Publications by authors named "Mahmoud Karimi Mobarakeh"

15 Publications

  • Page 1 of 1

Contralateral and siblings' knees are at higher risk of ACL tear for patients with a positive history of ACL tear.

Knee Surg Sports Traumatol Arthrosc 2020 Feb 14;28(2):622-628. Epub 2019 Nov 14.

Orthopedic Department, Orthopedic Research Center, Poursina Hospital, Guilan University of Medical Sciences, Parastar Ave., Rasht, Iran.

Purpose: Recent studies have shown that several genetic factors can cause susceptibility to anterior cruciate ligament (ACL) rupture. The aim of the present study was to evaluate certain underlying factors that increase the risk of ACL rupture.

Methods: Eight hundred thirty-six patients with ACL rupture who underwent ACL reconstructive surgery from 2010 to 2013 at an academic center completed a minimum of 5 years post-operation follow-up. The collected variables included sex, age, height, weight, exercise level, time interval between ACL rupture in the first knee and contralateral ACL rupture, dominant leg, side of the involved knee and sibling history of ACL rupture.

Results: The median follow-up duration was 6.5 (range: 5-8) years. Eighty-three patients (9.9%) had a contralateral ACL rupture, and 155 patients (18.5%) had siblings with a history of ACL rupture. The rate of contralateral ACL rupture was three times higher in women than in men and in patients with siblings with a history of ACL rupture than in those without such history. In addition, the risk of contralateral ACL rupture was higher in those younger than 30 years of age, those with a BMI of 20-25 kg/m and those who participated in regular sports activity. However, whether the involved knee was on the dominant or nondominant side had no effect on the incidence of contralateral ACL rupture. The results of the study showed that 69 (83.1%) of the contralateral ACL ruptures occurred within the first 2 years after the primary operation.

Conclusion: In a 5- to 8-year follow-up, one out of every ten patients had a contralateral ACL rupture, and two out of every ten patients had siblings with a history of ACL rupture. The findings suggest that having a sibling with a history of ACL rupture and being female are important risk factors for ACL rupture of the contralateral knee.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-019-05781-zDOI Listing
February 2020

Simultaneous arthroscopic ACL and PCL reconstruction using allograft Achilles tendon.

J Clin Orthop Trauma 2019 Oct 2;10(Suppl 1):S218-S221. Epub 2019 Jan 2.

Orthopedic Department, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: Multi-ligamentous injuries to the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are uncommon but debilitating injuries. They mostly lead in functional disabilities and further surgeries.

Hypothesis: The aim of the present study was to evaluate the outcomes of simultaneous arthroscopic reconstruction of ACL and PCL using allograft Achilles tendon.

Study Design: Case-series study.

Materials And Methods: This study was performed on patients with combined ACL-PCL injuries which attended for treatment to a referral center from January 2010 to January 2014. All of them underwent simultaneous arthroscopic reconstruction of ACL and PCL using allograft Achilles tendon. Range of motion (flexion and extension loss), giving way, anterior and posterior knee stability, proximal tibia step off, subjective assessment of knee function and patients satisfaction were evaluated at 3, 6, 12, 24 months and final follow-up. Data were analyzed by SPSS version 21 with consideration of P < 0.05 as significant difference.

Results: Among 28 included patients, 21 patients (75%) were male. Mean age of patients was 30.86 ± 7.25 years (range: 18-49 years). The mean follow-up time was 35.7 ± 6.8 months (range: 26-50 months). Our results demonstrated that knee function, stability, and range of motion were improved along the follow-up periods. At final follow-up none of the patients had giving way and all of them were completely satisfied from the surgery.

Conclusion: Simultaneous reconstruction of injured cruciate ligaments using allograft Achilles tendon resulted in appropriate functional outcomes and acceptable range of motion.

Level Of Evidence: IV.
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http://dx.doi.org/10.1016/j.jcot.2019.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823795PMC
October 2019

Double-plate fixation together with bridging bone grafting in nonunion of femoral supracondylar, subtrochanteric, and shaft fractures is an effective technique.

Musculoskelet Surg 2020 Aug 26;104(2):215-226. Epub 2019 Jun 26.

Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Purpose: The aims of the present study were to evaluate and report the therapeutic outcomes of double-plate fixation in combination with autogenous bridging bone grafting in treatment of nonunion fractures of femur.

Methods: In this retrospective case series study, 41 patients with nonunion fracture of femur who underwent surgery by double-plate fixation and autogenous bridging bone grafting in academic referral center from July 2010 to July 2015 were enrolled. Totally, 32 males and 9 females with mean age of 35 years were evaluated. They were evaluated for related risk factors, previous therapeutic methods, time interval between injury to nonunion surgery and surgery to full clinical and radiological union, duration of follow-up, levels of postoperative limb shortening, and movement limitations.

Results: Ten patients had open fractures and eight patients had infected nonunion in the femoral supracondylar, subtrochanteric, and shaft fractures. Nailing was the most common used method as the primary treatment of femoral shaft fractures. In addition, the mean follow-up time was 37 months. Full union was obtained even in infected cases. Deep vein thrombosis was found in one patient and pulmonary thromboembolism in another patient, and both patients were treated successfully. Moreover, limitations of articular movements were seen in seven patients.

Conclusion: Double-plate fixation in combination with bridging bone grafting is an effective method in the treatment of nonunion of femoral supracondylar, subtrochanteric, and shaft fractures even in the infected cases.
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http://dx.doi.org/10.1007/s12306-019-00615-0DOI Listing
August 2020

Intra-sheath versus extra-sheath ultrasound guided corticosteroid injection for trigger finger: a triple blinded randomized clinical trial.

Phys Sportsmed 2018 Feb 10;46(1):93-97. Epub 2017 Nov 10.

e General Practitioner, Guilan Road Trauma Research Center , Guilan University of Medical Sciences , Rasht , Iran.

Objective: The aim of this study is to compare clinical results of ultrasound-guided corticosteroid injection, intra-sheath versus extra-sheath of the finger flexor tendon.

Methods: A total of 166 patients with trigger finger were evaluated in a triple blind randomized clinical trial study. All the patients were injected with 1ml of 40mg/ml methyl prednisolone acetate, under the guidance of ultrasound. Half the patients were injected extra sheath, while the other half were injected intra sheath at the level of first annular pulley.

Results: The two groups were comparable in baseline characteristics (age, gender, dominant hand, involved hand and finger, and the symptoms duration). No significant difference was observed in the two groups with regards to Quinnell grading. In the final visit, 94% of patients from each group were symptom free.

Conclusion: Results of corticosteroid injection intra-sheath or extra-sheath of the finger flexor tendon under ultrasound guidance in patients with trigger finger are comparably alike. Extra-sheath injection at the level of A1 pulley is as effective as an Intra-sheath administration.
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http://dx.doi.org/10.1080/00913847.2018.1400897DOI Listing
February 2018

Predicting the Hamstring Tendon Diameter Using Anthropometric Parameters.

Arch Bone Jt Surg 2016 Oct;4(4):314-317

Guilan Road Trauma Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Background: Despite the importance of hamstring tendon autograft, one major disadvantage in applying this technique in the surgical reconstruction of anterior cruciate ligament is individual variability in the tendon diameter. Hence, the purpose of the present study was to use anthropometric parameters such as gender, height and body mass index to predict 4-strand (quadruple) hamstring tendons (gracilis and 2-strand semitendinosus tendons).

Methods: This is a cross-sectional study conducted on all consecutive patients who underwent arthroscopic ACL reconstruction between 2013 and 2015. The anthropometric variables (age, gender, height, and body mass index) were recorded. The quadruple hamstring tendon (gracilis and semitendinosus) autografts were measured using sizing cylinders. The relationship between these parameters was statistically determined using the Pearson Spearman test and linear regression test.

Results: The mean age of the 178 patients eligible for the study was 29.58±9.93 (118 males and 60 females). The mean hamstring tendon diameter was 7.8±0.7 mm, the mean for males was 7.9±0.6 and for females 7.8±9 mm (=0.0001). There were significant correlations between the mean hamstring tendon diameter with BMI (Pearson correlation=0.375, R=0.380, and =0.0001), height (Pearson correlation=0.441, R=0.121, and =0.0001), and weight (Pearson correlation=0.528, R= -0.104 and =0.0001). However, patient's age and genderwerenot found to be a predictor of the size of the hamstring tendon diameter.

Conclusion: Based on findings from this study weight, height, body mass index, and the length of the tendon may be predictors of the hamstring tendon diameter for anterior cruciate ligamentreconstruction. These findings could be used in preoperative planning of patients undergoing ACL reconstruction surgery to estimate the size of the graft and select of the appropriate type of graft.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100445PMC
October 2016

Hamstring tendon autograft versus fresh-frozen tibialis posterior allograft in primary arthroscopic anterior cruciate ligament reconstruction: a retrospective cohort study with three to six years follow-up.

Int Orthop 2016 Sep 18;40(9):1905-11. Epub 2016 Mar 18.

Orthopaedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Selection of various grafts for anterior cruciate ligament (ACL) reconstructions have been employed in order to improve on stability and function of the knee. This study aimed to compare stability and function of the knee after ACL arthroscopic reconstruction by single-loop tibialis posterior (TP) allograft and four-strand hamstring tendon (HT) autograft.

Materials And Methods: The retrospective cohort study included 104 patients in the TP group matched with 118 patients in the HT group in terms of demographic characteristics, associated meniscus injury, subjective and objective knee characteristics. All patients were followed up for at least three years with regards to mentioned criteria and time of return to former activities.

Results: The mean (range) age of TP (88 males and 16 females) and HT (99 males and 19 females) groups was 34.4 (19-48) and 36.9 (20-51) years, respectively. Median (range) follow-up durations were 55 (37-71) and 56 (36-72) months, respectively. No significant differences were observed post-operatively, regarding subjective and objective evaluations. Additionally, time duration for return to former activity was similar in both groups. Post-operative paresthesia and numbness of medial aspect of the calf were observed for two months in eight patients of the HT group which persisted to the final visit in one case. No similar symptom was seen in the TP group.

Conclusion: In arthroscopic ACL reconstruction, fresh frozen doubled TP allograft compared to HT autograft was equally effective in restoring function and stability of knee, permitting return to former activities.

Level Of Evidence: Retrospective comparative, Level III.
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http://dx.doi.org/10.1007/s00264-016-3164-9DOI Listing
September 2016

Treatment Outcomes of Corticosteroid Injection and Extracorporeal Shock Wave Therapy as Two Primary Therapeutic Methods for Acute Plantar Fasciitis: A Prospective Randomized Clinical Trial.

J Foot Ankle Surg 2015 Nov-Dec;54(6):1047-52. Epub 2015 Jul 26.

General Practitioner and Researcher, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.

The outcome of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of acute plantar fasciitis has been debated. The purpose of the present study was to evaluate and compare the therapeutic effects of CSI and ESWT in patients with acute (<6-week duration) symptomatic plantar fasciitis. Of the 116 eligible patients, 68 were randomized to 2 equal groups of 34 patients, each undergoing either ESWT or CSI. The ESWT method included 2000 impulses with energy of 0.15 mJ/mm(2) and a total energy flux density of 900 mJ/mm(2) for 3 consecutive sessions at 1-week intervals. In the CSI group, 40 mg of methyl prednisolone acetate plus 1 mL of lidocaine 2% was injected into the maximal tenderness point at the inframedial calcaneal tuberosity. The success and recurrence rates and pain intensity measured using the visual analog scale, were recorded and compared at the 3-month follow-up visit. The pain intensity had reduced significantly in all patients undergoing either technique. However, the value and trend of pain reduction in the CSI group was significantly greater than those in the ESWT group (p < .0001). In the ESWT and CSI groups, 19 (55.9%) and 5 (14.7%) patients experienced treatment failure, respectively. Age, gender, body mass index, and recurrence rate were similar between the 2 groups (p > .05). Both ESWT and CSI can be used as the primary and/or initial treatment option for treating patients with acute plantar fasciitis; however, the CSI technique had better therapeutic outcomes.
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http://dx.doi.org/10.1053/j.jfas.2015.04.026DOI Listing
August 2016

Effect of obesity on arthroscopic treatment of anterolateral impingement syndrome of the ankle.

J Foot Ankle Surg 2015 Jan-Feb;54(1):13-6. Epub 2014 Oct 24.

Medical Student, Student Research Center, Guilan University of Medical Sciences, Rasht, Iran.

The present case series study was performed to evaluate the effect of obesity on the arthroscopic findings and the functional outcome after arthroscopic treatment of anterolateral impingement syndrome of the ankle. The study was conducted on 36 patients (26 were classified as obese [body mass index ≥30 kg/m(2)] and 10 as not obese [body mass index <25 kg/m(2)]) who had previously undergone arthroscopic treatment of anterolateral impingement syndrome of the ankle. The arthroscopic findings and demographic features were recorded. The patients were examined postoperatively at 6 and 12 months postoperatively, and AOFAS scores were obtained. Our data showed that obese patients had the same arthroscopic findings as nonobese patients, except for chondral lesions. At 1 year of follow-up after performing arthroscopy, the presence of obesity had no effect on the functional outcome of arthroscopic treatment of anterolateral impingement syndrome of the ankle.Obesity has no effect on the effectiveness of arthroscopic treatment.
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http://dx.doi.org/10.1053/j.jfas.2014.09.005DOI Listing
August 2015

Snow Catastrophe Conditions: What is its Impact on Orthopedic Injuries?

Arch Bone Jt Surg 2014 Jun 15;2(2):111-3. Epub 2014 Jun 15.

Mohsen Mardani-Kivi MD, Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Iran places sixth amongst high risk natural disaster countries and Guilan province of Iran shoulders a large amount of socio-economic burden due to snow catastrophes. The more knowledge of circumstances we have, the more efficient our future encounters will be.

Methods: In this retrospective study, of all of the patients admitted to Poursina Hospital due to snow and ice related trauma in the first two weeks of February 2014, 306 cases were found eligible for entry into the present study.

Results: Of the 306 eligible patients (383 injuries), there were 175 men (57.2%) and 131 women (42.8%). Most patients suffered from orthopedic injuries (81%) and the most common fractures were distal radius fractures in the upper extremities and hip fractures in the lower extremities. Slipping was the most common and motor vehicle accidents had the rarest injury mechanisms. It was shown that the frequency of injuries were higher on icy days (67.6%) than snowy days (32.4%).

Conclusions: Snow crises may lead to increased risk of slipping and falling situations, especially on icy days. The peak of injury rates is a few days after snowfall with the most common injury being distal radius fracture. Providing essential instructions and supporting resource allocation to better handle such catastrophes may improve outcomes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151451PMC
June 2014

Is gabapentin effective on pain management after arthroscopic anterior cruciate ligament reconstruction? A triple blinded randomized controlled trial.

Arch Bone Jt Surg 2013 Sep 15;1(1):18-22. Epub 2013 Sep 15.

Mohsen Mardani-Kivi MD, Department of Orthopedic Surgery Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity . Gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. The aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consumption in patients who are candidate for anterior cruciate ligament (ACL) reconstruction arthroscopic surgery.

Methods: In this randomized, triple blind clinical trial, 114 patients who were candidate for arthroscopic ACL reconstruction were divided into two groups of gabapentin (G) and placebo (p), with 57 patients in each group. The intervention group received gabapentin 600 mg and a placebo was administered in control group. Patients received on-demand pethedine for pain management. The primary outcome was pain intensity according to the visual analogue scale (VAS) and the secondary outcome was the amount of opioid consumption and incidence of side effects (including: dizziness, sedation, nausea and vomiting) at 6 and 24 h visits.

Results: The mean pain intensity in G group at both the 6 and 24 hour visits was significantly lower than the control group (Both P<0.001). Also, patients in the gabapentin group consumed less opioid at both visits in comparison to the placebo group (p<0.001, P=0.032). The incidence rate of sedation, dizziness, nausea and vomiting was similar in both groups.

Conclusion: In arthroscopic ACL reconstruction, administering a preoperative single dose of 600mg gabapentin may decrease both pain intensity and opioid consumption.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151400PMC
September 2013

Role of gracilis harvesting in four-strand hamstring tendon anterior cruciate ligament reconstruction: a double-blinded prospective randomized clinical trial.

Knee Surg Sports Traumatol Arthrosc 2015 Apr 15;23(4):1086-91. Epub 2014 Feb 15.

Orthopedic Department, Kerman University of Medical Sciences, Kerman, Iran.

Purpose: Weakness in knee flexion following anterior cruciate ligament (ACL) reconstruction is one of the key issues in the treatment of an ACL tear. The purpose of this study was to examine and compare clinical outcome measures of ACL reconstruction using semitendinosus autograft (ST) versus semitendinosus + gracilis (ST/G) reconstructive techniques.

Methods: In a double-blind randomized clinical study, 19 patients with an ACL tear underwent either ST (59) or ST/G (61) and observed for 1 year. Both patients and the final examiner were unaware as to the type of graft received. Patients were evaluated according to subjective criteria, functional assessment tests, knee isometric torques, knee laxity using KT-2000 and knee range of motion.

Results: The study included 21 (17.6 %) female and 99 (82.4 %) male patients with a mean age of 29.9 ± 7.8 in the ST group and 32.4 ± 6.3 in the ST/G group. There were no significant differences found in surgical complications; IKD; Knee injury and Osteoarthritis Outcome Score; Lysholm; strength of the knee isometric flexors; and flexion and extension loss between the two groups. At the final visit, 86.9 % of ST group and 89.6 % of ST/G group had side-to-side difference of laxity <3 mm (n.s.).

Conclusions: Since anterior cruciate ligament reconstruction using quadrupled ST is more technically demanding than doubled STG and with there being no difference in outcomes and complications, no compulsory advice should be made on the former technique. However, gracilis harvesting may not be necessary based on the function and strength of the knee.

Level Of Evidence: Randomized controlled trial, Level I.
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http://dx.doi.org/10.1007/s00167-014-2890-zDOI Listing
April 2015

Corticosteroid injection with or without thumb spica cast for de Quervain tenosynovitis.

J Hand Surg Am 2014 Jan 4;39(1):37-41. Epub 2013 Dec 4.

Orthopedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rash; and the Orthopedic Department, Bahonar Hospital, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Purpose: To compare the corticosteroid injection (CSI) with or without thumb spica cast (TSC) for de Quervain tendinitis.

Methods: In this prospective trial, 67 eligible patients with de Quervain tenosynovitis were randomly assigned into CSI + TSC (33 cases) and CSI (34 cases) groups. All patients received 40 mg of methylprednisolone acetate with 1 cc lidocaine 2% in the first dorsal compartment at the area of maximal point tenderness. The primary outcome was the treatment success rate, and the secondary outcome was the scale and quality of the treatment method using Quick Disabilities of Arm, Shoulder and Hand and visual analog scale scores.

Results: The groups had no differences in mean age, sex, and occupation. The visual analog scale and Quick Disabilities of the Arm, Shoulder and Hand scores were similar in both groups before the treatment. The treatment success rate was 93% in the CSI + TSC group and 69% in the CSI group. Although both methods improved the patients' conditions significantly in terms of relieving pain and functional ability, CSI + TSC had a significantly higher treatment success rate.

Conclusions: The combined technique of corticosteroid injection and thumb spica casting was better than injection alone in the treatment of de Quervain tenosynovitis in terms of treatment success and functional outcomes.

Type Of Study/level Of Evidence: Therapeutic II.
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http://dx.doi.org/10.1016/j.jhsa.2013.10.013DOI Listing
January 2014

Celecoxib as a pre-emptive analgesia after arthroscopic knee surgery; a triple-blinded randomized controlled trial.

Arch Orthop Trauma Surg 2013 Nov 17;133(11):1561-6. Epub 2013 Sep 17.

Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran.

Background: Pre-emptive analgesia not only controls pain but also may result in the reduction of opioid consumption and related side effects following orthopedic surgeries. The purpose of the present study was to examine the therapeutic effects of celecoxib in reducing pain following the arthroscopic knee surgeries: anterior cruciate ligament (ACL) reconstruction and partial meniscectomy.

Materials And Methods: In this triple-blinded, randomized, placebo-controlled clinical trial, celecoxib 400 mg and identical placebo were administered, 2 h prior to operation, to 130 patient candidates for undergoing knee arthroscopic surgery of either isolated meniscectomy or ACL reconstruction. Pain intensity, 24 h opioid consumption and the related side effects were measured at 6 and 24 h post operation.

Results: The patients in both groups were similar with regards to demographic characteristics such as age, gender and body mass index. The results of the study indicated that the pain intensity and opioid consumption were lower in both subgroups (meniscectomy and ACL-R) in celecoxib group at 6 and 24 h post operation (P < 0.0001). The side effects of analgesics such as nausea and vomiting, sedation, and dizziness were not significantly different between the two groups (P > 0.05).

Conclusion: It seems that celecoxib as a pre-emptive analgesia agent is effective in decreasing acute postoperative pain and 24 h opioid consumption in patients undergoing arthroscopic knee surgery.
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http://dx.doi.org/10.1007/s00402-013-1852-0DOI Listing
November 2013

The effects of corticosteroid injection versus local anesthetic injection in the treatment of lateral epicondylitis: a randomized single-blinded clinical trial.

Arch Orthop Trauma Surg 2013 Jun 15;133(6):757-63. Epub 2013 Mar 15.

Orthopedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, P.O. Box: 4193713191, Rasht, Iran.

Introduction: This study seeks to compare two treatment methods of lateral epicondylitis: corticosteroid injection (CSI) and a local anesthetic injection (LAI).

Materials And Methods: In this single-blinded randomized clinical trial, 138 patients with the diagnosis of lateral epicondylitis were assigned either into CSI group receiving methylprednisolone 1 ml (49 patients) or LAI group (51 patients) receiving procaine 1 ml 2 % in a single dose at the maximal point tenderness site. The primary outcome measure was elbow disability using Quick DASH, and secondary outcome measures were pain intensity using Visual Analogue Scale (VAS) and recurrence rate at pretreatment visit and at 3-, 6- and 12-week post-treatment visits.

Results: There were no significant differences between the patients in both groups for demographic factors including age, gender, dominant hand, involved hand, and work pressure. Before treatment, the patients in both groups were suffering from the same rates of elbow disability and pain as measured by Quick DASH and VAS, respectively, (p > 0.05). In general, the recovery rate (comparison between pretreatment visit and last post-treatment visit) was significantly more effective and higher in CSI than LAI. CSI was dramatically more effective at 3-week visit, but less and less effective at 6- and 12-week visits. At 12-week visit the recurrence rate was 34.7 % (17 patients) in CSI group.

Conclusion: For lateral epicondylitis, CSI has the best short-term treatment results yet the highest recurrent rates. The combination of CSI with other treatment option or with a change in injection technique from single injection to peppering injection may be promising.
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http://dx.doi.org/10.1007/s00402-013-1721-xDOI Listing
June 2013

Evaluation of clinical outcomes of cementless total hip arthroplasty in patients under 30 years of age.

Eur J Orthop Surg Traumatol 2013 Oct 27;23(7):785-90. Epub 2012 Sep 27.

Orthopedic Research Center, "Poursina" Hospital, Guilan University of Medical Sciences, Parastaar St, P.O. Box: 4193713191, Rasht, Guilan, Iran,

Background: Historically, performing a successful hip joint replacement in patients aged fewer than 30 years has been an orthopedic challenge. The newer generation of prostheses and surgical techniques has the potential to increase the longevity of implants. The purpose of this study was to evaluate the outcomes of cementless hip arthroplasty in patients aged fewer than 30 years.

Materials And Methods: In this cross-sectional study, 41 patients (46 hips) were studied with a mean age of 24, 4 (from 17 to 30 years) of whom underwent cementless metal-polyethylene hip arthroplasty from 2004 to 2007. The Harris hip score (HHS) was used to assess the functional consequences. Patients were followed up in terms of early complications (thrombophlebitis of the lower limbs, dislocation, hematoma and infection) and late complications (aseptic loosening, dislocation and reoperation) at weeks 3 and 6, at 3 and 6 months, 1 year after surgery and annually thereafter.

Results: Patients were followed for an average of 5 years and 2 months (from 51 to 82 months). One early complication (symptomatic thrombophlebitis) and one late dislocation (2.2 %) were observed. There were no cases of aseptic loosening or osteolysis at the end of follow-up. The preoperative HHS was 59.6 (from 41 to 76), which rose to 82 and 83.5 after the 1-year and final follow-up, respectively, which was a significant increase.

Conclusions: Hip arthroplasty using a new generation of cementless proximal porous prosthesis with resistant polyethylene to cover the joint surfaces in patients aged fewer than 30 years is satisfactory and is accompanied by low complications.
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http://dx.doi.org/10.1007/s00590-012-1084-yDOI Listing
October 2013