Publications by authors named "Ali Keipourfard"

4 Publications

  • Page 1 of 1

Comparison of Clinical, Functional, and Radiological Outcomes of Total Knee Arthroplasty Using Conventional and Patient-Specific Instrumentation.

Arch Bone Jt Surg 2020 Sep;8(5):625-632

Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Recently, patient-specific instrumentation (PSI) systems have been developed in order to increase the accuracy of component positioning during total knee arthroplasty (TKA); however, the findings of previous studies are controversial in this regard. In the current randomized clinical study, the outcomes of computer tomography (CT)-based PS (patient specific)-guided TKA were compared to the results of conventional instrumentation (CVI) TKA. The guides were designed on the basis of distal femoral and proximal tibial pin orientation of the conventional related guides.

Methods: The present study was carried out on 24 TKA candidates randomly assigned to two PSI (n=12) and CVI (n=12) groups. The patients were postoperatively followed for 2 years. Then, the hip-knee-ankle angle (HKAA), femoral component flexion, and orientation of components in the coronal plane were measured. In addition, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Knee Society Score (KSS) questionnaire were completed for all the patients.

Results: The rate of the outliers of the HKAA was higher in the CVI group (41.7% and 8.3%; ); nevertheless, the difference was not significant in this regard. The rate of the outliers of other radiographic measurements and operational time were similar in both groups. Furthermore, there was no significant difference between the two groups in terms of the WOMAC and KSS.

Conclusion: The CT-based PS-guided TKA may result in the improved postoperative mechanical alignment of the limb and should be considered in complicated TKAs. However, future studies should investigate whether the results of PSI TKA support the considerably higher costs of this technique.
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http://dx.doi.org/10.22038/abjs.2020.41571.2124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547163PMC
September 2020

Diagnostic Value of Ischial Spine Sign in Patients with Acetabular Retroversion.

Arch Bone Jt Surg 2019 Mar;7(2):168-172

Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Acetabular Retroversion (AR) is a hip disorder and one of the causes of pain in this area. Evaluation of positive Cross Over Sign (COS) on AP X-Rays of the hip is currently the best method of diagnosis of AR. Several studies have measured co-existence of Ischial Spine Sign (ISS) in patients with AR. In this study we evaluated the diagnostic value of ISS in confirmation of AR and compared it with the diagnostic value of COS.

Methods: In this study, 4120 AP hip X-Rays from Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, were studied. Based on radiologic criteria, 1180 X-Rays were considered as standards and evaluated for ISS, COS and PWS (Posterior Wall Sign). Data analysis was done for correlation between ISS and COS.

Results: A total of 1180 out of 4120 X-Rays were considered as standard; among which, 86 were diagnosed with AR based on positive COS in presence of PWS. Both ISS and COS were positive concurrently in 69 X-Rays. ISS was positive in absence of COS in 11 X-rays. No significant difference in diagnostic value for diagnosis of acetabular retroversion was found between ISS and COS ().

Conclusion: According to our results, both ISS and COS signs can be employed for diagnosis of AR (acetabular retroversion). Considering the absence of a significant difference between these two signs in confirmation of AR, it can be perceived that the diagnostic value of ISS in confirmation of AR is equal to COS. Validation of the mentioned results requires further studies.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510926PMC
March 2019

Effects of Hip Geometry on Fracture Patterns of Proximal Femur.

Arch Bone Jt Surg 2016 Jun;4(3):248-52

Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur's geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures.

Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group). Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL), diameter of femoral head (FHD), diameter of femoral neck (FND), femoral head neck offset (FHNO), neck-shaft angle (alpha), femoral neck anteversion (beta) were measured and compared in all three groups.

Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011) while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference.

Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969372PMC
June 2016

Supracondylar Osteotomy in Valgus Knee: Angle Blade Plate Versus Locking Compression Plate.

Arch Bone Jt Surg 2016 Jan;4(1):29-34

Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: There are few studies comparing the biomechanical properties of angled blade plate and locking compression plates in supracondylar osteotomy. In the current randomized study, we prospectively compared the clinical and radiological outcomes of supracondylar osteotomy using these two plates.

Methods: Forty patients with valgus knee malalignment were randomly assigned to two equal numbered groups: angled blade plate and locking compression plates. All of the patients underwent medial closing wedge supracondylar osteotomy and were followed for one year. Before and after the operation the valgus angle and mechanical lateral distal femoral angle were compared between groups. Also, the rate of complications were compared.

Results: After the operation, the mean valgus angle and mechanical lateral distal femoral angle improved significantly in the two groups (P<0.001). Although, the preoperative amount of the valgus angle and mechanical lateral distal femoral angle were the same, at the last visit the valgus angle (5.4±2.1 versus 3.1±1.8; P=0.032) and mechanical lateral distal femoral angle (87.6±2 versus 89.7±3.2; P=0.041) were significantly lower and higher in the angled blade plate group, respectively. Nonunion occurred in four patients (20%) in the locking compression plates group (P=0.35).

Conclusion: Based on having a larger valgus angle and mechanical lateral distal femoral angle correction in the angled blade plate group and considerable rate of nonunion in the locking compression plate group, the authors recommend using the angled blade plate for fixation of medial closing wedge supracondylar osteotomy for patients with valgus malalignment. However, more long-term studies are required.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733232PMC
January 2016