@article { author = {RODRIGUEZ-MERCHAN, E. Carlos and Kachooei, Amir R.}, title = {Is There any Difference in the Survival of Conversion TKA After Previous HTO In Compare to Previous UKA? Factors to be Considered When Offering a Surgery}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {368-370}, year = {2021}, 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.2020.52131.2575}, abstract = {Medial unicompartmental knee arthroplasty (UKA) and valgus high tibial osteotomy (HTO) are reliable treatments for medial unicompartmental knee osteoarthritis, which are often indicated in relatively young and active patients. However, when the aforementioned surgical procedures fail or the osteoarthritis progresses, patients are offered conversion to the total knee arthroplasty (TKA). It has been recently published that a previous UKA more than doubles the risk of revision than a previous HTO. Although such study has some important limitations, the aforesaid risk must be taken into account when offering surgery to help patients contribute in shared-decision making.}, keywords = {TKA,previous UKA,previous HTO,risk of revision}, url = {https://abjs.mums.ac.ir/article_16859.html}, eprint = {https://abjs.mums.ac.ir/article_16859_df76fb22c40305728016a38df4a33686.pdf} } @article { author = {Kellish, Alec and Hakim, Abraham and Shahi, Alisina and Gutowski, Christina and Kleiner, Matthew}, title = {The Delivery of Orthopaedic Care amidst COVID-19 and Social Distancing}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {371-378}, year = {2021}, 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.2020.48498.2406}, abstract = {In this paper we present the findings of a literature review covering articles published in the last three decades describingthe application of telemedicine in orthopaedics. A review of the PubMed Central and Medline provided 75 articlesstudying the role of telemedicine, the majority directly examining the application of telemedicine in orthopaedic patients.We report the summarized findings of these studies, the financial and HIPAA considerations of using telemedicine, andprovide an example of our single urban level-1 trauma center’s strategy for incorporating telemedicine into the clinicalpractice of orthopaedic surgeons during the COVID-19 pandemic.Level of evidence: V}, keywords = {COVID-19,Orthopedics,social distancing,Telehealth,Telemedicine}, url = {https://abjs.mums.ac.ir/article_17003.html}, eprint = {https://abjs.mums.ac.ir/article_17003_b23c7407fd6eeb0839a14a4c7ce82723.pdf} } @article { author = {RODRIGUEZ-MERCHAN, E. Carlos}, title = {Patient Satisfaction Following Primary Total Knee Arthroplasty: Contributing Factors}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {379-386}, year = {2021}, 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.2020.46395.2274}, abstract = {The reported dissatisfaction rate after primary total knee arthroplasty (TKA) ranges between 15% and 25%. The purposeof this article is to perform a narrative review of the literature with the aim of answering the following question: What arethe main factors contributing to patient dissatisfaction after TKA? A review of the literature was performed on patientsatisfaction after TKA. The search engines used were MedLine (PubMed) and the Cochrane Library. The keywords usedwere “TKA” and “satisfaction”. The main reported preoperative factors positively contributing to patient satisfaction werethe following: fulfilment of preoperative expectations, preoperative complete joint space collapse, increasing patellar andlateral compartment osteophyte size, and TKA communication checklist. The principal preoperative factors negativelycontributing to patient satisfaction included female sex, comorbidities, and Hispanic race. The chief perioperative factorpositively contributing to patient satisfaction was cosmetic closure, whereas the fundamental perioperative factorsnegatively contributing to patient satisfaction included joint laxity, anterior tibial component slope, and greater femoralcomponent valgus angle. The principal postoperative factors positively contributing to patient satisfaction were thefollowing: ameliorated walking distance, improved range of motion, and improvements in pain. The most importantpostoperative factors negatively contributing to patient satisfaction included poor postoperative knee stability and softtissuebalance, functional limitation, surgical complication and reoperation, staff or quality of care issues, and increasedstiffness.Level of evidence: III}, keywords = {Arthroplasty,knee,Patient Satisfaction,Total knee arthroplasty}, url = {https://abjs.mums.ac.ir/article_16851.html}, eprint = {https://abjs.mums.ac.ir/article_16851_d93db0591d8c0d90fce657a89c079ed4.pdf} } @article { author = {Graham, Jack and McAlpine, Lindsay and Medina, Juana and Jawahier, Priscilla and Beredjiklian, Pedro and Rivlin, Michael}, title = {Recurrence of Ganglion Cysts Following Re-excision}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {387-390}, year = {2021}, 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.2020.34661.1958}, abstract = {Background: The recurrence of ganglion cysts after surgical excision has a reported rate of 4% to 40%. Recurrence rateafter revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cystsin patients who underwent a secondary excision procedure.Methods: With Institutional Review Board approval, we retrospectively identified by CPT code and reviewed charts ofpatients who had recurrent ganglion cyst excision performed over a five-year period (2010 – 2014). Recurrence was definedas reappearance of a cyst in the same area as it was previously. Demographic information including recurrences andrevision surgeries was collected in addition to outcome variables such as patient satisfaction, pain levels, and functionallimitations.Results: Out of the 42 revision cases identified 20 patients were reached. Mean time to recurrence of the cyst after the firstganglion cyst excision was 2.5 years (range: 1 month - 12 years). After the second ganglion cyst excision, three patients(15%) had a recurrence, each occurring within one year (mean: 11 months; range: 9-12). One of the three patients underwenta third successful ganglion cyst excision. The other two patients declined surgical intervention to date. Patients without asecond recurrence (n=17) reported an average pain score of 0.1 (range: 0-2) on a scale of 1-10. Three (18%) reported somedifficulty with day-to-day activities due to their scar. Seven (41%) patients reported at least transient numbness or tingling.Mean satisfaction was 9.8 on a scale of 1-10, and 100% reported that they would undergo another ganglion cyst excisionshould they ever have another recurrence.Conclusion: Patients should be advised about the risk of recurrence after re-excision of ganglion cysts, which was notedto be 15% in our cohort. This rate of recurrence is similar to that of primarily excised cysts.Level of evidence: III}, keywords = {Ganglion cyst,Recurrence,Surgical excision,wrist surgery}, url = {https://abjs.mums.ac.ir/article_17104.html}, eprint = {https://abjs.mums.ac.ir/article_17104_f0be53e2dc6498a47660ea8769057e34.pdf} } @article { author = {Pandey, Vivek and Joseph, CJ and Mathai, Naveen and Madi, Sandesh and Gowda, Lakshmikanth and Jaap, Willems}, title = {Five Year Follow up of Retrospective Cohort Comparing Structural and Functional Outcome of Arthroscopic Single-row versus Double-row Suture Bridge Repair of Large Posterosuperior Rotator Cuff Tear in Patients Less than or Equal to 70 Years}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {391-398}, year = {2021}, 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.2020.47883.2369}, abstract = {Background: High re-tear rates after repairing large-sized posterosuperior rotator cuff tears remain a significantconcern which may affect the clinical outcome. The most optimal type of repair (single versus double-row suturebridge) suited for large size tear remains debatable.Methods: In a retrospective cohort study with a minimum of five years follow up, the structural and functional outcome of103 patients with large size cuff tear repaired with single row (SR) or double row suture bridge (DRSB) were evaluated.The structural outcome was assessed with ultrasonography whereas functional outcome was evaluated with ConstantMurley (CM) and American shoulder elbow score (ASES).Results: There were 55 patients in the SR group and 48 patients in the DRSB group with a mean follow-up of 74.2months (range, 60-96 months). While comparing the structural integrity in two groups, we found significantly lower retearrates in the DRSB group as compared to the SR group (10.4% vs. 32.7%; P=0.006). Also, there were more focaldefects in the SR group (25.4%) than the DRSB group (8.3%). Overall, there was no significant difference in CM andASES scores when the SR group was compared to DRSB. However, subgroup analysis between those with intact andretorn tendon revealed significant difference (P=0.0001) in the clinical scores.Conclusion: At a minimum of five years follow-up, the DRSB repair of large posterosuperior cuff tear resulted insuperior structural healing over SR repair. Nevertheless, overall there was no significant functional difference betweenboth the techniques. However, the functional outcome of the healed tendon subgroup was superior to retear tendonsubgroup.Level of evidence: III}, keywords = {large size,Outcome,posterosuperior,repair,Rotator cuff tear,single row,suture bridge}, url = {https://abjs.mums.ac.ir/article_17002.html}, eprint = {https://abjs.mums.ac.ir/article_17002_a74f116bc6bff78bf34a45edb0809e9a.pdf} } @article { author = {Alsubheen, Sanaa Atyah and MacDermid, Joy Christine and Faber, Kenneth John and Overend, Tom}, title = {Factors Predicting Postoperative Range of Motion and Muscle Strength one Year after Shoulder Arthroplasty}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {399-405}, year = {2021}, 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.2020.48521.2405}, abstract = {Background: Shoulder arthroplasty improves shoulder range of motion (ROM), strength and function in patientswith advanced shoulder disease. However, clinical outcomes vary and are not always predictable among patients.Pre-operative factors and patients’ characteristics may influence improvement after surgery. This study examined theimpact of the pre-operative objective measures range of motion (ROM) and strength, age, sex, and comorbidities onshoulder ROM, strength status and the amount of improvement one year following shoulder arthroplasty.Methods: 140 patients were assessed pre-operatively and one year after shoulder arthroplasty in this prospectivecohort study. Pearson’s correlations and multiple regression analyses were performed to test the impact of potentialpredictors on abduction, flexion, internal rotation and external rotation ROM as well as on shoulder abductors, flexors,internal rotators and external rotators strength at one year.Results: Pre-operative ROM significantly predicted 10% - 37% of the improvement in ROM after surgery. Less preoperativeROM was associated with a greater improvement in ROM. Less pre-operative muscle strength was associatedwith a greater improvement in strength after surgery. Pre-operative shoulder muscles predicted 28% - 38% of thestrength status at one year, and 24% - 43% of the improvement in strength postoperatively. Older age was associatedwith less improvement in ROM and strength at one year. With other predictors, age explained 37% of the change inROM and 36% of the change in strength. Male sex was associated with greater improvement in muscle strength. Sexsignificantly predicted 24% - 36% of the change in strength.Conclusion: Pre-operative ROM and strength, age, and sex are significant predictors of the improvement in theshoulder ROM and strength one year after shoulder arthroplasty. The improvement in these measures is expected todecline with age and men are expected to gain more strength than women following this surgical intervention.Level of evidence: II}, keywords = {Muscle strength,Range of motion,Shoulder Arthroplasty}, url = {https://abjs.mums.ac.ir/article_17004.html}, eprint = {https://abjs.mums.ac.ir/article_17004_8f4c7096a85b197e57815c1715b57066.pdf} } @article { author = {Coste, Marine and Aggarwal, Vineet and Shah, Neil V. and Kim, David and Hariri, Omar and Day, Louis and Pascal, Scott and Mistry, Jaydev and Urban, William and Aibinder, William and Von Keudell, Arvind and Suneja, Nishant}, title = {Comparing Relative Value Units among Shoulder Arthroplasty, Hemiarthroplasty, and ORIF for Proximal Humerus Fractures in the Elderly: Which is Most Worth Your Time?}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {406-411}, year = {2021}, 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.2020.51204.2539}, abstract = {Background: Relative value units (RVUs) are assigned to Current Procedural Technology (CPT) codes and giverelative economic values to the services physicians provide. This study compared the RVU reimbursements for thesurgical options of proximal humerus fractures in the elderly, which include arthroplasty (reverse [RSA] and total [TSA]),hemiarthroplasty (HA), and open reduction and internal fixation (ORIF).Methods: Using the National Surgical Quality Improvement Program, a total of 1,437 patients of at least 65 yearsof age with proximal humerus fractures between 2008 and 2016 were identified. Of those, 259 underwent RSA/TSA(CPT code 23472), 418 underwent HA (CPT codes 23470 and 23616), and 760 underwent ORIF (CPT code 23615).Univariate analysis compared RVU per minute, reimbursement rate, and the average annual revenue across cohortsbased on respective operative times.Results: RSA/TSA generated a mean RVU per minute of 0.197 (SD 0.078; 95%CI [0.188, 0.207]), which wassignificantly greater than the mean RVU per minute for 23470 HA (0.156; SD 0.057; 95%CI [0.148, 0.163]), 23616 HA(0.166; SD 0.065; 95%CI [0.005, 0.156]), and ORIF (0.135; SD 0.048; 95%CI [0.132, 0.138]; p <0.001). This convertedto respective reimbursement rates of $6.97/min (SD 2.78; 95%CI [6.63, 7.31]), $5.48/min (SD 2.05; 95%CI [5.22,5.74]), $5.83/min (SD 2.28; 95%CI [5.49, 6.16]) and $4.74/min (SD 1.69; 95%CI [4.62, 4.87]). After extrapolation,respective average annual revenues were $580,386, $456,633, $475,077, and $395,608.Conclusion: RSA/TSA provides significantly greater reimbursement rates compared to HA and ORIF. Orthopaedicsurgeons can use this information to optimize daily procedural cost-effectiveness in their practices.Level of evidence: III}, keywords = {geriatric population,humeral fracture,relative value analysis,surgical management}, url = {https://abjs.mums.ac.ir/article_17007.html}, eprint = {https://abjs.mums.ac.ir/article_17007_2c39ae2c1f7742e925477457b907a701.pdf} } @article { author = {Henry, Tyler W. and Gutman, Michael and Backal, Amy and Namdari, Surena}, title = {The Surgical Treatment of Deep Infection in the Native Shoulder Joint}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {412-417}, year = {2021}, 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.2020.50100.2484}, abstract = {Background: The overall clinical picture surrounding native shoulder infections, and, in particular, the associatedlong-term functional outcomes of treatment are presently underreported. The purpose of this study is to examine thedemographics, diagnostic and treatment strategies, and functional outcomes of isolated shoulder joint sepsis treatedwith surgical irrigation and debridement (I&D).Methods: All patients treated with I&D for native shoulder sepsis between 2007 – 2017 were identified. Those withouta minimum of one-year follow-up were excluded. Functional outcomes scores, reoperations, and predictors of pooroutcome were evaluated.Results: Twenty-three patients were included in the final study population. Mean age-adjusted CCI score was 4.1 (SD= 3.4, Range = 0 – 10). Twelve patients (52.2%) were treated with open I&D, while 11 patients (47.8%) were treatedarthroscopically. Nine patients (39.1%) required multiple I&Ds (mean total number of I&Ds = 1.7, SD = 1.0, Range:1 – 4). Five patients (21.7%) had at least one documented reinfection after their initial hospitalization, with the initialrecurrence of infection occurring 2 – 15 months after the index procedure. Mean ASES score at final follow-up was 55.3(SD = 26.7, Range: 5.8 – 98.3) and mean SANE score was 53.3 (SD = 30.6, Range: 0 – 100). Stepwise multiple linearregression modeling identified intravenous drug abuse as the most significant predictor for final ASES score [F(1,18)= 6.12, p = .024, adjusted R2 = .254].Conclusion: Following isolated shoulder joint sepsis, infection clearance and acceptable functional outcomes can beachieved using surgical I&D followed by a course of antibiotics, but outcomes are variable.Level of evidence: IV}, keywords = {Infection,native,outcomes,Sepsis,shoulder,Treatment}, url = {https://abjs.mums.ac.ir/article_16855.html}, eprint = {https://abjs.mums.ac.ir/article_16855_b49d8f804c88c3df66ff5127bedf7322.pdf} } @article { author = {Zhang, Dafang and Earp, Brandon E. and Dyer, George}, title = {Skin Tenting in Displaced Midshaft Clavicle Fractures}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {418-422}, year = {2021}, 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.2020.45004.2230}, abstract = {Background: The objectives of this study were to (1) identify factors associated with skin tenting in displaced midshaftclavicle fractures and (2) analyze individual surgeon variation in this diagnosis.Methods: A retrospective cohort study was performed at two Level I trauma centers of 396 patients with displacedmidshaft clavicle fractures treated by 47 surgeons with open reduction internal fixation from January 2010 to March2019. Our main outcome measure was skin tenting, as diagnosed by the treating surgeon and used as an indicationfor surgical treatment.Results: Skin tenting was diagnosed by the treating surgeon in 34 out of 396 patients (9%) with displaced midshaftclavicle fractures. Multivariable logistic regression analyses showed that lower BMI (P=0.002) and fracture shortening(P=0.03) were independently associated with skin tenting in displaced midshaft clavicle fractures. There was widevariation among surgeons in the rate of diagnosis of skin tenting, ranging from 0% to 41% prevalence of skin tentingdepending on the treating surgeon (p <0.0001).Conclusion: Although lower BMI and greater fracture shortening were associated with skin tenting, the diagnosisis subjective. We found wide variation in the diagnosis of skin tenting, even among surgeons within a singlemetropolitan area.Level of evidence: III}, keywords = {Body mass index,displaced clavicle fracture,Midshaft clavicle fracture,skin tenting,surgeon variation}, url = {https://abjs.mums.ac.ir/article_16625.html}, eprint = {https://abjs.mums.ac.ir/article_16625_15b61f6a8d5976b5a642861536e70863.pdf} } @article { author = {Brennan, Caitlin and Yong, Li and Foley, Jon and McKie, Scott and Rust, Philippa}, title = {The Value of the Distal Radioulnar Joint Effusion in Diagnosing Triangular Fibrocartilage Complex Tears on Magnetic Resonance Imaging}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {423-426}, year = {2021}, 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.2020.48520.2464}, abstract = {Background: A retrospective study was conducted to evaluate the role of distal radioulnar joint (DRUJ) effusion inaiding the diagnostic accuracy of central triangular fibrocartilage complex (TFCC) tears on non-contrast MRI.Methods: 89 consecutive patients who had undergone wrist arthroscopy for ulna sided wrist pain in our unit wereidentified and their preoperative imaging reviewed. Two consultant musculoskeletal Radiologists independentlyreported the presence or absence of a DRUJ effusion and or a TFCC tear. The inter-observer variability was calculatedusing weighted Kappa tests. Two by two tables were constructed to calculate the sensitivity and specificity of reportedTFCC tear or DRUJ effusion on MRI in correctly diagnosing central TFCC tears identified at arthroscopy.Results: Sensitivity of MRI to report a TFCC tear was 0.56 and specificity was 0.79. Sensitivity increased to 0.89if either a DRUJ effusion or TFCC tear were seen on MRI. When observed together, the presence of both a DRUJeffusion and a TFCC tear seen on the imaging lead to a sensitivity of 0.74 and PPV of 82% when compared tofindings at arthroscopy. In the absence of both DRUJ effusion and TFCC tear, the specificity of MRI increased to 0.92.Agreement by the radiologists on the presence of DRUJ effusion was substantial (k value 0.67) and TFCC tear wasmoderate (k value 0.58).Conclusion: The presence of DRUJ effusion on MRI can further improve sensitivity of MRI in diagnosing central TFCCtears. The sensitivity of detecting a central TFCC tear on MRI scan when both a DRUJ effusion and a TFCC tear wereseen (0.74) is comparable to rates demonstrated on MRA meta-analysis results (0.78). Furthermore, considering theabsence of both a DRUJ effusion and TFCC tear seen on MRI is useful in excluding the presence of a TFCC tear atarthroscopy.Level of evidence: III}, keywords = {Arthroscopy,Triangular fibrocartilage complex,Wrist injuries}, url = {https://abjs.mums.ac.ir/article_17105.html}, eprint = {https://abjs.mums.ac.ir/article_17105_d0a310d95ef64fe22ffc4ac380d896e4.pdf} } @article { author = {Henry, Tyler and McEntee, Richard and Matzon, Jonas and Beredjiklian, Pedro K. and Lutsky, Kevin}, title = {Deep Infection after Distal Radius Open-reduction Internal Fixation: A Case Series}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {427-431}, year = {2021}, 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.2020.52635.2603}, abstract = {Background: Given its low incidence, the management of deep infection following distal radius open-reduction internalfixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this caseseries is to present the treatment strategies and functional outcomes associated with deep infection after distal radiusORIF.Methods: All patients with deep infections after distal radius ORIF over a ten-year period were identified and theirtreatment courses asessed.Results: The cohort consisted of three women and one man with an average age of 55.5 ± 17.6 years. Mean timefrom infection presentation to irrigation and debridement (I&D) with removal of hardware (ROH) was 16 days (Range:3 – 44 days). The identified bacterial species in all cases was Staphylococcus aureus (MRSA = 2, MSSA = 2). Threepatients were treated with intravenous antibiotics, while one patient was treated with oral antibiotics. Mean time frominfection presentation to final clinical follow-up was 11 months (Range: 3 – 20 months). Two patients required repeatI&D. A clinical determination of successful infection eradication was made in all cases.Conclusion: The reported rate of deep infection after distal radius ORIF is less than 1%. There is no well-definedtreatment algorithm for patients with deep infection after distal radius ORIF. However, removal of hardware and postoperativeoral or intravenous antibiotic therapy appears effective, and is consistent with the standard practices oftreating infection after other orthopaedic surgeries.Level of evidence: IV}, keywords = {Distal radius,Infection,open-reduction internal fixation,Treatment}, url = {https://abjs.mums.ac.ir/article_17010.html}, eprint = {https://abjs.mums.ac.ir/article_17010_f5790fdaa5f800924d0079d35398057e.pdf} } @article { author = {Lebowitz, Cory and Massaglia, Joseph and Hoffman, Christopher and Lucenti, Ludovico and Dheer, Sachin and Rivlin, Michael and Beredjiklian, Pedro}, title = {The Accuracy of 3D Printed Carpal Bones Generated from Cadaveric Specimens}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {432-438}, year = {2021}, 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.2020.50236.2495}, abstract = {Background: Computer assisted three-dimensional (3D) printing of anatomic models using advanced imaging haswide applications within orthopaedics. The purpose of this study is to evaluate the 3D printing accuracy of carpalbones.Methods: Seven cadaveric wrists underwent CT scanning, after which select carpal bones (scaphoid, capitate, lunate,and trapezium) were dissected in toto. Dimensions including length, circumference, and volume were measured directlyfrom the cadaver bones. The CT images were converted into 3D printable stereolithography (STL) files. The STL fileswere converted into solid prints using a commercially available 3D printer. The 3D printed models’ dimensions weremeasured and compared to those of the cadaver bones. A paired t-test was performed to determine if a statisticallysignificant difference existed between the mean measurements of the cadavers and 3D printed models. The intraclasscorrelation coefficients (ICC) between the two groups were calculated to measure the degree of agreement.Results: On average, the length and circumference of the 3D printed models were within 2.3 mm and 2.2 mm,respectively, of the cadaveric bones. There was a larger discrepancy in the volume measured, which on average waswithin 0.65 cc (15.9%) of the cadaveric bones. These differences were not statistically significant (P > 0.05). Therewas strong agreement between all measurements except the capitate’s length and lunate’s volume.Conclusion: 3D printing can add value to patient care and improve outcomes. This study demonstrates that 3D printingcan both accurately and reproducibly fabricate boney models that closely resemble the corresponding cadaveric anatomy.Level of evidence: V}, keywords = {cadaver,Carpal bones,Computed Tomography (CT),Three-dimensional (3D)}, url = {https://abjs.mums.ac.ir/article_17005.html}, eprint = {https://abjs.mums.ac.ir/article_17005_8d322eeefb28b71499b2f143ab71e574.pdf} } @article { author = {Miner, Harrison and Ring, David and Koenig, Karl}, title = {Convenience is Key for Patient Engagement with Remote Video Visits in a Musculoskeletal Practice}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {439-444}, year = {2021}, 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.2020.50024.2480}, abstract = {Background: Remote video visits (aka telemedicine, virtual care) have the potential to increase access to orthopaedicspecialty evaluation while decreasing the overall cost of care. Clinical implementation of remote video visits may benefitfrom an understanding of potential barriers to participation.Methods: We enrolled one hundred and thirty participants from a university-based musculoskeletal clinic with a largeuninsured population. We asked participants to complete a survey, including demographics and scaled perceptionquestions about remote video visits. Data from these surveys were analyzed with multivariable logistic regression todetermine factors associated with willingness to participate in video visits, as well as the situations in which patientswould consider a video visit.Results: Willingness to participate in video visits was associated with the perception of video visits being moreconvenient (OR 3.0) and a decreased perceived importance of physical exam (OR 0.36) but not age, technologycomfort, or travel distance to the clinic. Additionally, those with prior video visit experience were more comfortablewith technology, perceived video visits to be more convenient, and were more willing to have another video visit.Fifteen percent were willing to have a video visit for their first visit, while 78% would participate for a routine nonsurgicalfollow-up.Conclusion: Musculoskeletal telemedicine programs can become established by focusing on people that prioritizeconvenience, place less importance on a hands-on exam, and are established patients.Level of evidence: II}, keywords = {musculoskeletal care,Telemedicine,Virtual,willingness}, url = {https://abjs.mums.ac.ir/article_16571.html}, eprint = {https://abjs.mums.ac.ir/article_16571_440d38175f2f7b48934e079fc352454a.pdf} } @article { author = {Akbari Aghdam, Hossein and Bagherifard, Abolfazl and Motififard, Mehdi and Parvizi, Javad and Sheikhbahaei, Erfan and Esmaeili, Saeid and Saber samandari, Saeed and Khandan, Amirsalar}, title = {Development of Porous Photopolymer Resin-SWCNT Produced by Digital Light Processing Technology Using for Bone Femur Application}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {445-452}, year = {2021}, 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.2020.43409.2189}, abstract = {Background: Although bone tissue has the unique characteristic of self-repair in fractures, bone grafting is needed in somesituations. The synthetic substances that are used in such situations should bond to the porous bones, be biocompatibleand biodegradable, and do not stimulate the immune responses. Biomaterial engineering is the science of finding anddesigning novel products. In principle, the most suitable biodegradable matrix should have adequate compressive strengthof more than two megapascals. At this degradation rate, the matrix can eventually be replaced by the newly formed bone,and the osteoprogenitor cells migrate into the scaffold. This study aimed to evaluate the fabrication of a scaffold made ofpolymer-ceramic nanomaterials with controlled porosity resembling that of spongy bone tissue.Methods: A compound of resin polymer, single-walled carbon nanotube (SWCNT) as reinforcement, and hydroxyapatite(HA) were dissolved using an ultrasonic and magnetic stirrer. A bio-nano-composite scaffold model was designed in theSolidWorks software and built using the digital light processing (DLP) method. Polymer-HA scaffolds with the solvent systemwere prepared with similar porosity to that of human bones.Results: HA-polymer scaffolds had a random irregular microstructure with homogenizing porous architecture. The SWCNTimproved the mechanical properties of the sample from 25 MPa to 36 MPa besides having a proper porosity value near55%, which can enhance the transformation and absorption of protein in human bone.Conclusion: The combined bio-nanocomposite had a suitable porous structure with acceptable strength that allowed it tobe used as a bone substitute in orthopedic surgery.}, keywords = {3-D Printing,Biocompatible materials,carbon nanotubes,Hydroxyapatite,Tissue engineering}, url = {https://abjs.mums.ac.ir/article_16850.html}, eprint = {https://abjs.mums.ac.ir/article_16850_5842f9f45fc3dc7ab484b6834d2566bf.pdf} } @article { author = {Lim, Jiang An and Thahir, Azeem and Korde, Vinayak Amar and Krkovic, Matija}, title = {The Impact of COVID-19 on Neck of Femur Fracture Care: A Major Trauma Centre Experience, United Kingdom}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {453-460}, year = {2021}, 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.2020.50429.2502}, abstract = {Background: The aim of this study was to investigate the impact of the COVID-19 pandemic on the management andoutcome of patients with neck of femur fractures.Methods: Data was collected for 96 patients with neck of femur fractures who presented to the emergency departmentbetween March 1, 2020 and May 15, 2020. This data set included information about their COVID-19 status.Parameters including inpatient complications, hospital quality measures, mortality rates, and training opportunitieswere compared between the COVID-19 positive and COVID-19 negative groups. Furthermore, our current cohort ofpatients were compared against a historical control group of 95 patients who presented with neck of femur fracturesbefore the COVID-19 pandemic.Results: Seven (7.3%) patients were confirmed COVID positive by RT-PCR testing. The COVID positive cohort, whencompared to the COVID negative cohort, had higher rates of postoperative complications (71.4% vs 25.9%), increasedlength of stay (30.3 days vs 12 days) and quicker time to surgery (0.7 days vs 1.3 days).The 2020 cohort compared to the 2019 cohort, had an increased 30-day mortality rate (13.5% vs 4.2%), increasednumber of delayed cases (25% vs 11.8%) as well as reduced training opportunities for Orthopaedic trainees to performthe surgery (51.6% vs 22.8%).Conclusion: COVID-19 has had a profound impact on the care and outcome of neck of femur fracture patients duringthe pandemic with an increase in 30-day mortality rate. There were profound adverse effects on patient managementpathways and outcomes while also affecting training opportunities.Level of evidence: VI}, keywords = {Coronavirus,COVID-19,Hip fracture,Neck of Femur Fracture,SARS-CoV-2}, url = {https://abjs.mums.ac.ir/article_16856.html}, eprint = {https://abjs.mums.ac.ir/article_16856_311b56ce9e75f254b903df73945efd30.pdf} } @article { author = {Cardile, Carlo and Cazzaniga, Carlo and Manzini, Beatrice and Bongiovanni, Marco and Marasco, Roberto and Ragni, Paolo}, title = {The Charcot Knee Arthropaty: The Diagnostic and Surgical Challenge. A Case of Syphilis Arthropaty and a Review of Literature}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {461-466}, year = {2021}, 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.2020.51828.2557}, abstract = {The Charcot knee is a progressive, degenerative disease of the joint that may represent a diagnostic challenge; atthe moment, poorly controlled diabetes mellitus is the main cause of this condition. We describe here a case of a manpresenting with an end stage joint arthropathy who was diagnosed with neurosyphilis. Tabetic arthropathy is currentlya very rare disease, but in the past represented the main cause of joint arthropathy. Finally, we discussed the differentsurgical options of Charcot arthropathy, our choice of megaprosthesis implant and the failure of such procedure mainlydue to patient’s unreliability to care leading to infective complications and peri-prosthesis fracture.Level of evidence: IV}, keywords = {Arthroplasty,Charcot,knee,Syphilis,tabetic arthropaty}, url = {https://abjs.mums.ac.ir/article_17008.html}, eprint = {https://abjs.mums.ac.ir/article_17008_8760b067982ff04944059ea00990c654.pdf} } @article { author = {Sedigh, Ashkan and Zohoori, Mohammad and Ebrahimzadeh, Mohammad H. and Kachooei, Amir R.}, title = {Cubitus Varus Corrective Osteotomy and Graft Fashioning Using Computer Simulated Bone Reconstruction and 3D Printed Custom-Made Cutting Guides}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {467-471}, year = {2021}, 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.2020.52457.2592}, abstract = {Preoperative planning is of paramount importance in saving time as well as helping achieve a more precise correction ofthe deformities. Along with preoperative measurements, customized cutting guides can facilitate intraoperative correctionof the deformity with higher confidence. In this report, we are presenting the application of preoperative planning and3D printed customized cutting guides for correcting cubitus varus alignment of the elbow in an 18 year old male withsatisfactory intraoperative and postoperative results.Level of evidence: IV}, keywords = {3D-printing,Computer-aided-design,Cubitus varus,Elbow,Osteotomy,Pre-operative Planning}, url = {https://abjs.mums.ac.ir/article_17009.html}, eprint = {https://abjs.mums.ac.ir/article_17009_8428896e6c2696c9dadcfd0722b7b4c6.pdf} } @article { author = {Vaishya, Raju and Kumar, Sathish and Vaish, Abhishek and Babu, Y.S. Suresh}, title = {Effectiveness of the Guidelines for the Non-Operative Management of Knee Osteoarthritis}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {4}, pages = {472-474}, year = {2021}, 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.2020.51112.2535}, abstract = {Various treatment guidelines exist for the treatment of knee OA which is very common in the tropical countries. A multitude of treatment guidelines creates confusion for the primary physician to manage patients with OA. Therefore, a consensus treatment guideline is necessary to clarify this discrepancy and to manage the patients with evidence-based treatment modalities. Analysis of the six existing guidelines on the management of knee OA, based on the strength of their recommendations was performed. We studied six guidelines regarding various modes of non-operative treatment of knee OA. There is consensus on efficacy of self-management programmes, land-based exercise and weight loss. These guidelines do not recommend the use of acupuncture in OA and there was a mixed opinion for the use of physiotherapy modalities and orthotics. NSAIDS are recommended for pain relief, along with their topical forms, their long term use is not advisable. Role of paracetamol for early disease process and opioids for later part of the disease is debatable and use of Glucosamine and Chondroitin has been discouraged by most of these guidelines. Use of intra-articular steroids for acute pain and inflammation is recommended, but not for Stem cells and Platelet Rich Plasma therapy, by the majority.Use of HA is still debatable. Although there are multiple treatment guidelines described for the management of knee OA, there is no consensus on many treatment modalities. There are periodical changes in the treatment protocol due to new studies available with new results. Despite pharmacological and surgical modalities keep evolving, patient factors have to be considered while recommending the treatment in patients of knee OA.}, keywords = {knee,Osteoarthritis,Guidelines,Non-operative management,Pain,Drugs}, url = {https://abjs.mums.ac.ir/article_16574.html}, eprint = {https://abjs.mums.ac.ir/article_16574_e7e217c63dd2cea5b6ed73e3bce08e21.pdf} }