Studying the effect of medial open wedge high tibial osteotomy on the posterior slope of tibia among patients with Genu varum

BackgroundA slight change in the posterior slope of tibia results in complications such as limited movement of knee joint and higher risks of Osteoarthritis.AimsThe present research seeks to study levels of tibia’s posterior slope change and limited movement of knee joint and knee stability following medial open wedge osteotomy used to treat patients with genu varum.Methods The present research is a clinical trial conducted in the form of a before and after study on patients with genu varum resorting to Imam Reza (PBUH), Khanevade, and Fajr hospitals from 2009 to 2012. As many as 40 knees (32 patients) were studied and the posterior slope of tibia before and after medial open wedge high tibial osteotomy was measured by someone totally unaware of the research using true lateral radiography. Movement limitation and stability of the knee was measured before and after the operation using scope of motion and Lachman and Drawer test. Paired sample test was used in this research and SPSS was used to analyse the data.Results The average posterior slope of tibia before the operation was 9.912, while this value changed to 11.625 after the operation signifying a significant increase. In terms of limited knee joint movement, 7 patients were diagnosed with grade 5 Extension LAG after operation, while the remaining 33 patients had a normal motion range (Extension LAG=0).ConclusionMedial open wedge osteotomy above tibia can help increase the posterior slope of tibia

Comparison of the effectiveness of femoral fixation techniques (Aperfix and Endobutton) in anterior cruciate ligament surgery

BackgroundAnterior cruciate ligament (ACL) is a Strengthener ligament of the knee. About 50 persons per 100,000 annually counter ACL rupture. Based on studies, the majority of people who have high mobility jobs, and had reconstruction surgery after ACL rupture, have returned to pre-injury level of activity.AimsWe compared two methods of surgery (aperfix and endobutton) in this article. We want to answer these two main questions in this study:1 is the effectiveness of surgical methods (aperfix and endobutton) in patients with anterior cruciate ligament rupture, the same?.2 Are the aspects of the knee function, in two surgical methods (aperfix and endobutton) after ACL reconstruction surgery, the same?Methods This study is a prospective clinical trial on patients who had complete ACL rupture in an isolated trauma, who were nominated for ACL reconstruction surgery. We excluded the cases that had underlying disease or other damages from the study. 100 patients were randomly divided into two groups of 50 individuals. Then each group underwent surgery. The femoral fixations were by the two common methods of ";;;;;;;;;;;Aperfix";;;;;;;;;;; or ";;;;;;;;;;;Endobutton";;;;;;;;;;;. We followed up, the cases one year after surgery and evaluated them by lysholm score as well as with IKDC score.Results The mean lysholm score and IKDC score do not have statistically significant difference in the two groups. (Mean lysholm score in Aperfix group=95.66 vs. 94.56 in Endobutton group (p=0.057) and IKDC score=92.32 in Aperfix group vs 92.20 in Endobutton group (p=0.28)). However, in some aspects of knee function, such as locking, Swelling, and climbing stairs, patients who had undergone Aperfix approach, had better results.ConclusionSurgical methods have little difference however due to better results in some aspects of knee functions in this study and due to other studies, it can be said Aperfix method slightly has more benefits. Further investigations with larger number of cases and longer duration of follow-up are recommended

Studying the effects of primary arthroplasty on post-treatment results among elderly patients with pertrochanteric fracture

Various therapeutic methods are available to treat patients with intertrochantric fracture, which is usually caused by falling down. This complication is usually observed among the elderly, particularly old women. The choice of the proper therapeutic method depends on many factors including patient’s condition, type of fracture, and the amount of movement. Hip arthroplasty is one of these therapeutic methods, which have certain advantages and disadvantages. Immediate resumption of walking with the ability of weight toleration and absence of complications such as aseptic necrosis are some advantages of this method. Sixtyeight elderly patients with pertrochanteric fracture who had resorted to Iranian Army’s hospitals and had undergone arthroplasty. These cases were examined with due comparison with historical and external controls. Variables such a type of operation, age, post-operation pain, the pace of resuming walking ability, embolism, surgical site infection, bedsore and DVT were studied and compared against standard operation. The results achieved through assessment of variables showed a significant difference with standard operation in terms of variables such as post-operative movement ability, pain scale in various times, surgical complications, embolism, surgical site infection, bedsore, and DVT. Post-operative pain within the first 3 months following it are some complications with not much attention is paid to them, but they are important complications which can cause many negative and influential effects on patients. Arthroplasty is more expensive than standard operation and the patient may initially feel more pain