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
7
4
2019
07
01
Correlation of Single Assessment Numeric Evaluation (SANE) with other Patient Reported Outcome Measures (PROMs)
303
306
EN
Casey M.
O’Connor
0000-0001-9376-9801
Albany Medical Center, Department of Orthopedic
Surgery, Albany, NY
The University of Texas at Austin, Dell Medical School,
Austin, TX, USA
oconnoc1@amc.edu
David
Ring
0000-0002-6506-4879
The University of Texas at Austin, Dell Medical School,
Austin, TX, USA
david.ring@austin.utexas.edu
10.22038/abjs.2018.33884.1888
Background: The Single Assessment Numeric Evaluation (SANE) is a simple, one-question patient-reported outcome<br />measure (PROM). We systematically reviewed correlations between SANE and more extensive PROMs.<br />Methods: We identified studies with correlation coefficients between SANE and other shoulder, knee, and anklespecific<br />PROMs. We calculated mean, median and range across studies and time points of data collection.<br />Results: Eleven studies provided 14 correlations, six shoulder-specific PROMs in four studies, six knee-specific PROMs<br />in six studies and two ankle specific PROMs in one study. The mean correlation comparing SANE and knee-specific<br />PROMs was 0.60 (SD 0.24), median 0.66, and range 0.12 to 0.88. Among studies comparing SANE and shoulderspecific<br />PROMs mean correlation was 0.59 (SD 0.20), median 0.62 and range 0.20 to 0.89. The mean correlation<br />between SANE and ankle-specific PROMs was 0.69 (SD 0.17), median 0.69 and range 0.75 to 0.81.<br />Conclusion: There seems to be moderate correlation amongst PROMs, even those that are a single question. Future<br />research might address whether patient reported outcome measure a common underlying construct even when they<br />consist of a single question.<br />Level of evidence: V
Patient-reported outcome measures,PROMs,SANE,Single Assessment Numeric Evaluation
https://abjs.mums.ac.ir/article_11661.html
https://abjs.mums.ac.ir/article_11661_702171c5226c125835e482008d2eec7c.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
7
4
2019
07
01
Comparison of Asymmetric Reaming versus a Posteriorly Augmented Component for Posterior Glenoid Wear and Retroversion: A Radiographic Study
307
313
EN
Jia-Wei
Kevin Ko
0000-0001-6600-9735
Orthopedic Physician Associates at Swedish Orthopedic Insitiute, Seattle, WA, USA
jiawei.ko@gmail.com
Usman Ali
Syed
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
usyed11@gmail.com
Jonathan D.
Barlow
Ohio State University, Wexner Medical Center, Columbus, OH, USA
jondbarlow@gmail.com
Scott
Paxton
Brown University, Providence, RI, USA
escottpaxton@gmail.com
Bryan J.
Loeffler
OrthoCarolina, Charlotte, NC, USA
bryan.loeffler@orthocarolina.com
Ocean
Thakar
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
ocean.thakar@rothmaninsitute.com
Grant
Jamgochian
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
grant.jamgochian@rothmaninstitute.com
Joseph
Abboud
0000-0002-3845-7220
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
abboudj@gmail.com
Charles L.
Getz
0000-0002-9822-9692
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
charlesgetz@hotmail.com
Gerald R.
Williams
The Rothman Institute at Thomas Jefferson University,
Philadelphia, PA, USA
10.22038/abjs.2019.28430.1751
Background: Managing posterior glenoid wear and retroversion remains a challenge in shoulder arthroplasty.<br />Correcting glenoid version through asymmetric reaming (AR) with placement of a standard glenoid component and the<br />use of posteriorly augmented glenoid (PAG) components are two methods used to address this problem. Our objective<br />is to report the radiographic outcomes of patients with posterior glenoid wear and/or retroversion treated with either<br />approach.<br />Methods: Patients with posterior glenoid wear and a minimum of 15 degrees of retroversion, treated with AR and<br />standard glenoid component or with a PAG component (3 mm, 5 mm, or 7 mm posterior augmentation), were<br />consecutively identified through retrospective chart review. Pre-operative axillary views were evaluated for version,<br />humeral head subluxation in relation to scapular axis and to mid-glenoid face. Post-operative axillary views were<br />reviewed to measure corrected inversion and humeral head subluxation.<br />Results: There were 48 patients in the AR group and 49 patients in the PAG group. Version improved 6.8 degrees in the<br />AR group. In the PAG group, version improved 8.8 degrees with 3 mm augment, 13.4 degrees with 5 mm augment, and<br />12.8 with 7 mm augments. There were significantly more central peg perforations in the 5 mm PAG group compared<br />to other groups. The humeral head was re-centered within 6.1% of normal in all groups except 7 mm augments.<br />Conclusion: This study demonstrates that AR and PAGs have the ability to re-center the humeral head when utilized<br />in patients with retroversion and posterior wear. Use of a PAG component may allow for greater correction of glenoid<br />retroversion, however, there is an increased risk for central peg perforation with the specific implant utilized in this study.<br />Long-term follow-up is ongoing and needed to understand the clinical implications of these findings.<br />Level of evidence: IV
Augmented Glenoid,Glenoid Reaming,Shoulder Arthritis,Total Shoulder Arthoplasty
https://abjs.mums.ac.ir/article_12916.html
https://abjs.mums.ac.ir/article_12916_c061d5c60c78f835f9c1d7d09d0c1f37.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
7
4
2019
07
01
Use of a Digital Protractor and a Spirit Level to Determine the Intraoperative Anteversion of Femoral Component during Cemented Hip Hemiarthroplasty: a Prospective Clinical Trial
314
320
EN
Anuwat
Pongkunakorn
0000-0003-3305-7591
Department of Orthopaedic Surgery, Lampang Hospital
and Medical Educational Center, Mueang District,
Lampang, Thailand
dranuwat@hotmail.com
Patanapong
Palawong
Department of Orthopaedic Surgery, Lampang Hospital
and Medical Educational Center, Mueang District,
Lampang, Thailand
phatpa08@gmail.com
Swist
Chatmaitri
Department of Orthopaedic Surgery, Lampang Hospital
and Medical Educational Center, Mueang District,
Lampang, Thailand
swist_swist@hotmail.com
Nawakun
Phetpangnga
Department of Orthopaedic Surgery, Lampang Hospital
and Medical Educational Center, Mueang District,
Lampang, Thailand
nawakunnine@hotmail.com
10.22038/abjs.2018.33936.1894
Background: Femoral stem anteversion during hip arthroplasty is generally estimated by eye intraoperatively and has<br />proven to be different from targeted values. This study aims to determine the accuracy of a novel technique using a<br />digital protractor and a spirit level to improve surgeons’ estimation of stem anteversion.<br />Methods: A prospective non-randomized study was conducted among 93 patients with femoral neck fracture who<br />underwent cemented hemiarthroplasty via posterolateral approach. In the control group (N=62), five experienced<br />surgeons assessed stem anteversion related to the posterior femoral condylar plane using visual estimation with a<br />target angle of 15°-25°. In the study group (N=31), another two surgeons assessed stem anteversion with the same<br />target angle by placing a digital protractor on the femoral stem inserter handle while the assistant held the leg in the truly<br />vertical position, verified by a spirit level that was attached to the shin with cable ties. Stem anteversion was measured<br />blind, postoperatively, on 2D-CT and compared with the intraoperative results.<br />Results: The mean postoperative anteversion was 22.4° (-4.2° to 51.3°, SD 11.1°) in the control group and 23.0° (16.0°<br />to 29.9°, SD 3.6°) in the study group (P=0.810). The study group had more stems positioned in 15°-25° anteversion<br />(71.0% vs 32.3%, P=0.001) and the mean absolute value of surgeon error was -0.2° (-5.4° to 7.0°, SD 3.0°). Twentyeight<br />stems of the study group (90.3%) had an error within 5°. Surgeon overestimation >5° was found in 1 hip (3.2%)<br />and underestimation >5° was found in 2 hips (6.4%).<br />Conclusion: Using a digital protractor and a spirit level was reliable with high accuracy and precision to improve the<br />intraoperative estimation of cemented stem anteversion.<br />Level of evidence: II
digital protractor,Femoral stem anteversion,hip arthroplasty,spirit level
https://abjs.mums.ac.ir/article_11662.html
https://abjs.mums.ac.ir/article_11662_8cdbfec62126d3ca9e3d8a0837902844.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
7
4
2019
07
01
Predictive Value of Computed Tomography Scan for Posterior Ligamentous Complex Injuries in Patients with Thoracolumbar Spinal Fractures
321
324
EN
Babak
Ganjeifar
0000-0002-5212-5791
Department of Neurosurgery, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
b_ganjeifar@yahoo.com
Ehsan
Keykhosravi
0000000287622042
Department of Neurosurgery, Akbar Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
keykhosravie@mums.ac.ir
Gholamreza
Bahadorkhan
Department of Neurosurgery, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
bahadorkhangh@mums.ac.ir
Hossein
Mashhadinezhad
0000-0002-1080-3611
Department of Neurosurgery, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
mashhadinejadh@mums.ac.ir
Mohammad R.
Ehsaei
Department of Neurosurgery, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
ehsaeemr@mums.ac.ir
Fariborz
Samini
0000-0002-6936-9557
Department of Neurosurgery, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
saminif@mums.ac.ir
Masoud
Pishjoo
0000-0002-9539-4107
Mashhad University of Medical Sciences, Mashhad, Iran
masoud.pishjoo@gmail.com
Abdolreza
Mahmoodi
Mashhad University of Medical Sciences, Mashhad, Iran
mahmodiar@mums.ac.ir
Hamid
Rezaei
0000000000000000
Department of Neurosurgery, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
h_rezaee56@yahoo.com
10.22038/abjs.2019.35357.1930
Background: Thoracolumbar spinal fractures include a range of injuries of various severities from simple apophyseal<br />fractures to neurological injury and complex fractures associated with vertebral dislocation. The treatment of<br />thoracolumbar fractures is challenging, especially due to the difficulty of evaluating the posterior ligamentous complex<br />(PLC). The purpose of this study was to evaluate the diagnostic value of computed tomography (CT) scan in predicting<br />PLC injuries in the patients with thoracolumbar spinal fractures referring to the referral center of spinal trauma in the<br />east north of Iran in 2016.<br />Methods: This retrospective study was conducted on patients with thoracolumbar injuries referring to Shahid Kamyab<br />Hospital in Mashhad, east north of Iran, in 2016. The data were collected by entering the data of medical records into<br />special forms. The classification of spinal fractures was accomplished using the AO Spine Classification System.<br />Results: According to the results, 71 (71.7%) patients were male, and the subjects had a mean age of 44.6±17.7 years.<br />The PLC injury was observed in 28 (28.3%) patients. The PLC injury showed a significant relationship with facet joint<br />widening, increased interspinous process distance, and spinous process avulsion fracture (P<0.05).<br />Conclusion: As the findings of this study indicated, the diagnostic results of PLC injury by means of CT scan was<br />similar to those obtained by magnetic resonance imaging in patients with thoracolumbar spinal fractures.<br />Level of evidence: III
CT Scan,MRI,Posterior Ligamentous Complex (PLC),Thoracolumbar spinal injury Trauma
https://abjs.mums.ac.ir/article_12747.html
https://abjs.mums.ac.ir/article_12747_ffba241a3a0d979126ec706093193247.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
7
4
2019
07
01
Modified Tension Band Wiring in Adult Distal Humeral Fracture Types A2 and C1
325
330
EN
Saeed
Kokly
0000-0002-0678-0920
Orthopedic Department of 5Azar Hospital, Golestan
University of Medical Science, Gorgan, Iran
skokly@gmail.com
Alessandro
Castagna
0000-0002-2029-3539
Shoulder & Elbow Department, IRCCS Humanitas
Institute, Rozzano, Milan, Italy
alex.castagna@tin.it
Mohammadreza
Guiti
0000-0001-9911-5243
Tehran University of Medical Science, Tehran, Iran
m_guity@yahoo.com
10.22038/abjs.2018.21920.1569
Background: Distal humeral fractures accounts for approximately 2% of all fractures and nearly one-third of humeral<br />fractures in adults. In this regard, Modified Tension Bind Wiring (MTBW) technique was used for the fixation of the distal<br />humeral fractures type A2 and C1 (AO) to evaluate the early movement and complications of the patients.<br />Methods: This study was conducted on 25 patients, who were subjected to open reduction and internal fixation using<br />MTBW techniques, to evaluate the incidence of complications.<br />Results: The mean age of the participants was 53.7 years. Out of 25 patients, 16 cases had C1 and 6 individuals<br />suffered from A2. The mean tourniquet time was 43 min. The mean union time was 12.24 weeks and the mean duration<br />of the follow-ups was 13.72 months. The mean values for the lack of extension, flexion, and range of motion were 18o,<br />124o, and 106o, respectively. Wound haematoma and dehiscence were observed in two cases, who were treated after<br />conservative treatment. During 15-90 days, there were no signs of neurapraxia injuries. The non-union of olecranon<br />osteotomy site was seen in one case, who was treated by the MTBW technique. Since the range of motion was less<br />than 100o in 4 patients, device removal was performed 6 months after the surgery when the range of motion was<br />increased by nearly 12o. Moreover, patients were diagnozed with no serious complications, such as the nonunion of<br />fracture site, malunions, and deep infection. The radiological examination of the patients revealed the success of their<br />treatment.<br />Conclusion: Based on the obtained results, it can be concluded that MTBW is an effective technique in fracture<br />fixation, which allows gentle early motion. Moreover, this cost-effective technique decreased the surgery duration,<br />tourniquet time, and damage caused by soft tissue stripping.<br />Level of evidence: IV
AO,Distal humerus,Fracture,Periosteal stripping,Tension band wiring
https://abjs.mums.ac.ir/article_12485.html
https://abjs.mums.ac.ir/article_12485_9cd1764923e8cd3a0d753d530f5da134.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
7
4
2019
07
01
Iliac Pedicle Wedge Graft as a New Modification for Iliac Osteotomies in Young Adolescents: A Single-blind Randomized Clinical Trial
331
338
EN
Mohsen
Karami
Department of Orthopaedics, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
mn.karami@gmail.com
Alireza
Radyn Majd
Department of Orthopaedics, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
alireza.yakhchalian@sbmu.ac.ir
Mohammad A.
Tahririan
0000-0003-2122-1091
Department
of Orthopaedics, School of Medicine, Isfahan University of
Medical Sciences, Isfahan, Iran
tahririan@med.mui.ac.ir
Sajad
Badiei
Department of Orthopaedics, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran
Students Research Committee (Center), Isfahan University
of Medical Sciences, Isfahan, Iran
s_badiei@edc.mui.ac.ir
Amin
Karimi
0000-0002-3197-7223
Department of Orthopaedics, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
aminkarimi79@yahoo.com
10.22038/abjs.2018.24907.1652
Background: Iliac osteotomies in adolescent patients may accompany graft related difficulties such as graft absorption<br />and delayed union. A new modification of iliac osteotomies has been proposed to address these difficulties.<br />Methods: A total of 24 consecutive hip joints in 21 juvenile or adolescent patients who were candidate for salter or<br />triple pelvic osteotomy were included. A modification was performed to harvest a wedged bone graft based on a muscle<br />pedicle of Tensor Fascia Lata and inserted at pelvic osteotomy site instead of a traditional graft technique. The hips<br />were randomized into two groups. The traditional wedge graft was used in group 1, while the new modification was<br />performed in group 2. The primary outcome of this study was duration of union. The secondary outcomes were Center<br />Edge Angle (CE) Angle on pre-operation, immediately post-operation and at the end of follow-up.<br />Results: Both groups were similar statistically regarding their age, gender , estimated blood loss and the duration of<br />follow-up. However, significant differences were found in the time to complete union between the two groups (P=0.03).<br />CE angle decreased in both groups when comparing its last follow-up to its right postoperative values, but the decrease<br />was significant only in group 1(P=0.03). The type of surgery (Salter or TPO) had no significant effect on the average<br />time to union. That shows faster union in pedicle graft group and less coverage loss during follow-up period than<br />conventional graft patients.<br />Conclusion: With the modification proposed , the healing at the osteotomy site was faster and the loss of correction,<br />owing to the graft resorption, decreased. Using this pedicle wedge graft technique may improve the results of pelvic<br />osteotomies in adolescent.<br />Level of evidence: II
complication,pelvic osteotomy,surgical technique
https://abjs.mums.ac.ir/article_11253.html
https://abjs.mums.ac.ir/article_11253_a4c245804676b59e00bce86f74aebf08.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
7
4
2019
07
01
Correlation of Anthropometric Measurements of Proximal Tibia in Iranian Knees with Size of Current Tibial Implants
339
345
EN
Elham
karimi
7104-5341-0002-0000
Department of Biology and Anatomical Sciences, Faculty
of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
elham.karimi@sbmu.ac.ir
Reza
Zandi
0000-0002-0095-6745
Taleghani Hospital, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
reza.zandi.md@gmail.com
Mohsen
Norouzian
Department of Biology and Anatomical Sciences, Faculty
of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
norozian93@gmail.com
Ali
Birjandinejad
8690-8076-0001-0000
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
birjandinejada@mums.ac.ir
10.22038/abjs.2018.29229.1761
of the Caucasian population. The purpose of this study was to investigate the morphometry of the proximal tibia in the<br />standard resected surface of total knee arthroplasty (TKA).<br />Methods: In this descriptive study, the anthropometric data of the proximal tibia were measured in 132 knees (80 males<br />and 52 females) using magnetic resonance imaging in 2015. The collected data included anteroposterior (AP) length,<br />mediolateral (ML) width, medial AP, lateral AP, and aspect ratio (ML/AP). The medial and lateral AP distance to bone<br />center was calculated for symmetry analysis. The morphometric data were also compared with the same dimensions<br />of four current tibial implants.<br />Results: The mean age of the subjects was 38.26±11.45 year (age range: 20-60 years). The mean AP length and<br />mean ML width in the resected surface of the bone, as well as the mean aspect ratio (ML/AP) of tibial bone in all the<br />subjects, were 46.53±4.05 mm, 73.36±6.86 mm, and 1.58±0.11, respectively. The mean values of medial and lateral<br />AP distance up to bone center were 13.40±6.17 and 17.09±6.83 mm, respectively, indicating asymmetric proximal tibia<br />in the study population.<br />Conclusion: The measurements of anatomic shapes and dimensions of the proximal tibia revealed that women have<br />smaller dimensions than their male counterparts. Prostheses with smaller AP size tended to be undersized and larger<br />AP size had a tendency towards overhang in the mediolateral dimension. The data and obtained results of this study<br />can be used as guidance on designing tibial implant components suitable for TKA in the Iranian population.<br />Level of evidence: IV
Implant,knee,Morphometry,MRI,Proximal Tibia
https://abjs.mums.ac.ir/article_12492.html
https://abjs.mums.ac.ir/article_12492_6059f98f9978e11c2094bcc9cdf95e6a.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
7
4
2019
07
01
Short to Mid-term Outcomes of Single-stage Reconstruction of Multiligament Knee Injury
346
353
EN
Abolfazl
BagheriFard
0000000249658810
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
bagherifd@gmail.com
Mahmoud
Jabalameli
0000-0002-1595-4152
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
jabalamelimd@yahoo.com
Salman
Ghaffari
0000-0001-8641-5052
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
orthosalman@yahoo.com
Jafar
Rezazadeh
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
jafar5513@yahoo.com
Majid
Abedi
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
majid.abedi844@gmail.com
Masoud
Mirkazemi
Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
masoud.dr2003@gmail.com
Javad
Aghamohamadi
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
javad.aghamohamadi67@gmail.com
Afshin
Hesabi
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
afshinhesabi1979@gmail.com
Mehdi
Mohammadpour
0000-0002-0598-5043
Bone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
mehdi.668491@gmail.com
10.22038/abjs.2018.32447.1858
Background: Multiligament knee injury (MLKI) is a complex orthopedic injury leading to the tear of at least two of<br />the major knee ligaments. However, there is no consensus on the optimal management of this debilitating condition.<br />Regarding this, the present study was performed to evaluate the outcomes of single-stage multiligament reconstruction<br />surgery in patients with MLKI.<br />Methods: This retrospective study was conducted on 41 consecutive MLKI patients who underwent surgical<br />reconstruction. Objective evaluation of the outcome included active extension and flexion. Furthermore, the subjective<br />evaluation of the outcome was accomplished using the Lysholm scoring scale and International Knee Documentation<br />Committee (IKDC) form in Persian. Postoperative complications were also recorded for all patients.<br />Results: The mean age of the participants was 31.95±7.82 years. In addition, the mean follow-up period and the<br />mean time interval between the injury and surgery were recorded as 36.9±17.8 and 11.5±8.9 months, respectively. The<br />mean Lysholm and IKDC scores were obtained as 86.9±11.5 and 70±18.7, respectively. The mean Lysholm and IKDC<br />scores were not statistically different between the patients who underwent surgery less than 6 months after the injury<br />and those subjected to reconstruction 6 months postinjury (P=0.07 and P=0.3, respectively). Seven patients showed<br />postoperative restricted range of motion, which was resolved with physiotherapy. The only surgical complication was<br />popliteal artery injury.<br />Conclusion: As the findings indicated, the single-stage reconstruction of MLKI provided an acceptable outcome.<br />However, several aspects of this reconstruction, such as the timing of the surgery, still remain to be resolved in future<br />investigations.<br />Level of evidence: IV
complication,Multiligament knee injury,Outcome,reconstruction surgery
https://abjs.mums.ac.ir/article_11655.html
https://abjs.mums.ac.ir/article_11655_cbd4965f7f5c658601e6879b95418bfa.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
7
4
2019
07
01
Sterile Parts of Operating Gown during Lower Limb Joint Replacement Surgery
354
359
EN
Mohamad
Qoreishi
0000-0002-8975-3951
Shahid Beheshti University of Medical Sciences, Tehran,
Iran
qoreishy@gmail.com
Mohammadreza
Abbasian
0000-0002-4791-9925
Shahid Beheshti University of Medical Sciences, Tehran,
Iran
mohammadreza.abbasian@gmail.com
Farshad
Safdari
0000-0001-5508-0624
Bone Joint and Related Tissues Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
f.safdari.to@gmail.com
10.22038/abjs.2019.34046.1895
Background: The prevention of surgical site infection is one of the most concerning issues in operating rooms. Surgical<br />gowns are worn as one of the intraoperative strategies for infection prevention. The present study investigated whether<br />the gowns remained sterile during the surgical procedure. Furthermore, this study examined which parts of the surgical<br />gown were more prone to contamination.<br />Methods: The sterility of the gowns was investigated during eight total joint arthroplasties all of which were performed<br />by four surgeons. The samples were taken from the arms and frontal part of the sterile gowns pre- and postoperatively.<br />In the anterior surface of the gown, the sampling was initiated at a strip with 50 cm height from the ground followed<br />by the strips with 15 cm distances from caudal to cephalad. Furthermore, the frontal part of the gown was divided<br />into three parts in relation to the operating room table. Finally, the contamination rate was evaluated in each part. A<br />semiquantitative method was used for the analysis of bacterial culture.<br />Results: Before the operation, there were four samples tested positive for bacterial culture (1.06%). All of these samples<br />were taken from the most proximal strip near the neckline. After the surgery, the rate of contamination in the strips on<br />the frontal part of the gown was reported as 3.1% to 53%. Based on the operating table, the contamination rate was<br />35.9%, 8.9%, and 47.3% in the distal, middle, and proximal parts of the gown, respectively. The contamination rate at<br />the elbow crease was 23%, and at 5 and 10 cm above the creases were 24% and 36%, respectively.<br />Conclusion: The high rate of gown contamination during the operation is concerning. However, part of the gown that<br />was in contact with the operating room table remained clean most of the time. More safe strategies should be used for<br />infection prevention in operating rooms.<br />Level of evidence: IV
Contamination,Infection,Operating room,Sterility,surgical gown
https://abjs.mums.ac.ir/article_12502.html
https://abjs.mums.ac.ir/article_12502_0683824eaebe2c4fd1437f8b26d4e6f5.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
7
4
2019
07
01
Immediate Effects of Lumbosacral Orthosis on Postural Stability in Patients with Low Back Pain: A Preliminary Study
360
366
EN
Fatemeh
Azadinia
0000-0003-2513-7137
Department of Orthotics and Prosthetics, School of
Rehabilitation Sciences, Iran University of Medical
Sciences, Tehran, Iran
azadinia.fatemeh@yahoo.com
Ismail
Ebrahimi-Takamjani
0000-0002-5855-8432
Department of Physical Therapy, School of Rehabilitation
Sciences, Iran University of Medical Sciences, Tehran,
Iran
ebrahimi.pt@gmail.com
Mojtaba
Kamyab
0000-0003-1081-3083
Department of Orthotics and Prosthetics, School of
Rehabilitation Sciences, Iran University of Medical
Sciences, Tehran, Iran
mojtaba.kamyab@gmail.com
Morteza
Asgari
Department of Mechanical Engineering, Sharif University
of technology, Tehran, Iran
morteza_asgari@alum.sharif.edu
Mohamad
Parnianpour
Biomechanics Laboratory, Department of Mechanical
Engineering, Sharif University of Technology, Tehran, Iran
parnianpour@sharif.edu
10.22038/abjs.2019.34753.1912
Background: Lumbosacral orthosis (LSO) is commonly used for the treatment of back pain. The clinical and<br />mechanical effectiveness of this device has been repeatedly investigated in several studies; however, its sensorimotor<br />effectiveness has been rarely considered. Regarding this, the aim of the current study was to investigate the effect of<br />a non-extensible LSO on postural stability (as a construct of sensorimotor function) in patients with nonspecific chronic<br />low back pain (LBP).<br />Methods: This preliminary study was conducted on 17 patients with nonspecific chronic LBP using a single-group<br />quasi-experimental design. Postural stability was measured while the participants were placed in a quiet standing<br />position, under the combined conditions of base of support (rigid and foam surface), visual input (open eyes and closed<br />eyes), and LSO (with and without orthosis).<br />Results: The findings demonstrated that wearing orthosis during the most challenging postural task (i.e., blindfolded<br />while standing on a foam surface) significantly reduced postural sway parameters related to the position and<br />displacement of the center of pressure (COP; the sway area and sway amplitude in the anteroposterior direction;<br />P<0.001). However, the use of this device had no significant effect on COP velocity.<br />Conclusion: As the findings of the present study indicated, the use of a non-extensible LSO decreased the COP<br />displacement; however, it did not affect the COP velocity. Therefore, our data could not utterly support the effectiveness<br />of non-extensible LSO on postural stability as a construct of sensorimotor function. Postural control is an appropriate<br />indicator for assessing the global functioning of the sensorimotor system due to its dependence upon the interaction<br />between the neural and musculoskeletal systems. Consequently, further studies are needed to elucidate the positive<br />effects of LSO on the aspects of sensorimotor function.<br />Level of evidence: III
LBP,orthotic device,Postural balance
https://abjs.mums.ac.ir/article_12504.html
https://abjs.mums.ac.ir/article_12504_2cf32c01c5eb5946fead585b3fd40c70.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
7
4
2019
07
01
Injury Patterns among Motorcyclist Trauma Patients: A Cross Sectional Study on 4200 Patients
367
372
EN
Sayyed Hadi
Sayyed Hoseinian
0000-0002-5422-7919
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
shhoseinian@gmail.com
Mohammad H.
Ebrahimzadeh
0000-0003-4417-9877
Orthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
ebrahimzadehmh@mums.ac.ir
Mohammad T.
Peivandi
0000-0003-3338-1834
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
peivandimt@mums.ac.ir
Farshid
Bagheri
0000-0001-8629-1854
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
bagherif@mums.ac.ir
Jalil
Hasani
Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
jalil68.hasani@gmail.com
Sogol
Golshan
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
golshans931@mums.ac.ir
Ali
Birjandinejad
8690-8076-0001-0000
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
birjandinejada@mums.ac.ir
10.22038/abjs.2019.35177.1926
Background: Motorcyclists are among the most vulnerable groups of road accident victims, who are prone to a growing<br />mortality rate due to the constant rise in the number of accidents. This study was performed to investigate the injury<br />patterns among motorcyclist trauma patients admitted to Kamyab Hospital, the largest trauma center affiliated with<br />Mashhad Univercity of Medical Sciences, Mashhad, Iran, due to an accident.<br />Methods: This cross-sectional study was conducted on motorcyclists referred to our hospital due to accidents from<br />August 23, 2014 to August 22, 2016 to receive treatment. After the accurate examination of the collected data and<br />correction of the potential errors, they were subjected to analysis. The gathered data included the demographic<br />variables, injury pattern, accident time, and accident type. Data analysis was performed in Stata Software, version 12.<br />Results: A total of 4,205 motorcycle accident cases were hospitalized (14% of all cases were hospitalized during the<br />two-year study period). The mean age of the patients was 30 years, and 88% of them were male (a male to female ratio<br />of 7.3). Car- and pedestrian-motorcycle collisions were the most common causes of injury that accounted for 68% and<br />22% of the cases, respectively. The head was the most commonly injured site of the body; in this regard, 59.7% of the<br />admitted patients and 85.4% of total death cases had a head injury. In addition, 67% of the target population received<br />trauma in more than two parts of their body. The elbow, arm, and hip were the least regions involved.<br />Conclusion: Motorcycle accidents cause severe physical injuries to the patients’ body. Head injury was the most<br />common type of trauma, leading to a wide range of disabilities. Therefore, the use of crash helmets and avoidance of<br />dangerous driving behaviors will remarkably decrease such trauma.<br />Level of evidence: IV
Injury,motorcyclist,Trauma
https://abjs.mums.ac.ir/article_13402.html
https://abjs.mums.ac.ir/article_13402_15c91225bfd7468f81780e6c80496805.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
7
4
2019
07
01
Percutaneous Versus Open Hamstring Lengthening in Spastic Diplegic Cerebral Palsy
373
378
EN
Javad
Khaje Mozafari
0000-0001-7194-8884
Bone and Joint Reconstruction Research Center, Shafa
Orthopaedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
mozafari.ortho@gmail.com
Karim
Pisoudeh
0000-0002-4618-607X
Bone and Joint Reconstruction Research Center, Shafa
Orthopaedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
kpisoudeh@gmail.com
kaveh
Gharanizadeh
Bone and Joint Reconstruction Research Center, Shafa
Orthopaedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
kavehgharani@gmail.com
Mansour
Abolghasemian
0000-0002-5846-2764
Bone and Joint Reconstruction Research Center, Shafa
Orthopaedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
mabolghasemian@gmail.com
10.22038/abjs.2019.36118.1953
Background: Open hamstring lengthening (oHSL) is commonly performed to decrease knee contracture and improve<br />gait and posture for children with spastic diplegia. Furthermore, percutaneous hamstring lengthening (pHSL) is also<br />gaining popularity as an alternative to the open approach. This study aimed to compare the results of pHSL versus<br />oHSL and to determine the efficacy and safety of the percutaneous approach.<br />Methods: This retrospective included 54 patients (108 knees) with spastic diplegia operated for flexed knee gait with<br />either open or percutaneous HSL. The mean age of the participants at the time of surgery was 10.3±1.7 years (age<br />range: 5-25 years) for the open and 8.5±1.5 years (age range: 7-23 years) for the percutaneous group. Overall, 29 and<br />25 children were subjected to oHSL and pHSL, respectively.<br />Results: The mean durations of follow-up were 19.1 months (range: 12-49 months) and 18.3 months (range: 14-<br />45 months) for oHSL and pHSL groups, respectively. In the open group, the mean of preoperative popliteal angle<br />decreased from 64.3±3.6 to 28.4±4.3 (P<0.001), and in the percutaneous group from 63.8±2.7 to 29.5±2.3 (P<0.001).<br />The obtained results revealed no significant differences between the two approaches leading to a similar improvement<br />among the investigated patients (P=0.83).<br />Although the Gross Motor Function Class Score improved significantly within each group (P<0.001); this improvement<br />was insignificant between the groups (P=0.88). The mean of hospital stay for the percutaneous group was 1.6 days<br />(range:1-3 days) compared to 3.6 days (range: 2-6 days) for the open group, which indicated a significant difference<br />(P=0.001). The mean values of total cost were $333 and $473 in the percutaneous group and open group (P=0.001),<br />respectively. There was no significant difference between the groups regarding the complication rate (P=0.85).<br />Conclusion: Percutaneous HSL is a safe, easy, rapid, and brief procedure that is as effective as the open technique for<br />children with spastic diplegia in a short period of time. However, it is essential to examine the effects of this approach<br />during longer follow-ups to generalize the findings of the current study.<br />Level of evidence: III
Cerebral palsy,Diplegia,Hamstring Lengthening,Percutaneous,Popliteal Angle
https://abjs.mums.ac.ir/article_12512.html
https://abjs.mums.ac.ir/article_12512_3b3096f2e6163f07baf900d799bd01d2.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
7
4
2019
07
01
Fatal Cobalt Cardiomyopathy Following Revision Total Hip Arthroplasty – A Brief Report with Review of Literature
379
383
EN
Deepak
Gautam
0000-0002-8104-320X
Department of Orthopedics, All India Institute of Medical
Sciences (AIIMS), New Delhi, India
cmcdeepak@yahoo.com
Ashish
Pande
Department of Orthopedics, Military Hospital, Kirkee,
Pune, India
pande80@gmail.com
Rajesh
Malhotra
0000-0001-5971-003X
Department of Orthopedics, All India Institute of Medical
Sciences (AIIMS), New Delhi, India
rmalhotra62@gmail.com
10.22038/abjs.2018.31469.1818
Ceramic bearing surfaces are being increasingly used in young patients undergoing total hip arthroplasty. However,<br />failures have been reported including fractures even with the newer third generation ceramics. The recommended<br />treatment for fracture of ceramic bearing surfaces is complete synovectomy and revision total hip arthroplasty.<br />However, disappointing results have also been reported with this approach. The residual ceramic particles may lead<br />to complications. We report a fatal case of cobalt toxicity leading to cardiomyopathy secondary to the catastrophic<br />failure of a Cobalt-Chrome femoral head, which followed the revision of a fractured ceramic-on-ceramic total hip<br />arthroplasty.<br />Level of evidence: IV
Ceramic head fracture,Cobalt Toxicity,Fatal cardiomyopathy,Metal on Polyethylene,Revision hip arthroplasty
https://abjs.mums.ac.ir/article_11155.html
https://abjs.mums.ac.ir/article_11155_da58e499366e4747c8e4845f8a06b854.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
7
4
2019
07
01
Improvement of Orthopedic Residency Programs and Diversity: Dilemmas and Challenges, an International Perspective
384
396
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
Raymond M.
Smith
Department of Orthopaedic Surgery, Harvard Medical
School, Massachusetts General Hospital, Boston, MA, USA
malcolm.smith@mgh.harvard.edu
Mohammad H.
Ebrahimzadeh
Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Hans-Christoph
Pape
Universitaets Spital Zuerich, Switzerland
traumatologie@usz.ch
Javad
Parvizi
University of Tehran, Tehran, Iran
parvj@aol.com
Khaled J.
Saleh
0000-0000-0000-0000
Michigan Musculoskeletal Institute, Madison Heights, USA
kjsaleh@gmail.com
Jens-Peter
Stahl
Department of Trauma, Klinikum Dortmund, Germany
jens-peter.stahl@klinikum.do
Johannes
Zeichen
Department of Trauma, Johannes Wesling Klinikum
Minden, Germany
johannes.zeichen@muehlenkreiskliniken.de
James F.
Kellam
Department of Orthopedics, University of Texas, USA
james.kellam@carolinashealthcare.org
SM
Javad
Mortazavi
0000-0003-4189-7777
Joint Reconstruction Research Center
Tehran University of Medical Sciences
smjmort@yahoo.com
Ashok
Rajgopal
Fortis Bone and Joint Institute, India
a_rajgopal@hotmail.com
Vivek
Dahiya
Fortis Bone and Joint Institute, India
v_dahiya@hotmail.com
Wolfgang
Zinser
Department of Orthopedics, St Vinzenz Hospital
Dinslaken, Germany
wolfgang.zinser@st-vinzenz-hospital.de
Leonid
Reznik
Omsk State Medical University, Russia
leo-reznik@yandex.ru
Igor
Shubnyakov
R.R. Vreden Russian Research Institute of Traumatology
and Orthopaedics. Saint Petersburg, Russia
shubnyakov@mail.ru
Marco
Pecina
Department of Orthopaedic Surgery, School of Medicine
University of Zagreb,Croatia
marko.pecina@zg.t-com.hr
Jupiter B.
Jesse
Department of Orthopaedic Surgery, Harvard Medical
School, Massachusetts General Hospital, Boston, MA, USA
jjupiter1@partners.org
10.22038/abjs.2018.29430.1852
Background: To date, little has been published comparing the structure and requirements of orthopedic training programs<br />across multiple countries. The goal of this study was to summarize and compare the characteristics of orthopedic training<br />programs in the U.S.A., U.K., Canada, Australia, Germany, India, China, Saudi Arabia, Russia and Iran.<br />Methods: We communicated with responders using a predetermined questionnaire regarding the national orthopedic<br />training program requirements in each respondent’s home country. Specific items of interest included the following: the<br />structure of the residency program, the time required to become an orthopedic surgeon, whether there is a log book,<br />whether there is a final examination prior to becoming an orthopedic surgeon, the type and extent of faculty supervision,<br />and the nature of national in-training written exams and assessment methods. Questionnaire data were augmented by<br />reviewing each country’s publicly accessible residency training documents that are available on the web and visiting<br />the official website of the main orthopedic association of each country.<br />Results: The syllabi consist of three elements: applied clinical knowledge, applied clinical skills, and professional and<br />management skills. The application of simulation techniques for both teaching and assessment are fundamental to<br />modern surgical education. The skill of today’s trainees predicts the quality of future orthopedic surgeons. The European<br />Board of Orthopaedics and Traumatology (EBOT) exam throughout the European Union countries should function as<br />the European board examination in orthopedics. We must standardize many educational procedures worldwide in the<br />same way we standardized patient safety.<br />Conclusion: Considering the world’s cultural and political diversity, the world is nearly unified in regards to orthopedics.<br />The procedures (structure of the residency programs, duration of the residency programs, selection procedures, using a log<br />book, continuous assessment and final examination) must be standardized worldwide, as implemented for patient safety.<br />To achieve this goal, we must access and evaluate more information on the residency programs in different countries and<br />their needs by questioning them regarding what they need and what we can do for them to make a difference.<br />Level of evidence: III
Cultural Competences,Educational Procedures,Politics,residency programs,Women in orthopedics
https://abjs.mums.ac.ir/article_12493.html
https://abjs.mums.ac.ir/article_12493_f4589146637d15282bbc87db70c8dc39.pdf