Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Scapulothoracic arthrodesis for winged scapula due to facioscapulohumeral dystrophy (a new technique).

We introduced a new scapulothoracic arthrodesis technique in 6 patients (2 bilaterally) with winging of the scapula due to facioscapulohumeral muscular dystrophy from 1984 to 2000. The procedure involved a combination of plating and wiring techniques. The indications were symptomatic winging, limitation of active shoulder motion, pain, and impaired daily living activity. Our objective was to improve motion, strength, and performance of activities of daily living, as well as to provide pain relief. As a result of the technique, active motion improved in all patients, flexion improved from 64 degrees to 104 degrees, and abduction improved from 67.5 degrees to 112.5 degrees. The only complication was a hemothorax in a bilateral case that was easily treated. The length of follow-up averaged 32.5 months (14-55 months), and results did not change with time

Megaprostheses for well-fixed TKA femoral fractures

The use of distal femoral replacement (DFR) prosthesis is an option for treating distal femoral periprosthetic fracture (PPF). It is particularly helpful when the distal femoral bone is small and not amenable to rigid fixation. We report the results of 13 distal femoral PPFs at an average age of 77.5 years that were treated by this technique. At a mean follow-up of 30.5 months, the average Knee Society Score and functional score were 82 and 20, respectively. All patients who were ambulatory before fracture, regained their ability to walk after the surgery. There was a revision surgery for treating patellar instability. DFR is a reliable treatment for distal femoral PPFs with poor bone stock that allows for early ambulation in an elderly and low-demand group of patients. © 2015 Elsevier Inc

Exostosis-like intra-articular periosteal osteoblastoma: a rare case.

Osteoblastoma is a relatively rare benign bone tumor, most often located in the vertebral column or metaphysis of the long bones, particularly the femur and the tibia. Periosteal osteoblastoma is the least common type. Exostosis-like appearance is not common even in periosteal osteoblastoma, a very rare type of this tumor. In addition, an intraarticular location is uncommon for osteoblastomas. Here we report the case of a 25-year-old man with intra-articular exostosis-like periosteal osteoblastoma of the hip that resulted in impingement and osteoarthritis

The Use of a Closed-Suction Drain in Revision Knee Arthroplasty May Not Be Necessary: A Prospective Randomized Study

Background: The benefit of suction drains (SD) for the first 24-48 hours following joint replacement surgery is controversial. We aimed to determine if there is any difference in the early outcome of revision TKA when performed with, or without SD. Methods: 83 cases indicated for revision knee arthroplasty were randomized to receive (42) or not receive (41) a deep intra-articlular drain. First-stage revisions for treating periprosthetic infection were excluded. Patients were statistically compared for demographic parameters, early complications and early knee functional outcome. The assessed outcomes included total blood loss, number of transfusions, fever and wound complication rate at 24 months follow-up. In addition, the change in knee society score at 12 weeks postoperatively was compared between the groups. Results: There were no significant difference in demographic factors, wound complications, knee scores at 12 weeks and infection rate 24 months after surgery in either group. Average blood loss was 1856ml and 1533ml for the drain and no drain groups, respectively (P value=0.0470). The need for transfusion was significantly less in the no-drain group with an average of 0.15 unit/patient as compared to an average 0.37 unit/patient for the drain group (P value=0.0432). Conclusion: We were unable to find a point of superiority for using a drain for revision knee arthroplasty. Future studies with longer follow-up and larger population of patients are needed to make a valid conclusion. © 2016 Elsevier Inc

Rotating hinge knee causes lower bone�implant interface stress compared to constrained condylar knee replacement

Purpose: To compare the stresses at bone�arthroplasty interface of constrained and semi-constrained knee prostheses, using the finite element (FE) method as a predictor of the survivorship of the implants. Methods: Three-dimensional FE models of the knee implanted with rotating hinge (RHK) and legacy constrained condylar (LCCK) prostheses were generated to study the loads and stresses for two situations: medial- and lateral collateral ligament deficiencies in full extension. Results: On average, the shear stress developed at bone�implant interface dropped from 16.9 to 13.7 MPa (18.9), and the interface von Mises stress lowered from 37.6 to 30.2 MPa (19.6) in RHK compared to those in LCCK prostheses. RHK design also resulted in a more uniform stress distribution at the interfaces in both femur and tibia. The average polyethylene liner stress dropped from 9.6 to 2.6 MPa (a 72.7 decrease) in RHK design when compared to that in LCCK design. Conclusion: The more uniform interface stress suggests fewer density changes at the periprosthetic regions due to bone remodelling. Moreover, the lower polyethylene stresses are likely to reduce wear and damage. These findings reveal that the RHK design may have more favorable mechanical features compared to LCCK design in full extension boundary conditions, implying a potentially better survivorship. However, the findings should be interpreted cautiously as other configurations were not investigated. © 2018, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)