Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Point-of-Care Ultrasonography in Orthopedics: A Helpful Tool to Improve Patient Care3233241574410.22038/abjs.2020.47207.2306ENSM Javad MortazaviTehran University of Medical Sciences
Joint Reconstruction Research Center, Tehran, Iran0000-0003-4189-7777Mohammad Hossein NabianJoint
Reconstruction Research Center, Tehran University of Medical
Sciences, Tehran, Iran0000-0002-4144-3188Journal Article20200315An enormous technological improvement in Ultrasonography devices has occurred during last decade, providing excellent soft-tissue contrast and high spatial resolution images. Nowadays, musculoskeletal ultrasonography is going to be a stethoscope in the hand of orthopedic surgeons for the diagnosis of many musculoskeletal pathologies, as well as an accurate guide for therapeutic interventions. Therefore, it is wise for practicing orthopedic surgeons to learn musculoskeletal ultrasonography in collaboration with radiology colleagues as this would improve the patients' care .Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Present Situation of Patellofemoral Arthroplasty in the Management of Solitary Patellofemoral Osteoarthritis3253311574610.22038/abjs.2020.15746ENE. Carlos RODRIGUEZ-MERCHANDepartment of Orthopaedic Surgery, La Paz University
Hospital, Madrid, Spain0000-0002-6360-0113Journal Article20180120Patellofemoral (PF) osteoarthritis (OA) is a somewhat predominant illness, affecting up to 24% of women and 11% of<br />men over the age of 55 years who suffer from symptomatic knee OA. The purposes of this narrative overview are to<br />summarize the present situation of patellofemoral arthroplasty (PFA) in the treatment of solitary PF-OA, and to give<br />an account of the clinical results of PFA for the management of solitary PF degenerative OA of the knee. A Cochrane<br />Library and PubMed (MEDLINE) examination related to the position of PFA in PF-OA was carried out. A number of<br />publications have encountered that PFA is an efficacious treatment for solitary PF-OA. Additionally, a systematic review<br />described fairly good results of PFA survivorship and functional outcomes at short- and mid-run follow-up in the setting<br />of solitary PF-OA. Success of PFA depends on accurate patient selection rather than prosthetic failure or wear. In many<br />reports, the main cause of PFA failure is advancement of tibiofemoral OA. In contemporary times, encouraging results<br />have been accomplished by the association of PFA and unicompartmental knee arthroplasty (UKA). In conclusion,<br />patients with solitary PF-OA with severe anterior knee pain may be candidates for PFA. The success of the surgical<br />procedure and the long-run survivorship of PFA are related to a good surgical technique and observation to meticulous<br />indications and contraindications in patient selection. Newer prostheses have also played a part to ameliorated<br />outcomes. PFA is an alternative for younger patients with solitary PF-OA.<br />Level of evidence: IIIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Truly Existing or Hyped up? Unravelling the Current Knowledge Regarding the Anatomy, Radiology, Histology and Biomechanics of the Enigmatic Anterolateral Ligament of the Knee Joint3323421574710.22038/abjs.2019.40067.2074ENDinesh Kumar. VDepartment of Anatomy, Jawaharlal Institute of
Postgraduate Medical Education and Research,
Puducherry, India0000-0001-8234-2829Yogesh Ashok SontakkeDepartment of Anatomy, Jawaharlal Institute of
Postgraduate Medical Education and Research,
Puducherry, IndiaShishir Suranigi MurugharajDepartment of Orthopaedics, Pondicherry Institute of
Medical Sciences, Puducherry, IndiaJournal Article20190502Ever since its description, anterolateral ligament (ALL) of the knee joint remains as the hotspot of controversies.<br />Though it has been described under various descriptions, the structure gained its limelight when it was christened<br />as anterolateral ligament by Claes in 2013. The main reason for the controversies around it is the lack of concrete<br />evidences regarding its attachments, morphology, biomechanical aspects and radiological appearance. Similarly the<br />role of ALL in pivot shift phenomenon also remains as a point of debate. The advocates of ALL suggest that because<br />of its ability to modulate internal rotation and attachment to the lateral meniscus, ALL contributes to the pivot shift<br />phenomenon. Similarly, the orientation of ALL stands as the reason for varied documentation with respect to imaging<br />techniques. With the growing body of evidence, it is imperative to fix our stand regarding the structure because, if<br />found to be morphologically persistent, it can be used for concomitant anterolateral stabilization along with anterior<br />cruciate ligament reinforcement surgeries. The present review tries to systematically review the anatomy, variations in<br />classifications, descriptions, histology, radiology and biomechanical features of ALL. At the end of the review, we would<br />like to find the answer for the question: Is ALL a distinct ligamentous structure located at the anterolateral aspect of the<br />knee? What is the contribution of it to the tibial internal rotation stability?<br />Level of evidence: IIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Effect of Ozone (O3) versus Hyaluronic Acid on Pain and Function in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis3433541574910.22038/abjs.2020.46925.2292ENJavad Javadi HedayatabadOrthopedic Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran0000-0001-8267-8541Amir R. KachooeiOrthopedic Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran- Rothman Institute, Thomas Jefferson University,
Philadelphia, USA0000-0001-7795-1830Negar Taher ChaharjouyOrthopedic Research Center, Mashhad University of
Medical Sciences, Mashhad, IranNiloufar VaziriOrthopedic Research Center, Mashhad University of
Medical Sciences, Mashhad, IranHasan Mehrad-MajdClinical Research Development Unit, Ghaem Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-4835-8872Maryam EmadzadehClinical Research Development Unit, Ghaem Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1526-3765Mansour AbolghasemianIran University of Medical Sciences, Tehran, Iran0000-0002-5846-2764Mohammad H. EbrahimzadehOrthopedic Research Center, Mashhad University of
Medical Sciences, Mashhad, IranJournal Article20200302Background: Of the pharmacological modalities for knee osteoarthritis (OA), intra-articular injections including ozone<br />(O3) and hyaluronic acid (HA) are commonly used for reducing pain and improving function. In this systematic review<br />and meta-analysis, we aimed to compare the effect of O3 versus HA in reducing pain and increasing function in patients<br />with knee OA.<br />Methods: After searching databases, we included 6 randomized controlled trials on patients with knee OA that<br />compared the effects of intra-articular injection of ozone versus HA. The primary outcome was visual analogue scale<br />(VAS) of pain. The secondary outcome was Western Ontario and McMaster Universities Arthritis Index (WOMAC)<br />score.<br />Results: There was a total of 237 patients in the HA group and 230 patients in the Ozone group. Of 6 studies, 4 were<br />in English, 1 was in Persian, and 1 was in German language. The overall Standardized Mean Difference (SMD) for VAS<br />pain did not show a significant difference between the groups although it favored HA injection (1.27 [95%CI: (-0.12)-<br />2.66]). Total WOMAC score showed a significant difference over the time favoring HA injection (4.5 [95%CI: 1.1-8]).<br />However, no single time point showed any significant difference between groups.<br />Conclusion: This meta-analysis showed no significant difference between HA and ozone in reducing pain and<br />improving function in patients with knee OA, although the overall results favored HA over ozone. Since previous studies<br />have shown comparable results between HA and placebo, ozone seems to fall in the same category with more placebo<br />effect rather than a real disease-modifier.<br />Level of evidence: IMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Intra-articular versus Intravenous Tranexamic Acid in Total Knee Arthroplasty: A Randomized Clinical Trial3553621575010.22038/abjs.2019.39080.2039ENSM Javad MortazaviJoint Reconstruction Research Center, Tehran University
of Medical Science, Tehran, Iran0000-0003-4189-7777Babak SattartabarJoint Reconstruction Research Center, Tehran University
of Medical Science, Tehran, IranAlireza MoharramiJoint Reconstruction Research Center, Tehran University
of Medical Science, Tehran, Iran0000-0002-8457-8197Seyed Hadi KalantarJoint Reconstruction Research Center, Tehran University
of Medical Science, Tehran, Iran0000-0002-5747-4974Journal Article20190315Background: Total knee arthroplasty (TKA) can cause excessive blood loss requiring allogenic transfusions.<br />Tranexamic acid (TXA) has been increasingly used for lowering blood loss. The present study aimed to compare<br />the efficacy of intravenous (IV) and intra-articular (IA) administrations of TXA in TKA patients who receive aspirin as<br />chemoprophylaxis and uses no drain post-operative.<br />Methods: In this prospective randomized clinical trial, 49 TKA patients were intravenously given 15 mg/kg dose of<br />TXA, and 49 patients intraarticularly received 15 mg/kg of TXA. Demographic information, pre-operative and postoperative<br />hemoglobin values of the patients were used for assessing total perioperative blood loss by GOOD &<br />NADLER formulae.<br />Results: There was not any significant difference between the IV TXA and IA TXA groups concerning blood loss<br />(P=0.102). However, the decrease in hemoglobin level at 48 hours post-operation compared to the preoperative<br />level in the IV TXA group was significantly higher than that in the IA TXA group (-2.3 ±0.8 vs. -1.9 ±1.0 g/dL;<br />P=0.038). No blood transfusion was needed, and the deep venous thrombosis and pulmonary embolization were<br />not observed in either of the groups (P>0.05).<br />Conclusion: Our study showed that during TKA, the IA TXA is equally safe and effective as its IV infusion concerning<br />decreased blood loss and adverse effects. The use of TXA during TKA is safe for patients who receive less potent<br />chemoprophylaxis agents such as aspirin.<br />Level of evidence: IMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Efficacy of Intravenous Versus Topical Use of Tranexamic Acid in Reducing Blood Loss after Primary Total Knee Arthroplasty: A Randomized Clinical Trial3633671575110.22038/abjs.2020.40528.2099ENAli TorkamanDepartment of Knee Surgery, Firouzgar Hospital, Iran
University of Medical Sciences,Tehran , Iran0000-0003-2532-5111Amir RostamiBone and Joint Reconstruction Research Center,
Firouzgar Hospital, Iran University of Medical Sciences,
Tehran, IranMohammad Reza SarsharBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, IranHamidreza YazdiBone and Joint Reconstruction Research Center,
Firouzgar Hospital, Iran University of Medical Sciences,
Tehran, IranHossein Akbari AghdamDepartment of Orthopedic Surgery, School of Medicine,
Isfahan University of Medical Sciences , Isfahan, Iran
- Bone and Joint Reconstruction Research Center, Iran
University of Medical Sciences, Tehran, Iran0000-0001-6983-4458Paniz MotaghiIran University of Medical Sciences, Tehran, Iran0000-0003-3000-171XJournal Article20190615Background: Blood loss during and immediately after total knee arthroplasty (TKA) is among the most challenging<br />concerns. It has been demonstrated that Tranexamic acid (TXA) can help to reduce perioperative blood loss. TXA<br />can be used as an oral, topical or intravenous injection. Many studies evaluated the effectiveness of each route of<br />administration but few works on a comparison between them. The current study aimed to compare the effectiveness<br />of intravenous injection versus topical use of TXA in reducing perioperative blood loss after primary total knee<br />arthroplasty.<br />Methods: Eighty-five patients who were a candidate for total knee arthroplasty were randomized into two groups:<br />one group received Intravenous injection of 15 mg/kg TXA, 10 min before tourniquet inflation while the other group <br />received 1 g diluted TXA during wound closure. The postoperative blood loss was estimated by measuring the<br />whole drain output and also hemoglobin (HB) drops. Both groups compared based on the need for allogenic blood<br />transfusion and also thromboembolic events.<br />Results: Patients who received topical TXA had a higher total drain output (p <0.0001) compared to intravenous<br />injection. The hemoglobin drop also was more in the topical group although it was marginally significant (P=0.05).<br />Conclusion: Intravenous injection of TXA is more effective in reducing postoperative blood loss after primary TKA<br />compared to topical administration.<br />Level of evidence: IMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury3683721575310.22038/abjs.2019.41123.2113ENPichitchai AtthakomolDepartment of Orthopaedic Surgery, Massachusetts
General Hospital, Boston, MA, USA- Department of Orthopaedics, Faculty of Medicine,
Chiang Mai University, Thailand0000-0001-9737-4110Sezai OzkanDepartment of Orthopaedic Surgery, Massachusetts
General Hospital, Boston, MA, USAKyle R. EberlinDivision of Plastic and Reconstructive Surgery,
Massachusetts General Hospital, Boston, MA, USANeal ChenDepartment of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School0000-0002-8967-9018Jonathan WinogradDivision of Plastic and Reconstructive Surgery,
Massachusetts General Hospital, Boston, MA, USASang-Gil LeeDepartment of Orthopaedic Surgery, Massachusetts
General Hospital, Boston, MA, USAJournal Article20190614plexus injury. Few studies report the rate of revision surgeries following free functional muscle transfers. We examined<br />the reoperation rate and indication for reoperation after primary reconstruction of upper extremity function with a free<br />gracilis transfer after brachial plexus injury.<br />Methods: From 2003-2016, we identified 25 patients who underwent a free functional gracilis muscle transfer for<br />restoration of upper extremity function. We reviewed their medical charts to record patient, injury, and treatment<br />characteristics. Indication for reoperation and reoperative procedure were also identified.<br />Results: Fourteen out of 25 patients (56%) had a reoperation after FFGT. Four flaps were re-explored for vascular<br />compromise, but there were no flap failures. The majority of reoperations involved adjustment of tendon excursion<br />(8/14) which demonstrated that tenolysis was the main procedure.<br />Conclusion: Despite promising results of free functional gracilis transfers, reoperation is relatively common and should<br />be discussed with the patient as a preoperative strategy. Early exploration of vascular compromise may decrease the<br />flap failure. Poor tendon excursion is a common unpredicted consequence after FFMT and is the main indication for<br />reoperation.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Angioleiomyoma of the Hand: A Case Series and Review of the Literature3733771575410.22038/abjs.2020.15754ENCaleb M. YeungDivision of Orthopaedic Oncology, Department of
Orthopaedic Surgery, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, USA0000-0003-3232-2867Laura MooreDivision of Orthopaedic Oncology, Department of
Orthopaedic Surgery, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, USAJonathan LansDivision of Orthopaedic Oncology, Department of
Orthopaedic Surgery, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, USA0000-0002-6159-4645Santiago A. Lozano-Calderón,Division
of Orthopaedic Oncology, Department of Orthopaedic Surgery,
Massachusetts General Hospital, Harvard Medical School,
Boston, MA, USA0000-0002-0681-9004Journal Article20190828Background: Angioleiomyomas are rare tumors arising from vascular tissue that can occasionally present in the hand.<br />Reports of angioleiomyomas in this location are highly limited. Here, we describe the presentation and outcomes of a<br />series of cases of angioleiomyomas.<br />Methods: A retrospective case review of five patients with angioleiomyomas arising in the hand was performed. Patients<br />were identified via International Classification of Diseases, Ninth and Tenth Revision (ICD-9 and ICD-10) diagnosis<br />codes and were reviewed through the electronic medical record for demographic information, tumor characteristics,<br />management, and outcomes. A literature review was also conducted of angioleiomyomas.<br />Results: Five patients were diagnosed with angioleiomyoma at our institution between 1992 and 2015. Patients<br />presented with a painful, slow-growing hand mass in all cases. The majority of patients were male and of middle-age.<br />All of the patients were successfully treated with marginal excision and had full return to functional status without<br />recurrence.<br />Conclusion: Angioleiomyomas are rare tumors that can arise in the hand and should be included in the differential<br />diagnosis of a patient presenting with a painful hand mass. They can be successfully treated with marginal excision.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Fracture Surgery in Known COVID-19 Infected Patients: What Are the Challenges?3783821575510.22038/abjs.2020.47899.2372ENMehrdad SadighiDepartment of Orthopedic Surgery, Shohada Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-4333-3126SM Javad MortazaviJoint Reconstruction Research Center (JRRC), Imam
Khomeini Hospital Complex, Tehran University of Medical
Science, Tehran, Iran0000-0003-4189-7777Adel EbrahimpourDepartment of Orthopedic Surgery, Shohada Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-3721-127XAlireza Manafi-RasiDepartment of Orthopedic Surgery, Imam Hossein
Hospital,Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0001-6355-704XMohammad H. EbrahimzadehOrthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran0000-0003-4417-9877Meisam Jafari KafiAbadiDepartment of Orthopedic Surgery, Shohada Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iranhttps://orcid.org/00Seyyed Saeed KhabiriDepartment of Orthopedic Surgery, Kermanshah
University of Medical Sciences, Kermanshah Iran0000-0002-8906-7660Saber Barazandeh RadDepartment of Orthopedic Surgery, Shohada Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, IranMonireh YaghoubiDepartment of Orthopedic Surgery, Kermanshah
University of Medical Sciences, Kermanshah IranMohammadreza ChehrassanDepartment of Orthopedic Surgery, Shohada Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-3068-9764Journal Article20200415Background: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture<br />patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during<br />the surgical treatment of fracture patients with concomitant COVID-19 infection.<br />Methods: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who<br />were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February<br />2020 to April 3, 2020.<br />Results: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven<br />patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The<br />mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all<br />patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive<br />care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge.<br />Conclusion: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay<br />of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital<br />resources would lead to successful operation and acceptable outcome.<br />Level of evidence: IIIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Equivalent PROMIS Scores after Nonoperative or Operative Treatment of Trapeziometacarpal Osteoarthritis3833901575610.22038/abjs.2019.41772.2128ENSuresh K. NayarOrthopaedics, Johns Hopkins University School of Medicine, Baltimore, USA0000-0001-6495-3570Rebecca GlasserOrthopaedics, Johns Hopkins University School of Medicine, Baltimore, USAEugene DeuneOrthopaedics, Johns Hopkins University School of Medicine, Baltimore, USAJohn IngariOrthopaedics, Johns Hopkins University School of Medicine, Baltimore, USADawn MLaPorteOrthopaedics, Johns Hopkins University School of Medicine, Baltimore, USAJournal Article20190713Background: Patient-Reported Outcomes Measurement Information System (PROMIS) scores can quantify symptoms<br />and limitations after upper extremity surgery. Our objective was to determine how these scores compare amongst<br />patients with trapeziometacarpal osteoarthritis treated either nonoperatively or operatively.<br />Methods: In this retrospective comparative study, we compared PROMIS scores (upper extremity function [UEF],<br />pain interference, and depression) between 43 patients who underwent nonoperative treatment (nonsteroidal antiinflammatory<br />drugs/splinting/injections) and 33 patients who underwent trapeziectomy with ligament reconstruction<br />and tendon interposition for trapeziometacarpal osteoarthritis (minimum 6-month recovery period) by 4 surgeons from<br />2014–2018. PROMIS scores were compared across all patients by Eaton-Littler staging. We used linear regression to<br />assess correlations between time-since-surgery and each PROMIS domain. Multivariable linear regression was used<br />to identify patient and disease factors independently associated with PROMIS scores.<br />Results: Surgery was not associated with better UEF (37 vs. 40, P=0.23), less pain interference (58 vs. 56, P=0.42),<br />or fewer symptoms of depression (47 vs. 46, P=0.59). Similarly, no differences were observed across all patient by<br />Eaton-Littler stage for UEF (P=0.49), pain (P=0.48), or depression (P=0.90). For the operative group, greater timesince-<br />surgery, or patient recovery period, correlated moderately with worse UEF (R=0.41) and increased pain (R=0.37).<br />Conclusion: In small retrospective comparative cohorts, surgery was not associated with better UEF, pain, or<br />depression scores compared with nonoperative treatment for trapeziometacarpal osteoarthritis.<br />Level of evidence: IIIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Survival and Incidence Rate of Ewing Sarcoma; a National Population-based Study in Iran (2008-2015)3913991575710.22038/abjs.2020.44095.2206ENAdel EbrahimpourCancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
- Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-3721-127XMohammadreza ChehrassanCancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
- Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-3068-9764Mehrdad SadighiCancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
- Department of Orthopedic Surgery, Shohadaye Tajrish
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, IranMehdi Azizmohammad LoohaDepartment of Biostatics, Faculty of Paramedical
Sciences, Shahid Beheshti University of Medical Sciences,
Tehran, Iran0000-0002-0700-1431Amin KarimiDepartment of Orthopedic Surgery, Taleghani Hospital,
Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-3197-7223Atieh AkbariCancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, IranAlireza RaeisiShiraz University of Medical Sciences, Shiraz, IranMohammad Esmaeil AkbariCancer Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, IranJournal Article20191108Background: The effect of race and ethnicity on some kind of malignant bone tumors including Ewing sarcoma<br />has been proven in different studies. In order to evaluate the latter, national cancer registries may help to increase<br />understanding about potential cancer causes, prevention and control strategies, and apply these findings to control<br />health problems among populations with similar characteristics.<br />Methods: A national population-based cancer registry study based on all patients affected by Ewing Sarcoma was<br />registered in the Iran National Cancer Registry (INCR) between 2008 and 2015 was designed. Demographic data of<br />microscopically confirmed cases of bone Ewing sarcoma were registered. Patients with Ewing sarcoma were divided<br />in groups to describe the primary site of the tumor (including axial or appendicular bones) and analyzed. In order to<br />analyze the survival rate, randomized selection of the patient through the INCR data-base was performed.<br />Results: A total of 678 cases of malignant Ewing sarcoma of the bone were identified through the INCR. The mean<br />age of Ewing sarcoma in Iran was 21.53 years. Nearly half of patients were observed at the age group of 15-24. The<br />total crude incidence rate of Ewing sarcoma was 1.29 in 1 million. The mean 5 year survival rate was 47%. The Mean<br />survival rate for study population was 5.53.<br />Conclusion: The crude incidence rate of Ewing sarcoma in Iran is relatively lower with respect to other registries. The<br />majority of patients are in 15-25 years group and shows affection by Ewing sarcoma in an older age. Socioeconomic<br />factors had direct influence on survival rate.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Anthropometric Measurements of Distal Femur to Design the Femoral Component of Total Knee Arthroplasty for the Iranian Population4004061575810.22038/abjs.2018.32420.1861ENAli BirjandinejadOrthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran8690-8076-0001-0000Reza ZandiTaleghani Hospital, Shahid Beheshti University of
Medical Sciences, Tehran, Iran0000-0002-0095-6745Elham KarimiDepartment of Biology and Anatomical Sciences,
Faculty of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran7104-5341-0002-0000Journal Article20180607Background: Acquiring knowledge about anatomic and geometric quantities of bones is among the most vital<br />parameters in orthopedic surgery that has a significant effect on the treatment of various disorders and subsequent<br />outcomes. The aim of this study was to obtain anthropometric information for distal femur in order to compare with<br />similar dimensions of prosthesis used in total knee arthroplasty (TKA) surgery and to design more suitable and optimal<br />components.<br />Methods: Morphological data of distal femur were measured in 132 knees (81 males and 51 females) using magnetic<br />resonance imaging (MRI). The data included anterior-posterior (AP) length, medial-lateral (ML) width, medial AP (MAP),<br />lateral AP (LAP), MAP to LAP distance in the anterior distal femur namely anterior medial lateral (AML) width, medial<br />and lateral condyle width, and intercondylar notch. The aspect ratio (ML/AP) was also calculated and the results were<br />compared with similar dimensions of currently used knee implants.<br />Results: Our data showed that men are significantly larger in all dimensions than women. In the distal femur with<br />similar AP lengths in both sexes, women had a smaller ML width than men (p <0.001). Comparison between the distal<br />femur and studied prostheses showed no high correlation and similarity between the femoral component and femoral<br />condyle prostheses in the resected surface of the bone.<br />Conclusion: The results of this study can provide the data needed to design prostheses suitable for the Iranian<br />population.<br />Level of evidence: IIIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Application of Oscillating Saw for Lumbar en Bloc Laminectomy: A Case Series4074121575910.22038/abjs.2020.15759ENFarshad NikoueiBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran
2 Faculty of Medicine,oooo-ooo2-8232-5911Naveed NabizadehBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran0000-0002-6109-1204Elham MirzamohammadiFaculty of Medicine, Iran University of Medical Sciences,
Tehran, IranMaryam AmeriDepartment of Forensic Medicine and Toxicology, Iran
University of Medical Sciences, Tehran, IranSaeed SabbaghanBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, IranBehrooz GivehchianBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran0000-0002-5084-0679Farshad SafdariBone and Joint Related Tissue Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran0000-0001-5508-0624Journal Article20181106Background: An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describe<br />a relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) using<br />an oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications.<br />Methods: This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. The<br />bones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed if<br />any evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomy<br />from initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end of<br />decompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured,<br />and any dural injuries were reported.<br />Results: Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at<br />70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtained<br />as 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tear<br />occurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy.<br />Conclusion: Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is a<br />safe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce a<br />remarkable reduction in the time of surgery.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Effect of Total Knee Arthroplasty on Hindfoot Alignment in Patients with Severe Genu Varum and Genu Valgum4134191576010.22038/abjs.2019.33735.1883ENHosseinali HadiOrthopedic Department, Arak University of Medical
Sciences, Arak, Iran0000-0001-6590-4308Mahmood Jabal AmoliBone and Joint Reconstruction Research Center, Shafa
Yahyaian Hospital, Iran University of Medical Science,
Tehran, IranAbolfazl BagherifardBone and Joint Reconstruction Research Center, Shafa
Yahyaian Hospital, Iran University of Medical Science,
Tehran, Iran0000000249658810Ahmadreza BehrouziValiasr Hospital, Arak University of Medical Sciences,
Arak, IranFatemeh SafiRadiology Department, Faculty of Medicine, Arak
University of Medical Sciences, Arak, IranAmir AzimiOrthopedic Department, Arak University of Medical
Sciences, Arak, Iran0000-0003-4061-2557Mahtab GhanbariNursing Department, Qom University of Medical
Sciences, Qom, IranGholamreza Azarnia SamarinOrthopedic Department, Arak University of Medical
Sciences, Arak, Iran0000-0002-7668-4010Journal Article20180801Background: The maintenance of deformity in the ankle and hindfoot after correction of knee deformity following knee<br />arthroplasty may cause abnormal tension in the knee and patient dissatisfaction. The aim of this study was to determine<br />the effect of knee arthroplasty on the hindfoot alignment in patients with severe genu varum and valgum.<br />Methods: A total of 84 patients with primary osteoarthritis, were enrolled in the study. The knee deformity was measured<br />using a long leg film before surgery. The long axial radiographic view of hindfoot was taken in the standing position for<br />all patients, before and six months after surgery. Comparisons were made on changes in the hindfoot angles measured<br />before and after surgery.<br />Results: A total of 84 patients with mean age of 62.28 ± 7.77 years, 77 (92%) and seven patients (eight percent)<br />had knee varus and valgus deformity, respectively. In the knee varus group, the mean preoperative hindfoot angle<br />was + 5.32 ± 6.12 ° (valgus) which was changed to - 0.25 ± 4.91 ° (varus) in the postoperative phase. In the knee<br />valgus group, the mean pre and postoperative hindfoot angles were - 7.71 ± 7.06° (varus) and - 2.14 ± 5.92 ° (varus),<br />respectively. The mean preoperative hindfoot angle in severe and very severe varus knee groups were + 5.45 ± 3.30<br />and + 5.28 ± 6.86 °, respectively. These angles were changed to + 0.21± 5.17 and -1.60 ± 3.89° six months after<br />surgery, respectively. The mean preoperative hindfoot angle in severe and very severe valgus knee deformity groups<br />were - 7.00 ± 4.69 and -8.66 ± 10.69 °, respectively. These angles were changed to - 2.00 ± 5.71 and - 2.33 ± 7.50<br />°after surgery, respectively. There was no significant difference between patients with severe and very severe deformity<br />in terms of pre and post-operative hindfoot angle.<br />Conclusion: The hindfoot alignment is significantly corrected after knee arthroplasty. The severity of knee deformity<br />does not correlate with the severity of the hindfoot deformity before and after surgery.<br />Level of evidence: IMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Modified Camitz versus BRAND Procedures for the Treatment of Severe Carpal Tunnel Syndrome: A Comparative Trial Study4204251576110.22038/abjs.2020.15761ENMohammad DehghaniDepartment of Orthopedic, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran0000-0002-9185-8779Behrooz FadaeiDepartment of Orthopedic, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran0000-0003-0711-1750Shirvan RastegarDepartment of Orthopedic, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran0000-0002-3294-7691Abolghasem ZarezadehDepartment of Orthopedic, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, IranKeyvan GhadimiSchool of Medicine, Isfahan University of Medical
Sciences, Isfahan, IranRoham NikkhahSchool of Medicine, Isfahan University of Medical
Sciences, Isfahan, IranSepehr EslamiDepartment of Orthopedic, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, IranJournal Article20190101Background: Carpal tunnel syndrome (CTS) is characterized by complications such as pain, paresthesia, and<br />numbness in the fingers. There are some surgical therapies for the management of severe carpal tunnel, but differences<br />exist between the treatments available for creating the opposition. The current study was conducted to compare the<br />effect of modified Camitz and BRAND techniques on thumb opposition in patients with severe CTS.<br />Methods: A total of 40 patients with severe CTS who were candidates for opponensplasty were enrolled in this clinical<br />trial study at Alzahra and Kashani hospitals, Isfahan, Iran, from 2014 to 2018. The patients were divided into two groups<br />of modified Camitz and BRAND. Quick DASH-9 and Kapandji scores as well as pulp and side pinch and pronation<br />angle were assessed before and after the surgeries.<br />Results: Quick DASH-9 score, Kapandji score, pulp and side pinch and pronation angle significantly improved postoperatively<br />(P=0.0XXX, P=0.0XXX, P=0.0XXX, P=0.0XXX, and P=0.0XXX, respectively). But, no significant differences<br />were seen in the mentioned variables between both groups pre and post-operative (P>0.05, for all the studied variables).<br />No postsurgical complications were seen in any of the groups.<br />Conclusion: The findings of the present study demonstrated that, both Modified Camitz and BRAND techniques<br />are effective and safe techniques, yielding high improvements, but no serious complications. Both techniques can be<br />considered for treatment of patients with severe CTS.<br />Level of evidence: IIMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study4264311576210.22038/abjs.2019.39026.2038ENSohrab KeyhaniOrthopedic Department Chair, Akhtar Orthopedic
Training and Research Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran0000-0002-4455-5214Mehran SoleymanhaOrthopaedic Research center, Department of
Orthopaedic, Poursina Hospital and School of Medicine,
Guilan University of Medical Sciences, Rasht, Iran0000-0002-7603-7091Rene VerdonkDepartment of Orthopedics and Traumatology, Ghent
University, Ghent, BelgiumMohammadreza AbbasianAkhtar Orthopedic Training and Research Hospital,
Shahid Beheshti University of medical Sciences, Tehran,
Iran0000-0002-4791-9925Journal Article20190311Background: Although some surgical techniques have been described for the operative treatment of unstable<br />Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the<br />present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.<br />Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage<br />Repair Society (ICRS)) of the femoral condyle were investigated. Surgical intervention considered in cases of stage III<br />(4 cases) and IV (2 cases) and in stage II (10 cases) ones that were nonresponsive to conservative treatment. At the<br />initial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.<br />Results: The mean preoperative IKDC score (53.4) increased significantly following surgery (84.3) (p <0.001).<br />Based on the IKDC grading system, before the operation, the knee status was graded as nearly normal, abnormal,<br />and severely abnormal in 4, 10, and 2 patients, respectively. At final post-surgical follow up, 15 normal and 1<br />abnormal knee were documented (p <0.001). The mean Lysholm score increased from 44.3 per operatively to 86.3<br />(p <0.001).Tegner activity score improved from 2.8±1 pre operatively to 5.6 ±2 (p <0.001).<br />Conclusion: Surgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes.<br />In addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one appropriate<br />for autogenous osteochondral grafting with healthy cartilage.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Prevalence, Zone, and Type of the Meniscus Tear in Patients with Anterior Cruciate Ligament (ACL) Injury; Does Delayed ACL Reconstruction Affects the Meniscal Injury?4324381576310.22038/abjs.2019.39084.2076ENSohrab KeyhaniShahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0002-4455-5214Ali Akbar EsmailiejahShahid Beheshti University of Medical Sciences, Tehran,
IranMohamad Sajad MirhoseiniAlborz University of Medical Sciences, Karaj, Iran0000-0001-6582-8077Seyyed-Mohsen HosseininejadShahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0001-6640-2983Naser GhanbariShahid Beheshti University of Medical Sciences, Tehran,
IranJournal Article20190515Background: Meniscus tear is a common finding in patients with anterior cruciate ligament (ACL) injury and may affect<br />the natural history of the injury and the outcomes of treatment. In the current study, the characteristics of meniscus tears<br />in patients who underwent arthroscopic ACL reconstruction were investigated.<br />Methods: The hospital records of 1022 patients were reviewed. The measured variables included the presence of<br />meniscus tear, ramp and root injury, the zone of injury based on the Cooper classification, and the type of tear. The ACL<br />tears with delay more than 3 months for ACLR were recorded as chronic injuries.<br />Results: The incidence of meniscus tear was 44.4%; among whom, bucket-handle injury was the most common type<br />(30.4%) and the ramp lesion was found in 20.5%. The meniscus was repaired in 56.6%. The incidence of medial<br />meniscus injury was significantly higher in chronic ACL tears and vice versa (p <0.001). The incidence of ramp lesion<br />(9.1% Vs 20.5%) and root tear (1.3% Vs 2.9%) were significantly higher in the chronic and acute tears, respectively<br />(p <0.001).<br />Conclusion: Delay more than 3 months in ACLR was associated with the increased incidence of meniscal injury,<br />specially the medial meniscus, and ramp lesion. It seems that early ACLR may be more helpful for the patients.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Surgical Excision as the First Therapeutic Choice in Single-muscle Hemangiomas: a Case Series4394441576410.22038/abjs.2019.40674.2098ENKhodamorad JamshidiBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran0000-0001-9475-5866Milad Haji Agha BozorgiBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran0000-0001-6723-626XHassan Assad KassirBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, IranAlireza MirzaeiBone and Joint Reconstruction Research Center, Shafa
Orthopedic Hospital, Iran University of Medical Sciences,
Tehran, Iran0000-0002-1569-6130Journal Article20190526Background: Conservative management is generally the primary treatment for intramuscular hemangimas. However,<br />many patients will require surgery later in their life, after suffering a long period of pain. We aimed to evaluate the<br />oncologic and functional outcomes of surgery as the initial treatment of single-muscle hemangiomas.<br />Methods: Medical profiles of 17 patients with hemangiomas of vastus medialis for whom surgery was selected as<br />the initial treatment were reviewed. The indication for surgery was a bothersome pain. Postoperative muscle strength<br />was assessed with manual muscle testing (range 0-5). The postoperative pain was measured by a visual analog scale<br />(VAS) for pain (range 0-10). Lyshölm-Tegner knee scoring scale was used for the evaluation of knee function.<br />Results: The mean age of the patients was 25.9±8.6 years. Surgery was performed as wide resection in 13 cases and<br />as marginal resection in 4 cases. At a mean follow-up of 55.76±30 months, two local recurrences (11.8%) were observed.<br />At the last evaluation session, muscle strength grade was 5/5 in 13 patients and 4/5 in four patients. Postoperative<br />pain was noticed in four patients (VAS=1). Knee function was excellent in 13 patients and good in four patients. Both<br />of the local recurrences occurred in marginally resected lesions. Three out of four cases with reduced muscle strength,<br />postoperative pain, and reduced function were also treated with marginal resection.<br />Conclusion: If a wide surgical margin is achievable without compromising the limb function, surgical resection could<br />be considered as the primary choice of treatment for single-muscle hemangiomas.<br />Level of evidence: IVMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501The Effect of Suspension and Conventional Core Stability Exercises on Characteristics of Intervertebral Disc and Chronic Pain in Office Staff Due to Lumbar Herniated Disc4454531576510.22038/abjs.2019.40758.2102ENReza KhanzadehDepartment of Sport Injuries and
Corrective Exercises, Faculty of Sport Sciences, University
of Isfahan, Isfahan, Iran0000-0001-7141-3142Reza MahdavinejadDepartment of Sport Injuries and Corrective
Exercises, Faculty of Sport Sciences, University of Isfahan,
Isfahan, Iran0000-0001-8016-8839Ali BorhaniDepartment of radiology, Medical Sciences
University of Tehran , Tehran, IranJournal Article20190530Background: The purpose of this study was to identify the effects of eight weeks of conventional and suspension core<br />stability exercises by use of the designed device on characteristic of intervertebral discs in low back pain.<br />Methods: A total of 27 men with chronic low back (CLB) pain due to lumbar disc herniation in L4-L5 and L5-S1 regions<br />were enrolled in this quasi-experimental study. After assessing the pain intensity using a visual analog scale (VAS) and<br />determining the disc herniation index using MRI, each group of patients were asked to perform either conventional<br />or suspension exercises for eight weeks, each week consisting of three training sessions. The pain intensity was<br />assessed at the end of the first, second, third, fourth and eighth weeks and the disc hernia index was determined again<br />at the end of the eight weeks of exercises.<br />Results: The results indicated significant changes in the intensity of pain in both groups through the period of eight<br />weeks of exercise with a remarkable pain relief. In relation to the structural characteristics of the intervertebral disc, data<br />analysis did not reveal any significant change between the pre- and post-test.<br />Conclusion: Considering the beneficial effects of the stability exercises and specially suspension stability exercises<br />with respect to pain alleviation and reduced use of sedatives and anti-inflammatory drugs, this method can be helpful<br />at early stages of treatment for chronic pains.<br />Level of evidence: IMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Primary Synovial Sarcoma Presenting as a Huge Mass: A Report of a Rare Case and Review of Literature4544561576610.22038/abjs.2020.15766ENSeyed Hosein Fattahi MasoumLung Diseases Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran0000-0003-4257-8233Amir Hossein JafarianMashhad University of Medical Sciences, Mashhad, Iran0000-0002-1656-5925Alireza Sharifian AttarDepartment of Anesthesia, Faculty of Medicine, Mashhad
University of Medical Sciences,Mashhad,IranFatemeh Sadat Abtahi MehrjardiEndoscopic and Minimally Invasive Surgery Research
Center, Mashhad University of Medical Sciences,
Mashhad, IranMehrdad FakhlaeiEndoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, IranLeila. S AraniUniversity of Pennsylvania, Philadelphia, PA, USASharifeh KamalimotlaghUniversity of Pennsylvania, Philadelphia, PA, USAAsieh Sadat FattahiEndoscopic and Minimally Invasive Surgery Research
Center, Mashhad University of Medical Sciences,
Mashhad, Iran0000-0001-7459-8429Journal Article20190923Primary synovial sarcoma of mediastinum is very rare among soft tissue sarcomas. Only a few cases have been reported<br />in the literatures. The best treatment is still unclear, but, surgical resection is the main therapy. In this article we report<br />a case of a 20*20 cm (2000gr) primary giant mediastinal synovial sarcoma in a 42 year-old man. We performed radical<br />excision of the tumor and the metastasis.<br />Level of evidence: VMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Anticoagulation Strategies for the Orthopaedic Surgeon: Reversal and Timelines4574601576710.22038/abjs.2019.44803.2222ENMatthew D. RiedelYale University Department of Orthopaedics and
Rehabilitation, Yale University School of Medicine, New
Haven CT, USA0000-0001-6640-7071Ian T. WatkinsUniversity of Miami Leonard M. Miller School of
Medicine, Miami FL, USAJohnathon R. McCormickUniversity of Miami Leonard M. Miller School of
Medicine, Miami FL, USAHans P. Van LanckerDepartment of Orthopaedic Surgery, St. Elizabeth
Medical Center, Brighton MA, USA- Harvard Medical School, Boston, MA, USA0000-0002-7660-8739Journal Article20191204Article Highlights:<br /> 1) This article provides a full anticoagulant reference for the practicing orthopaedic surgeon which can be used in any clinical scenario, whether urgent or elective surgical intervention is required<br /> 2) A comprehensive list of anticoagulant reversal agents and drugs with short half-lives (for bridging) are described with the intention to provide the data needed to safely manage a patient peri-operatively during urgent orthopaedic surgical care (i.e. fracture or infection)<br /> 3) Half-life and method of excretion for all drugs are included with the intention to accurately guide decisions regarding the appropriate timing of scheduling elective orthopaedic surgical care with regards to anticoagulant metabolism and effect <br /> 4) The practicing orthopaedic surgeon using this guide should always consider medical co-management of these complex patients as their medical co-morbidities may not be amenable to anticoagulant reversal or peri-operative cessation of therapy, even for a short period<br /> 5) The data contained in this article stands to serve as a foundation upon which institution-specific guidelines regarding the peri-operative management of orthopedic patients on long-term anticoagulation can be developedMashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Reply to “A Critical Review of Proximal Fibular Osteotomy for Knee Osteoarthritis”4614621576810.22038/abjs.2019.44398.2215ENSamundeeswari SaseendarCARE Sports Injury, India0000-0002-5103-3115Saseendar Shanmugasundaram SaseendarApollo Hospital, Muscat, Sultanate of Omanhttps://orcid.org/0000-0003-3953-0968Srinivas BS KambhampatiSri Dhaatri Orthopaedic, Maternity and Gynaecology
Center, Vijayawada, Andhra Pradesh, India0000-0002-4978-3590Journal Article20191112Proximal fibular osteotomy is a surgical procedure that has evoked significant interest and controversy in the recent past. Vaishya et al have made a significant effort in compiling the available evidence on the topic. However, we would like to make some significant suggestions and additions to the findings in their manuscript.Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic AssociationThe Archives of Bone and Joint Surgery2345-46448320200501Distal Femoral Valgus Cut Errors in Total Knee Replacement4634641576910.22038/abjs.2020.46578.2280ENHamidreza YazdiBone and Joint Reconstruction Research Centre,
Firoozgar Hospital, Department of Knee Surgery, Iran
Univesity of Medical Sciences, Tehran, IranMohammad Taher GhaderiBone
and Joint Reconstruction Research Center, Shafa Orthopedic
Hospital, Iran University of Medical Sciences, Tehran, Iranhttps://orcid.org/00Journal Article20200218The causes of malalignment in total knee arthroplasty can be categorized into three different groups; 1) Errors in bone cuts 2) Errors in implant fixations, and 3) The method of setting down the cutting guides (1). We would like to announce that more several distal femoral valgus cut errors may occur during total knee replacement.