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
9
6
2021
11
01
Cutting-Edge Posterior Cruciate Ligament Reconstruction Principles
607
617
EN
Foley
J. Schreier
1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A
2 University of North Dakota School of Medicine and Health Sciences, 1301 N Columbia Rd, Grand Forks, ND 58203 U.S.A
Mark
T. Banovetz
1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A 3 University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 U.S.A
Ariel
N. Rodriguez
1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A 4 Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC 20007 U.S.A
Robert F.
LaPrade MD, PhD
0000-0002-9823-2306
Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A
laprademdphd@gmail.com
10.22038/abjs.2021.59467.2946
The posterior cruciate ligament (PCL) is the primary stabilizer to posterior tibial translation of the knee. PCL injuries classically occur as the result of a posteriorly directed force against the anterior part of the tibia. They frequently occur as multiligament injuries or with concomitant cartilage or meniscal injuries. The posterior drawer test is highly sensitive and specific for PCL injuries. Posterior stress radiography is critical for objective assessment of posterior tibial translation and grading of PCL injuries. Grade I and II injuries may be treated nonoperatively, but in general isolated grade III injuries and multiligament injuries require surgical intervention due to the inevitable development of osteoarthritis. Anatomical and biomechanical studies have led to the development of an anatomic double-bundle reconstruction, which has been reported in clinical outcome studies to result in better functional and objective outcomes than single-bundle reconstructions. This article focuses on the clinically and surgically relevant anatomy and biomechanics of the PCL, diagnosis and treatment of PCL injuries, and a description of the anatomic double-bundle PCL reconstruction technique.
Posterior cruciate ligament,Reconstruction,meniscus root
https://abjs.mums.ac.ir/article_18882.html
https://abjs.mums.ac.ir/article_18882_ae9b952e44716781ee9161ced94ee969.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
9
6
2021
11
01
The Influence of Obesity on Unicompartmental Knee Arthroplasty Outcomes: A Systematic Review And Meta-Analysis
618
632
EN
Hannah Jia Hui
Ng
0000-0002-2267-647X
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore 11 Jalan Tan Tock Seng, Singapore 308433
hannahnjh@gmail.com
Wei Jie
Loke
Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom
wjloke@gmail.com
Wee
Liang Hao James
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore 11 Jalan Tan Tock Seng, Singapore 308433
james_wee@ttsh.com.sg
10.22038/abjs.2021.57357.2842
Obesity is associated with a greater prevalence of symptomatic knee osteoarthritis. Obese patients are thought to have worse outcomes following unicompartmental knee arthroplasty (UKA).The aim is to compare clinical and functional outcomes of UKA in obese to non-obese patients. A systematic review on six databases (PubMed, MEDLINE, Embase, Web of Science, Scopus, and CENTRAL) from inception through July 2020 was performed. We extracted data to determine revision risk (all-cause, septic, and aseptic), complication risk, and infection risk, functional outcome scores (Knee Society Score [KSS], Oxford Knee Score [OKS], and range of movement [ROM]) in patients with obesity (BMI >30kg/m2) to non-obese patients (BMI <30kg/m2). Meta-analysis was performed using a random effects model. The MINORS criteria was used for quality assessment. Twelve of 715 studies were eligible. Compared with non-obese patients, obese patients had a higher risk ratio for all-cause revision (RR 1.49; 95% CI 1.04 to 2.13; p = 0.03); aseptic revision (RR 1.36; 95% CI 1.01 to 1.81; p=0.04) and complications (RR 2.12; 95% CI 1.17 to 3.85; p=0.01). No significant differences were found in risk of septic revision and overall infection. Obese patients also had lower KSS scores (MD -3.21; 95% CI -5.52 to -0.89; p<0.01), OKS scores (MD -2.21; 95% CI -3.94 to -0.48; p=0.01), and ROM (MD -7.17; 95% CI -12.31 to -2.03; p<0.01). The average MINORS score was 14.2, indicating a moderate quality of evidence. In conclusion, the risk of revision, aseptic revision, and complications are higher in obese patients. The clinical significance of a lower functional score in obese may not be appreciable. Despite the greater risks, there is no conclusive evidence that obesity should be a contraindication to UKA. Further studies are required to corroborate the current conclusions with higher-quality study designs. Level of evidence: III
Unicompartmental knee arthroplasty,partial knee,Obesity,Body mass index,outcomes,Meta- analysis
https://abjs.mums.ac.ir/article_18663.html
https://abjs.mums.ac.ir/article_18663_264f8b5f7801adc4ae54fb1a1e3873c0.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
9
6
2021
11
01
Staged Bilateral Total Knee Arthroplasty: when should the Second Knee be Replaced?
633
640
EN
S. Ali
Ghasemi
0000-0002-0746-9210
1 Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA
2 Albert Einstein medical center Philadelphia, PA, USA
ghasemisar2@gmail.com
Sherwin
Rashidi
Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA
shervin.rsh@gmail.com
Mohammad Reza
Rasuli
Rothman institute1 Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA
3 Department of Anesthesiology, Perioperative and Pain Medicine Stanford School of Medicine, Stanford, CA, USA
rasouli.mr@gmail.com
Javad
Parvizi
0000-0002-6985-5870
Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA
javadparvizi@gmail.com
10.22038/abjs.2021.49007.2432
Background: Bilateral total knee arthroplasty (BTKA) under the same anesthesia (simultaneous) or staged are options for patients with end-stage arthritis of the knee that carries advantages and limitations. Not all patients are candidates for simultaneous BTKA, and therefore, surgeons prefer to stage the two TKAs. The optimal safe interval between two TKAs is not known. The present systematic review aimed to determine the optimal time interval between the two stages of BTKA. Methods: Pubmed and Scopus databases were searched to identify publications from January 1979 to November 2017 in English that compared the outcomes of staged BTKA performed using various time intervals between the two TKAs. Data on systemic and local complications following staged BTKA were extracted, and the pooled data were analyzed to adjust for age. Results: In total, 23 studies that enrolled 117,090 patients undergoing staged BTKA were included in this systematic review. A significant increase was observed in the incidence of myocardial infarction (OR=8.4 and 8.32), other cardiac complications (OR=17.71 and 18.18), deep vein thrombosis (OR=4.72 and 4.89), pneumonia (OR=3.37 and 3.45), and knee revision (OR=3.73 and 4.14) in patients undergoing the second TKA within 30 days or 90 days of the first TKA. However, the replacement of the second knee within this time interval was associated with a significantly lower risk of pulmonary embolism (OR=0.145 and 0.128), superficial (OR=0.14 and 0.79) and deep knee infection (OR=0.0 and 0.0), as well as vascular complications (OR=0.0 and 0.42). Conclusion: Time interval of less than 30 or 90 days between two TKAs performed in patients with BTKA was associated with a higher risk of systematic complications. However, the shorter time intervals between the two TKA may reduce the risk of other complications. This information may help surgeons' council patients better when deciding on the optimal time interval between two TKAs. Level of evidence: I
Bilateral Total Knee Arthroplasty,Systematic review,Two-stage procedure
https://abjs.mums.ac.ir/article_18643.html
https://abjs.mums.ac.ir/article_18643_c4d6b9081f04475c9ccad9928d5b8a68.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
9
6
2021
11
01
Clinical Outcome Comparison between Staged –Bilateral Versus Simultaneous Bilateral 1 Total Knee Replacements
641
646
EN
Mohammad Mahdi
Sarzaeem
0000-0002-6256-1036
Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
mmsarzaeem@yahoo.com
Farzad
Amoozadeh Omrani
Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran
farzad_amoozadeh@yahoo.com
Mohammad Mahdi
Omidian
0000-0002-9416-2160
Department of Biomaterials, Faculty of Biomedical Engineering, Science and Research, Branch, Islamic Azad University, Tehran, Iran
omid_medicine@yahoo.com
Mohammadali
Sahebalzamani
0000-0002-3775-5816
Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
ali_bme@yahoo.com
Ehsan
Maniei
Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
emaniei@yahoo.com
10.22038/abjs.2021.48053.2379
Background: This retrospective study aimed to compare the clinical outcomes of patients with staged and simultaneous bilateral total knee arthroplasty (TKA). Methods: The present study included 100 patients with a mean age of 62±3.72 years from 2014 to 2017. Among them, 51 and 49 patients underwent simultaneous and staged bilateral TKA, respectively. The two groups were compared regarding the range of motion (ROM), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) improvement, and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores. The mean follow-up duration was 24 months (range: 12-36 months). Results: According to the results obtained from the SF-36 questionnaire (possessing eight different factors of quality of life), there was no significant difference between the two groups. Furthermore, the OKSs were 39.98±1.52 and 38.68±2.55 in the simultaneous and staged groups, respectively. Moreover, the WOMAC improvement scores were obtained at 84.15±2.2 and 83.26±2.6 in the simultaneous and staged groups, respectively. The final knee ROM was acceptable without a significant difference between the two groups Conclusion: Substantial controversy about the complications, functional, and clinical outcomes has negatively affected the decision of the surgeons on conducting bilateral sequential TKA. This clinical assessment revealed that all determinants, including OKS, WOMAC, SF-36, ROM, postoperative bleeding, and hospitalization duration exhibited almost the same improvement in both groups. According to this study, no statistically significant difference exists in both procedures. Level of evidence: III
Arthroplasty,knee,Knee Prosthesis,Replacement
https://abjs.mums.ac.ir/article_17894.html
https://abjs.mums.ac.ir/article_17894_fd39e7cc8fc551fa57fdb9b84a23d333.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
9
6
2021
11
01
Outcomes of Tibial Plateau Fracture Surgical Fixation: a Comparative Study Between Younger and Older Age Groups
647
652
EN
Seyed Majid
Aghamiri
0000-0002-5677-0114
Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
s.majid.aghamiri@gmail.com
Mohammad Mahdi
Sarzaeem
0000-0002-6256-1036
Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
mmsarzaeem@yahoo.com
Mostafa
Shahrezaee
0000-0002-2612-9203
Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
moshahrezayee@yahoo.com
Mohammadmahdi
Omidian
Department of Orthopedic, Shahid Beheshti University of Medical Sciences, Tehran, Iran
omid.medicine@yahoo.com
Farzad
Amouzadeh Omrani
Department of Orthopedic, Shahid Beheshti University of Medical Sciences, Tehran, Iran
farzad90am@yahoo.com
10.22038/abjs.2021.52884.2629
Background: Tibial plateau fractures account for approximately 8% of the fractures of the elderly. Low bone quality that is more common in the elderly is one of the major challenges in fixing fractures and may be a barrier to achieving satisfactory outcomes after a surgical fracture treatment. Accordingly, surgical fixation of tibial plateau fractures was controversial in the elderly. This study aimed to investigate and compare the clinical outcomes of surgical fixation in patients over and under 60 years of age. Methods: This study was conducted as a retrospective cohort study of data that were prospectively collected. In total, 48 patients who underwent surgery with open reduction and internal fixation before August 2019 were recruited and followed up at least one year after surgery. Demographic characteristics, the range of motion of the knees, visual analog scale (VAS) score of pain intensity, and the Oxford Knee Score (OKS) were obtained in this study. Furthermore, Short Form-36 (SF-36) questionnaire was used to evaluate patient satisfaction. Results: In total, 19 and 29 patients were over and under 60 years of age, respectively. According to Schatzker’s classification, the most common type of fracture was type VI. The range of motion in the knees did not differ significantly between the two groups (P>0.05). Moreover, OKS and the VAS of pain intensity were not significantly different in both groups (P>0.05). In addition, SF-36 scores were not significantly different between elderly patients and the age-matched general population. However, younger patients had lower scores in the physical function and vitality scales of SF-36, compared to the age-matched general population. Conclusion: Based on the results of the present study, it can be stated that increasing age did not affect the surgical outcomes of patients with tibial plateau fractures. Level of evidence: III
clinical outcome,elderly patient,tibial plateau fracture
https://abjs.mums.ac.ir/article_18650.html
https://abjs.mums.ac.ir/article_18650_cff9166d6ca1d5a1c60aa6ab3392aa07.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
9
6
2021
11
01
Return to Sport and Re-Injury Rate after Double-Bundle Anterior Cruciate Ligament Reconstruction with at least Five Years of Follow-Up
653
658
EN
Alexandre
Carneiro Bitar
0000-0002-5156-8144
Instituto Vita, São Paulo, Brazil
bitar@institutovita.com.br
Antonio
Rodolpho Hakime Scalize
Instituto Vita, São Paulo, Brazil
antonio.scalize@outlook.com
Guilherme
Abreu
Instituto Vita, São Paulo, Brazil
guilherme.abreu@vita.org.br
Caio
D’Elia
0000-0002-4446-5219
Instituto Vita, São Paulo, Brazil
caio@institutovita.com.br
Luiz
Henrique Boraschi Vieira Ribas
Instituto Vita, São Paulo, Brazil
luiz.ribas@institutovita.com.br
Wagner
Castropil
0000-0001-8762-450X
Instituto Vita, São Paulo, Brazil
castropil@vita.org.br
10.22038/abjs.2021.52664.2605
Background: This study retrospectively evaluated the medium- and long-term results of patients submitted to double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. Methods: A retrospective study of case series at a single center. Cases submitted to isolated ACL reconstruction with at least five years of follow-up were included. The following data were collected: demographic data; practice of competitive sport before the injury; previous surgery; injury/surgery in the contralateral knee; return to the practices of sports and level; re-injury (postoperative time; mechanism; need for surgery); and symptoms at the last clinical follow-up visit. Descriptive and sub-group analyses were performed. Results: Sixty-nine patients were included; 52 men (75%), 49 athletes (71%), 47 (68%) with primary injury, mean age of 30 years (SD 10). The patients were followed up for an average of 8.7 years (minimum 5, maximum 11.8) after surgery. After the reconstruction, 67 (97%) returned to the sport; 75% at the same level as before the injury. Ten patients (14%) suffered re-injury after an average of 32 months (between 9 and 50 months). Regarding the outcome of re-injury, no statistically significant differences were found between subgroups of athletes vs non-athletes or primary injury vs revision surgery, despite a significant tendency towards increased re-injury levels in athletes. However, this tendency was not statistically significant. Conclusion: In our series of patients operated on with the double-bundle technique and with a long follow-up time, 14% presented re-injury, with no differences between primary and revision cases, and with a trend towards higher re-injury levels among the athletes in relation to the non-athletes. The rate of return to sport was satisfactory, with 97%, of which 75% were playing at the same level as before the injury. Level of evidence: IV
knee,Sport,anterior cruciate ligament,Arthroscopy
https://abjs.mums.ac.ir/article_17895.html
https://abjs.mums.ac.ir/article_17895_2b054fda5ddbf079a9118545722705a4.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
9
6
2021
11
01
Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach
659
664
EN
George A.
Komnos
0000-0002-6832-0014
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
gekomnos@hotmail.com
Jorge
Manrique
0000-0003-0895-2586
1 Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
2 Cleveland Clinic Florida, Weston, FL, USA
jorgemanriquemd@gmail.com
Carol
Foltz
0000-0002-2997-1316
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
carol.foltz@rothmanortho.com
Mitchell
R.
Klement
0000-0002-6080-3054
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
mitch.klement@gmail.com
Camilo
Restrepo
0000-0002-2821-118X
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
camilo.restrepo@rothmanortho.com
JavadJ
Parvizi
0000-0002-6985-5870
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
javadparvizi@gmail.com
10.22038/abjs.2021.50237.2497
Background: Blood conservation and reduction in the need for allogeneic blood transfusion (ABT) has been a subject of importance in total hip arthroplasty. There are a number of well-recognized parameters that influence blood loss during total hip arthroplasty (THA). The role of surgical approach on blood loss and the rate of ABT during THA is not well studied. The hypothesis of this study was that blood loss and the need for ABT is lower with direct anterior (DA) approach. Methods: In a case-control retrospective cohort study, we analyzed 1,524 primary THAs performed at a single institution by seven fellowship-trained surgeons between January 2015 to March 2017. All patients received THA using either the modified direct lateral (DL) or direct anterior (DA) approach using a standard operating table. The overall ABT rate was 10.2% (155/1,524) in the cohort. Demographic, surgical, and postoperative data were extracted and analyzed. Logistic regression was used to identify independent risk factors for transfusion. Results: Higher preoperative hemoglobin (p<0.001), use of DA approach (p<0.016) and administration of tranexamic acid TXA, (p=0.024) were identified as independent factors which reduced the odds of ABT. Operative time (p<0.001) was associated with an increased odd of ABT, while age, BMI and type of anesthesia were not statistically significant. Conclusion: Based on the findings of this study, direct anterior approach for THA appears to be protective against blood loss and reduced ABT rate, when controlling for confounding variables. Level of evidence: III
Total hip arthroplasty,Allogeneic Blood Transfusion,Blood loss,Direct Anterior,Direct Lateral
https://abjs.mums.ac.ir/article_18765.html
https://abjs.mums.ac.ir/article_18765_f7de1211a2e8f2b369c66bcfdc09f563.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
9
6
2021
11
01
Comparison of the Dynamic Hip Screw with the Dynamic Hip External Fixator for Intertrochanteric Fractures: Report of a Randomized Controlled Trial
665
676
EN
Ali
Moradi
0000-0001-5796-8774
Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
moradial@mums.ac.ir
Meisam
Moradi
Orthopedic Surgeon, Department of Orthopedics, Faculty of Medicine, Gonabad University of medical sciences, Gonabad , Iran
moradim941@mums.ac.ir
Maryam
Emadzadeh
0000-0002-1526-3765
Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
emadzadehm@mums.ac.ir
Farshid
Bagheri
0000-0001-8629-1854
Shahid Kamyab Hospital, Mashhad, Iran
bagherif@mums.ac.ir
10.22038/abjs.2021.53705.2672
Background: Pelvic fracture is one of the most common fractures in the elderly, especially in the intertrochanteric region. Therefore, in the present study, an external fixator was designed specifically for intertrochanteric fractures. The present study aimed to compare the operating time, amount of bleeding, and mortality rate between the patients who received either dynamic hip external fixators (DHEF) or dynamic hip screw (DHS). Methods: In 2018, 46 patients with intertrochanteric fracture due to trauma and high anesthesia risk were included in the study and randomly assigned to two groups of control (n=24, patients treated with DHS) and intervention group (n=22, patients treated with the DHEF). Treatment was carried out using the DHEF which was newly designed and placed outside the patient's body under short and light anesthesia. After 3 and 12 months of follow-up, the two groups were compared for some variables, including mortality rate, pain intensity, Harris hip score (HHS), cut-off rate of the device, femoral neck angles before and after the operation, hemoglobin changes, hematocrit levels before and after the operation, the number of injected blood units, and the number of hospitalization days. Results: Mortality rate was higher in open surgery with DHS. The assessment of variables in both intervention and control groups demonstrated that duration of operation (P<0.001), hospitalization length, time to union (P=0.001), pain intensity five days after the operation, as well as changes in Hb and HCT, were significantly higher in the control group than the intervention group. The mean HHS scores of 83.5±14.3 and 78.2±11.5 were gained for the DHEF and DHS groups, respectively (P=0.22). conclusion Considering the superior results of treatment with the external fixator in comparison with the DHS, such as lower mortality rate and fewer complications, a dynamic hip external fixator can be prescribed in patients with intertrochanteric fractures and high anesthesia risk. Level of evidence: I
Dynamic hip screw,Dynamic Hip External Fixator,intertrochanteric fracture
https://abjs.mums.ac.ir/article_17790.html
https://abjs.mums.ac.ir/article_17790_9458a410dd73d1341b0fd947a1ca6ff5.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
9
6
2021
11
01
Periprosthetic Joint Infection after Endoprosthetic Reconstruction: Saving the Limb-Salvage
677
685
EN
Wylie
Lopez
Department of Orthopaedic Surgery, Massachusetts
General Hospital, MA, USA
wlopez3@partners.org
Kayoumars
Azizpour
Harvard Medical School, Boston MA, USA
k.azizpour90@gmail.com
Kevin
Raskin
Department of Neurosurgery, Leiden University
Medical Center, Leiden, The Netherlands
kraskin@mgh.harvard.edu
Lozano-Calderon
Santiago A.,M.D.
0000-0002-0681-9004
Massachusetts General Hospital, Boston, MA, USA
slozanocalderon@mgh.harvard.edu
10.22038/abjs.2021.52948.2628
Background: This study evaluates mega-endoprosthetic survival after revision for periprosthetic joint infection (PJI)<br />and two-staged reconstruction using a cement spacer. Mega-endoprosthetics offer patients an important treatment<br />option for limb salvage. However, PJI is a devastating complication which affects between 2-10% of patients. It<br />commonly results in revisions, amputation, and sometimes death. Literature in terms of success rates, limb salvage<br />and Megaprostheses survival after revision for infection is limited. We present here our experience and the impact of<br />length of the spacer in prostheses survival.<br />Methods: A retrospective chart review was implemented using Fisher’s exact test for categorical data and the Kaplan-<br />Meier method for prosthesis survival. Patient information was acquired through our institution’s electronic medical<br />records. Variables such as diagnosis, complications, length of cement spacer, and number of surgeries were recorded.<br />We analyzed spacer length and prosthesis survival based on these variables.<br />Results: Fisher’s Exact test showed no correlation between length of spacer and amount of repeat surgery (P = 0.245).<br />After two-stage revision and mega-prosthesis insertion, there was a 63.2% chance of complication and a 26.3% chance<br />of amputation. This indicates a 73.7% probability for limb salvage in this sample (Kaplan-Meier).<br />Conclusion: These data suggest long-term viability of mega-endoprostheses after two-stage revision despite a high<br />complication rate.<br />Level of evidence: IV
Limb salvage,Mega-endoprosthesis,Periprosthetic joint infection,two-stage revision
https://abjs.mums.ac.ir/article_17635.html
https://abjs.mums.ac.ir/article_17635_405e95f31081a7a0d2cb66b8235aba39.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
9
6
2021
11
01
Does Resiliency Mediate the Association of Psychological Adaptability with Limitations and Pain Intensity after Upper Extremity Trauma?
686
694
EN
Cindy
Nguyen
0000-0002-0079-0669
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
cindynguyen1994@gmail.com
Joost
T.P.
Kortlever
0000-0003-3825-5546
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
kortlever.joost@gmail.com
Amanda I.
Gonzalez
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
amanda.gonzalez@austin.utexas.edu
Tom J.
Crijns
0000-0002-2910-5071
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
tom.crijns@austin.utexas.edu
David
Ring
0000-0002-6506-4879
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
david.ring@austin.utexas.edu
Gregg A.
Vagner
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
gavagner@yahoo.com
Lee M.
Reichel
Department of Surgery and Perioperative Care
Dell Medical School – The University of Texas at Austin
1701 Trinity Street, Austin, TX, 78705, USA
leereichel@gmail.com
10.22038/abjs.2021.51098.2533
Background: Given the influence of psychosocial factors on musculoskeletal symptoms and limitations, this study assessed if the ability of resilience (an individual's ability to adapt under stress) mediates the association of psychological adaptability with magnitude of physical limitations and pain intensity during recovery from an upper extremity injury. Methods: A total of 107 patients were enrolled in this prospective, longitudinal, observational cohort study. Patients completed the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF), an 11-point ordinal measure of pain intensity, the Brief Resilience Scale (BRS), and the Psychological Adaptation Scale (PAS). We used structural equation modeling to assess the mediation effect by resiliency and psychological adaptability on patient-reported disability and pain at initial assessment and after three months. Results: PAS and BRS were not independently associated with PROMIS PF or pain intensity at enrollment or after three months, so it was not possible to assess if resiliency mediated the association of psychological adaptability with physical function or pain. There were no factors independently associated with resilience. Conclusion: General measures of psychological adaptability and resiliency do not correlate with symptoms and limitations as well as specific measures of adaptiveness in response to nociception. Level of evidence: II
Resilience,Brief Resilience Scale,Psychological Adaptation Scale,Structural equation modeling,Mediation
https://abjs.mums.ac.ir/article_17451.html
https://abjs.mums.ac.ir/article_17451_9ec466a2838a73e233e6ee585453ff8a.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
9
6
2021
11
01
Treatment of Fracture-Dislocations of Proximal Interphalangeal Joint by Applying of Dynamic Mini External Fixator: Clinical and Radiographic Results
695
701
EN
Parviz
Ahangar
0000-0002-2175-216X
1 Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2 Trauma Research center, Department of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
ahangarparviz@yahoo.com
Alireza
Rahimnia
0000-0001-9063-8435
1 Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2 Trauma Research center, Department of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
alireza.rahimnia@gmail.com
Masoud
Mokhtari
Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
drmokhtarimasoud@yahoo.com
Amirhossien
Rahimnia
0000-0002-4451-4930
Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
rahimnia.amir@gmail.com
10.22038/abjs.2021.54249.2709
Background: Fracture-dislocations of the proximal interphalangeal joint of fingers are believed to be challenging injuries that usually lead to residual pain and stiffness. To date, several treatment options have been applied. Dynamic traction-external fixation is a safe and easy technique offering good results in many works of literature. The dynamic mini external fixator using K-wires and mini rods provide sufficient dynamic traction and facilitate early mobilization of the injured joint. The present study was conducted to evaluate the results of a dynamic mini external fixator for the treatment of those lesions. Methods: In total, 40 patients who suffered from proximal interphalangeal fracture-dislocations were treated at our institution between November 2017 and November 2019. Dynamic mini external fixator device was utilized for their treatment. Clinical and radiographic parameters were evaluated at 2, 4, 6, 12, and 24 weeks after surgery. Results: This study included 30 (75%) males and 10 (25%) females with a mean age of 38.7±9.9 years. In total, 6 (15%) patients had concomitant fractures or fractures in their hands. All the fractures, including 27 (67.5%) dorsal fracture-dislocations and 13 (32.5%) Pilon fractures, were united without the occurrence of any malunion or major residual subluxation. One Pilon fracture needed to be realigned by reassembling the device at the second week of follow-up. Furthermore, 36 (90%) patients achieved full range of joint motion, and 4 (10%) patients had mild loss of motion arc. In addition, 8 (20%) patients developed mild pin site infection treated with oral antibiotics without device removal. Following six months, one (2.5%) patient mentioned minimal residual pain. Conclusion: The dynamic mini external fixator was found to be a safe and applicable technique to manage proximal interphalangeal fracture-dislocations. To obtain significantly accurate results, regular follow-up and accurate device care are of great necessity. Level of evidence: IV
Articular,Early ambulation and range of motion,External fixators,Finger joint,Fracture dislocation
https://abjs.mums.ac.ir/article_17897.html
https://abjs.mums.ac.ir/article_17897_a863eacd1efb81c45300253e50611108.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
9
6
2021
11
01
Anterior Bridge Plate Osteosynthesis in Comminuted Fracture Shaft of Humerus in Manual Workers- is it Optimum Choice?
702
707
EN
Pankaj
Mishra
0000-0002-47004063
Department of orthopaedics All India institute of Medical Sciences Bhopal M.P India
swastipankajshilpi@gmail.com
Maneesh
Verma
drmaneesh@orcid.com
Department of orthopaedics Government medical college Datia M.P India
drmaneeshortho@gmail.com
Rahul
Verma
Department of orthopaedics Gandhi medical college Bhopal M.P India
shilpi.tiwari1@gmail.com
10.22038/abjs.2021.52287.2579
Background: Bridge plate osteosynthesis of fractures by minimal invasion and near acceptable reduction is becoming popular and acceptable entity. Management of humeral shaft fracture has evolved a lot with their pros and cons. Anterior bridge plate osteosynthesis (ABPO) for humeral shaft fracture is pertinent to a minimal invasive procedure, and it has evolved as a new entrant in the surgical techniques. This study was designed to carry out the results and efficacy of ABPO in the comminuted fracture shaft of the humerus in the manual workers. Methods: Study included the closed comminuted fracture of shaft of humerus in skeletally mature patients engaged predominantly in manual works, like overhead sports activity, laborers, and industrial workers. All fractures were managed by either 4.5-mm narrow locking compression plate (LCP) or dynamic compression plate (DCP).The functional outcome for elbow was measured by Mayo's elbow performance score (MEPS) and functional outcome of shoulder was measured by UCLA (University of California at Los Angeles) shoulder score system. Results: In this study 37 patients were enrolled. Mean duration for satisfactory radiographic union was 12.3 weeks. The mean duration of follow-up period was 14.5 months. In respect to elbow function, the average Mayo elbow score was 92.42 ±2.17 and average UCLA score of shoulder function was 34 ±0.34. Conclusion: The ABPO is an optimum choice for managing the comminuted fracture shaft of humerus in manual labors. The outcomes are favorable and reproducible with very few risks. Level of evidence: IV
humerus,Fractures,Comminuted
https://abjs.mums.ac.ir/article_17466.html
https://abjs.mums.ac.ir/article_17466_2cea9489d470c6358da3908a4a0b0261.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
9
6
2021
11
01
Validity and Reliability of an Adapted Persian Version of the Scoliosis Research Society-30 Questionnaire
708
713
EN
Hasan
Ghandhari
0000-0002-6576-2466
Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
h.ghandhari.spine@gmail.com
Ebrahim
Ameri
0000-0003-3115-6545
Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
ameri.e@iums.ac.ir
Ali
Mahmoudi
Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
a.mahmoud.ortho@gmail.com
Farshad
Nikouei
Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
farshadnikoie@yahoo.com
Saeed
Sabbaghan
0000-0002-8581-3339
Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
dr.s.sabbaghan.spine@gmail.com
Elham
Mirzamohammadi
Occupational Medicine Department- Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
mirzamohammadi.e@iums.ac.ir
10.22038/abjs.2021.47205.2305
Background: Adolescent idiopathic scoliosis (AIS) is a common type of spinal deformity confronting surgeons. The Scoliosis Research Society Health-Related Quality of Life (SRS-30) Questionnaire has been translated into Persian to evaluate its internal consistency, reliability, validity, and cross-cultural adaptability in the Persian population. Methods: The translation and cultural adaptation process was based on the American Academy of Orthopaedic Surgeons guidelines. A total of 102 AIS patients referring to our institution were enrolled in this study within March 2014-March 2016. The 36-item Short Form (SF-36) was used for adapting the Persian SRS-30 questionnaire. The convergent validity of the Persian SRS-30 was examined using the Pearson correlation coefficient. Furthermore, its internal consistency and validity were tested using Cronbach α with bootstrapped 95% confidence interval. Interclass Correlation Coefficient (ICC) was used to test and retest reliability. Results: The total correlation coefficient between the Persian SRS-30 and SF-36 was obtained at 0.74 (0.67-0.80), which was statistically significant (P=0.001). The total Cronbach α for the Persian SRS-30 was estimated at 0.84, ranging from 0.51 in satisfaction with management domains to 0.88 in mental health domains. The Persian SRS-30r domains indicated satisfactory test-retest reliability with ICC rage of 0.79-0.87. Conclusion: The Persian SRS-30 translation was reliable and valid for the AIS Iranian patients. The internal consistency of this instrument was found to be good and excellent in all domains except satisfaction with management, which was moderate. The authors believe that the Persian version of SRS-30 is simple and easy to use and now it can be applied in clinical settings for future outcome studies in Iran. Level of evidence: IV
Adolescent idiopathic scoliosis,Scoliosis research society-30r,Reliability,Validity,Iran
https://abjs.mums.ac.ir/article_17778.html
https://abjs.mums.ac.ir/article_17778_599542213fa34e2f5ff5a509d8b7ffe0.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
9
6
2021
11
01
Primary Intraosseous Malignant Glomus Tumor of the Finger with a Different Radiological Appearance: a Case Report and Review Literature
714
717
EN
Hossein
Saremi
0000-0002-2914-5110
Department of Orthopedics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
hosseinsaremi.shoulder@gmail.com
Arash
Dehghan
0000-0001-9914-8862
Department of Pathology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
a.dehghan50@yahoo.com
Hassan
Hosseini
Department of Orthopedics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
dr.hasanhosseini1365@gmail.com
10.22038/abjs.2021.58335.2888
Primary intraosseous malignant glomus tumor is very rare and is often presented as an osteolytic lesion. The present case study reports a malignant intraosseous glomus tumor of the index finger that was presented as an osteosclerotic lesion and invaded adjacent tissues, leading to ray amputation. We also reported result of a five-year follow-up and presented a short literature review for the lesion. Level of evidence: IV
Glomus Tumor,intraosseous,osteosclerotic lesion
https://abjs.mums.ac.ir/article_18665.html
https://abjs.mums.ac.ir/article_18665_fab8d7bee642fdfc9d21e69e22794809.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
9
6
2021
11
01
Scientometrics Analysis of Iranian Orthopedics Academic Departments
718
721
EN
Adel
Ebrahimpour
0000-0003-0758-3010
Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
adel.ebrahimpour@yahoo.com
Ahmadreza
Afshar
0000-0002-3676-5932
Department of Orthopedics, Imam Khomeini Hospital,
Urmia University of Medical Sciences, Urmia, Iran
afshar_ah@yahoo.com
Ali
Tabrizi
0000-0002-4385-6445
1 Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
2 Department of Orthopedics, Imam Khomeini Hospital,
Urmia University of Medical Sciences, Urmia, Iran
ali.tab.ms@gmail.com
Mehrdad
Sadighi Shamami
0000-0002-4333-3126
Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
mehrdad_1330@yahoo.com
10.22038/abjs.2021.55448.2760
Background: Scientometrics is one of the bibliometrics subsets aiming to study the status of scientific development<br />of scientific and research institutes. This study aimed to investigate the scientific status of orthopedic departments<br />in different universities of Iran using the national scientometr ics system of the Ministry of Health in Iran.<br />Methods: This cross-sectional study investigated the researchers and orthopedic departments in different universities<br />of Iran based on the data from the scientometrics system of the Ministry of Health in Iran until the beginning of<br />2021. All researchers and publications related to orthopedics, as well as the relationship of these researchers, have<br />been studied part-time and full-time. The number of publications, indexing level, academic degree, and academic<br />position has been also registered and examined through the scie ntometrics system.<br />Results: This study included 280 researchers from different universities in Iran. The mean number of the published<br />articles was 20.6±19.8. The highest number of faculty members were from Iran (n=27; 9.64%), Shahid Beheshti<br />(n=26; 9.28%), Tehran (n=25; 9.28%), as well as Mashhad and Shiraz Universities of Medical Sciences (n=18;<br />6.42%) in descending order. The overall mean values of the H- and G-index were determined at 5.85±2.7 and<br />9.3±4.2, respectively. Furthermore, the number of citations per published article wa s obtained at 6.7±1.3. It should<br />be mentioned that Mashhad University of Medical Sciences obtained the highest H-index (9.6) and G-index (10.6),<br />respectively.<br />Conclusion: The scientific productions and publications of the Iranian orthopedic academic institutions were similar<br />to those of the international scientific institutes in terms of H-index and number of citations per published article. It<br />is worth mentioning that Mashhad University of Medical Sciences was the leader in this regard.
Evaluation,Medical research,research performance,Scientometry
https://abjs.mums.ac.ir/article_17637.html
https://abjs.mums.ac.ir/article_17637_bd959a76ba6421b8c98a24502a54bf94.pdf