091
Department of Orthopedics, Kashani Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
tahririan@med.mui.ac.ir
Mehdi
Motififard
Department of Orthopedics, Kashani Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
motifi358@yahoo.com
Ali
Omidian
Department of Orthopedics, Kashani Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
aliomidian@gmail.com
Hossein
Akbari Aghdam
0000-0001-6983-4458
Department of Orthopedics, Kashani Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
akbariorthoped@gmail.com
Amir
Esmaeali
Department of Orthopedics, Kashani Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
amir_esmaeli@yahoo.com
10.22038/abjs.2016.7936
<br /> <strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The main purpose of this study was to determine the relationship between serum vitamin D and the status of bone mineral density in patients with low-energy hip and distal radius fracture. </span></span><br /> <span style="font-size: xx-small;"><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">This retrospective case-control study was performed between January 2013 and January 2014. Participants aged 55 years or older were divided to case group including 85 patients with low-energy hip fracture and 83 patients with low-energy distal radius fractures, and 82 subjects as a matched control group. Bone mineral density was measured with dual energy X-ray absorptiometry and serum sample was obtained to check vitamin D, calcium, phosphorus, alkaline phosphatase, and protein. </span></span><br /> <span style="font-size: xx-small;"><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Study subjects for final evaluation consisted of 78 in hip and distal radius fracture groups and 80 in control group. There were no significant differences in the mean serum levels of calcium, phosphorus and alkaline phosphatase between the three groups. The overall mean serum level of vitamin D3 was significantly different among the three groups. </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Similar results were observed with hip and spine t-score between the groups. </span></span><br /> <span style="font-size: xx-small;"><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">There is not only a direct relation between serum vitamin D and the risk of low energy hip and distal radius </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">fractures, but also a significant relation between low bone density in hip and spine area with low serum calcium was observed. </span></span>
Bone mineral density,Distal radius fracture and hip fracture,Low energy fracture,Vitamin D
https://abjs.mums.ac.ir/article_7936.html
https://abjs.mums.ac.ir/article_7936_033aee2f83b236691ecef4e789fdbb54.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Analgesia Following Arthroscopy – a Comparison of Intraarticular Bupivacaine and/or Midazolam and or Fentanyl
28
31
EN
Mahmoud
Nahravani
Department of Anesthesiology Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
nahravanim1@mums.ac.ir
Seyed Mostafa
Moosavi Tekye
Department of Anesthesiology Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
moosavim@mums.ac.ir
Mohammad
Alipour
0000-0003-1512-2804
Assistant Professor of Anesthesiology
Ghaem Hospital,
Mashhad University of Medical Science
Mashhad, 91766-99199, Iran
alipourm@mums.ac.ir
Hadi
Makhmalbaf
0000-0002-3344-8632
Orthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
makhmalbafh@mums.ac.ir
Monnavar
Afzal Aghaee
Mashhad University of Medical Sciences, Mashhad, Iran
afzalaghaeem1@mums.ac.ir
10.22038/abjs.2016.7857
<br /> <strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Arthroscopic intervention is very common for conducting orthopedic surgeries. After a knee arthroscopic surgery, different drugs are used through intra-articular administration to induce analgesia. The aim of this study was to evaluate analgesic effects of Bupivacaine (marcaine), Bupivacaine plus midazolam, and Bupivacaine plus fentanyl in reducing pain after knee arthroscopic surgery. </span></span><br /> <span style="font-size: xx-small;"><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Frothy five patients who were candidate for knee arthroscopy were divided into three groups. Group A, B and </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">C received Bupivacaine (50 mg), Bupivacaine (50 mg) plus midazolam (50 μg/kg), and Bupivacaine (50 mg) plus fentanyl (3 μg/kg), respectively. The analgesic solutions were diluted with normal saline up to 20 ml. The analgesic effects were </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">evaluated by VAS during first 24 hrs after surgery. With the VAS > 4, extra analgesic (pethidine) was administrated for </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">patient. </span></span><br /> <span style="font-size: xx-small;"><strong>Results:</strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The amount of induced analgesia and need for extra analgesic was different between groups; however, it was not statistically significant (p<0.109). The amount of administered analgesic (pethidine) in first 24 hours post-operatively was 275 mg for group A, while it was 150 mg for group B and 75 mg for group C. In group A, 46.67% of patients required further analgesic while this was 26.67% and 13.34% for groups B and C respectively (p<0.109). </span></span><br /> <span style="font-size: xx-small;"><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Intra-articular administration of studied drugs in all three groups reduced post-operation pain. The amount </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">of induced analgesia was the highest for group C, while group B drugs induced better analgesia compared to group C. </span></span>
Analgesia,Bupivacaine,Fentanyl,Intra-articular,Knee arthroscopy,Midazolam
https://abjs.mums.ac.ir/article_7857.html
https://abjs.mums.ac.ir/article_7857_75f04d5e9dffe3e2e73b755d4b3e5e46.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
The Zeitgeist of Challenging the Evidence. A Perspective on the International Consensus Meeting on Periprosthetic Joint Infection
32
38
EN
Hangama C.
Fayaz
0000-0003-4654-2457
Department of Orthopaedic Surgery, Harvard Medical
School, Massachusetts General Hospital, Boston, MA, USA
dr.hana.fayaz@hotmail.de
Jesse B.
Jupiter
Department of Orthopaedic Surgery, Harvard Medical
School, Massachusetts General Hospital, Boston, MA, USA
jjupiter1@partners.org
10.22038/abjs.2016.7934
<br /><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Meeting on Periprosthetic Joint Infection (ICMPJI) to be the "flawless pledge of international academics" to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process. </span></span><br /><span style="font-size: xx-small;"><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The proceedings of the ICMPJI was reviewed, and the critical consensus agreements that were reached were communicated via e-mail to 48 leading orthopaedic surgeons, microbiologists and statisticians around the world. Of these, 30 responded, 8 did not, and 10 of respondents were not aware of the ICMPJI. </span></span><br /><span style="font-size: xx-small;"><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">A thorough review of the ICMPJI proceedings identified a clear need to resolve some of the dilemmas that we highlight in this paper. The Delphi procedure has been described as a survey technique that enables a group dynamic-based practice. Although there have been several published reports on this procedure, its scientific merit is still being debated. Several challenges and questions have been raised regarding the application of the Delphi technique, but there is no doubt that it is a vital approach for achieving consensus on subjects where none currently exists. </span></span><br /><span style="font-size: xx-small;"><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Performing prospective clinical studies in this area is currently the best and only option to overcome this </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">challenge. In the long term, this approach will not only incorporate the standard of clinical evidence but also adopt regional mores for treating infection, which include patient values, cultural differences and local financial resources. </span></span>
Delphi Procedure,International Consensus Meeting,level of evidence,Periprosthetic joint infection,Quality of patient care,Trans-continental controversy
https://abjs.mums.ac.ir/article_7934.html
https://abjs.mums.ac.ir/article_7934_19de252b13f98c6c425fe15d70833eb8.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Minimally Invasive Surgical Approach to Distal Fibula Fractures: A Technique Tip
39
45
EN
Tyler A.
Gonzalez
Department of Orthopaedic Surgery, Massachusetts General
Hospital, Boston, USA
tagonzalez@partners.org
Bonnie
Chien
Department of Orthopaedic Surgery, Massachusetts General
Hospital, Boston, USA
bchien@partners.org
Mohammad
Ghorbanhoseini
Orthopedic Surgeon, Harvard Medical School, BIDMC, Carl
J. Shapiro Department of Orthopaedics, Boston, USA
dr.ghhoseini@gmail.com
John Y.
Kwon
Department of Orthopaedic Surgery, Harvard Medical School,
Division of Foot and Ankle Surgery, BIDMC, Department of
Orthopaedic Surgery, BIDMC, Boston, USA
jykwon@bidmc.harvard.edu
10.22038/abjs.2016.7966
<br /> <span style="font-size: xx-small;">Wound complications following ankle fracture surgery are a major concern. Through the use of minimally invasive surgical </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">techniques some of these complications can be mitigated. Recent investigations have reported on percutaneous fixation of distal fibula fractures demonstrating similar radiographic and functional outcomes to traditional open approaches. The purpose of this manuscript is to describe in detail the minimally invasive surgical approach for distal fibula fractures. </span></span>
Ankle fractures,Distal fibula fracture,Minimally invasive surgery,Wound complications
https://abjs.mums.ac.ir/article_7966.html
https://abjs.mums.ac.ir/article_7966_777fb5117dec30d2418cfbc8176f83af.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Comparison of Pediatric and General Orthopedic Surgeons’ Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus
46
51
EN
Ramin
Haj Zargarbashi
Orthopedics and Trauma Surgery Department, Children’s
Hospital Medical Center, Tehran University of Medical
Sciences, Tehran, Iran
r_zargar@yahoo.com
Hirbod
Nasiri Bonaki
0000-0001-9051-2154
School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran
hirbodnasiri@gmail.com
Shayan
Zadegan
Sina Trauma and Surgery Research Center, Tehran
University of Medical Sciences, Tehran, Iran
shayan.zadegan@gmail.com
Taghi
Baghdadi
0000-0002-3015-3767
Orthopedics and Trauma Surgery Department, Imam
Khomeini Hospital, Tehran University of Medical
Sciences, Tehran, Iran
taghibaghdadi@hotmail.com
Mohammad Hossein
Nabian
0000-0002-4144-3188
Orthopedics and Trauma Surgery Department, Children’s
Hospital Medical Center, Tehran University of Medical
Sciences, Tehran, Iran
dr.nabian@gmail.com
Mehdi
Ramezan Shirazi
Orthopedics and Trauma Surgery Department, Imam
Khomeini Hospital, Tehran University of Medical
Sciences, Tehran, Iran
mehdi.shirazi@yahoo.co.uk
10.22038/abjs.2017.8148
<br /> <span style="font-size: xx-small;">Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked to answer an 8-item questionnaire on DDH and flexible flatfoot. The questions were provided with two- or multiple choices and a single choice was accepted for each one. Chi-square and Fisher’s exact tests was performed to compare the responses. For a neonate with limited hip abduction, hip ultrasonography was the agreed-upon approach in both groups (100% POS vs 71% GOS), and for its interpretation 79% of POS relied on their own whereas 73% of GOS relied on radiologist’s report (</span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P=0.002</span></span></em><span style="font-size: xx-small;">). In failure of a 3-week application of the Pavlik harness, ending it and closed reduction (57% POS vs. 41% GOS) followed by surgery quality assessment with CT scan (64% POS vs. 47% GOS) and without the necessity for avascular necrosis evaluation (79% POS vs. 73% GOS) were the choice measures. In case of closed reduction failure, open reduction via medial approach was the favorite next step in both groups (62% POS and 80% GOS). For the patient with flexible flat foot, reassurance was the choice plan of 79% of pediatric orthopedists. Our findings demonstrated significant disagreements among the orthopedic surgeons. This proposes insufficiency of high-level evidence. </span>
Congenital hip dislocation,Consensus,Flatfoot,Orthopedics,Pediatrics
https://abjs.mums.ac.ir/article_8148.html
https://abjs.mums.ac.ir/article_8148_a4127fd6626a8012259bc55322fb5777.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Axillary Artery Injury Associated with Proximal Humerus Fracture: A Report of 6 Cases
52
57
EN
Rinne M.
Peters
0000-0002-1484-4226
Department of Orthopaedic Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA,
USA
rinnepeters27@hotmail.com
Mariano E.
Menendez
Department of Orthopaedic Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA,
USA
memenendez@partners.org
Jos J.
Mellema
Department of Orthopaedic Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA,
USA
josjmellema@gmail.com
David
Ring
0000-0002-6506-4879
Department of Orthopaedic Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA,
USA
david.ring@austin.utexas.edu
R.
Malcolm Smith
Department of Orthopaedic Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA,
USA
malcolm.smith@mgh.harvard.edu
10.22038/abjs.2016.6326
<br /><span style="font-size: xx-small;">Proximal humerus fractures are common, but associated injury of the axillary artery is uncommon. The majority of published blunt traumatic axillary artery injuries are associated with anterior glenohumeral dislocation; a few are associated with isolated proximal humerus fractures or fracture-dislocation. Experience within our institution demonstrates that axillary artery injury is often unrecognized on initial presentation owing to palpable peripheral pulses and the absence of ischemia and places the hand at risk of necrosis and amputation if there is prolonged ischemia and the forearm at risk of compartment syndrome after revascularization. Accurate physical examination in combination with a low threshold for Doppler examination or angiography can establish the diagnosis of axillary artery injury. We present 6 cases of axillary artery injury associated with proximal humerus fractures in order to highlight the potential for this vascular injury in the setting of a proximal humerus fracture. </span>
Axillary,Artery,Fracture,humerus,Injury,Proximal
https://abjs.mums.ac.ir/article_6326.html
https://abjs.mums.ac.ir/article_6326_1ce8a8e802d441380da33067f2caebad.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review
58
62
EN
Mohammad Naghi
Tahmasebi
0000-0003-4644-6756
Shariati Hospital, Tehran University of Medical Siences, Tehran, Iran
mntahmasebi@gmail.com
Gholamreza Ghorbani
Amjad
0000000222960745
Shariati Hospital, Tehran University of Medical Siences, Tehran, Iran
amjad52m@yahoo.com
Mohammad Hasan
Kaseb
Imam khomeni , Tehran University of Medical Siences, Tehran, Iran
kasebm.h@gmail.com
kaveh
Bashti
Shariati Hospital, Tehran University of Medical Siences, Tehran, Iran
bashtikaveh@yahoo.com
10.22038/abjs.2016.7858
<br /> <span style="font-size: xx-small;">Multiplanar or global laxity in arthritic knee is rare , most of this patients have neuromuscular disorder (post poliomyelitis , spinal dystrophy) or history of knee trauma. Ligament insufficiency and severe bone loss is significant in this patient. The estimated prevalence for the concurrence of charcot marie-tooth (CMT) with myasthenia gravis (MG) suggests an extremely rare event. We have presented a 54-year-old female patient with CMT and MG complaining of progressive pain, swelling, and crepitation of the knee joints who had been undergone total knee arthroplasty (TKA) with rotating hinge prosthesis. She had an acute myasthenia crisis soon after operation with prolonged intubation and intensive care unit admission. Radiographies and physical examination revealed bilateral severe unstable arthritic knee joints and left knee posterior dislocation. Short-term postoperative follow-up revealed improved knee function and resolution of all symptoms in the operated side. </span>
Charcot marie-tooth,CMT,MG,Myasthenia gravis,TKA,Total knee arthroplasty,Unstable knee
https://abjs.mums.ac.ir/article_7858.html
https://abjs.mums.ac.ir/article_7858_dcce1241f21f1623098eb28b7b68c33c.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Intrapelvic Protrusion of a Broken Guide Wire Fragment during Fixation of a Femoral Neck Fracture
63
65
EN
Ahmadreza
Afshar
0000-0002-3676-5932
Department of Orthopaedics, Urmia University of Medical
Sciences, Urmia, Iran
afshar_ah@yahoo.com
10.22038/abjs.2015.5246
<br /> <span style="font-size: xx-small;">During fixation of a femoral neck fracture in a 23-year-old male patient with cannulated screws, a broken guide wire fragment inadvertently advanced through the hip joint and protruded into the pelvis. A second surgical approach was needed to remove the broken fragment from the pelvis. Awareness of such a potentially devastating complication will make surgeons more cautious during implementation of orthopedic instruments and increases patient’s safety during surgery. </span>
Cannulated screw,complication,femoral neck fracture,Guide wire,Patient’s Safety
https://abjs.mums.ac.ir/article_5246.html
https://abjs.mums.ac.ir/article_5246_980d280d06ea388c26f6c2f8d9d053c2.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Osteochondritis Dissecans of the Humeral Head: A Case Report and Review of the Literature
66
69
EN
Davod
Jafari
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
jafariortho@gmail.com
Hooman
Shariatzadeh
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
hoomansh@yahoo.com
Farid
Najd Mazhar
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
najdortho@gmail.com
Mohammad Ali
Okhovat
0000-0001-6779-6662
Shahid Beheshti University of Medical Sciences, Tehran, Iran
okhovatortho@gmail.com
Mehran
Razavipour
0000-0002-2290-3214
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
razavimehran@yahoo.com
10.22038/abjs.2016.7862
<br /> <span style="font-size: xx-small;">Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. In this study, we report an asymptomatic case of humeral head OCD, which was detected incidentally following a trauma. X-rays showed an area of lucency around an oval bony fragment measuring about 1 cm on the superior aspect of the humeral head. However, the patient was pain-free and the shoulder range of motion was normal. </span>
Glenohumeral joint,humerus,Osteochondritis dissecans
https://abjs.mums.ac.ir/article_7862.html
https://abjs.mums.ac.ir/article_7862_4915b73574fef1b639c0547a9a68262e.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
5
1
2017
01
01
Loosening of Total Knee Arthroplasty after Brucellosis Infection: A Case Report
70
71
EN
Mohammad Ali
Sazgari
Knee and Sport Medicine Research Center, Milad Hospital,
Tehran, Iran
msazgari@yahoo.com
Fateme
Bahramian
Knee and Sport Medicine Research Center, Milad Hospital,
Tehran, Iran
fbahramian69@gmail.com
Fateme
Mirzaee
Knee and Sport Medicine Research Center, Milad Hospital,
Tehran, Iran
Zohreh
Zafarani
Knee and Sport Medicine Research Center, Milad Hospital,
Tehran, Iran
zzafarani@yahoo.com
Hamid Reza
Aslani
0000-0002-3257-8312
Knee and Sport Medicine Research Center, Milad Hospital,
Tehran, Iran
hraslani1342@gmail.om
10.22038/abjs.2017.19756.1512
<br /> <span style="font-size: xx-small;">In this report we describe a 78-year-old man whose total knee arthroplasty showed the symptoms of infection with brucella with radiographic signs of loosening 5 years after the index surgery. The patient was treated successfully after a 2-stage revision arthroplasty surgery along with using rifampicin and doxycycline for 8 weeks. </span>
Brucellosis,Knee arthroplasty,Knee replacement,Loosening
https://abjs.mums.ac.ir/article_8150.html
https://abjs.mums.ac.ir/article_8150_09fb9adbb538db1f1fc85286d34f7495.pdf