Publications by authors named "Mehdi Motififard"

18 Publications

  • Page 1 of 1

Determining the relation between total knee arthroplasty surgery site drainage in two weeks after surgery with periprosthetic joint infection (PJI) in two years.

Int J Burns Trauma 2021 15;11(1):62-68. Epub 2021 Feb 15.

Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Background: Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) surgeries and prompt diagnosis and treatment are vital; however, no study has been conducted to determine the relationship between characteristics and duration of surgical site discharge and PJI.

Methods: This is a longitudinal observational study that was performed at Al-Zahra and Kashani and Sadi university hospitals from 2017 until 2019. A total of 961 elective TKA were performed on 850 consecutive patients. Patients were followed up for two years after surgery. Data regarding the occurrence of discharges, types of discharges, duration of discharges, the incidence of PJI and superficial infections were collected.

Results: The rate of superficial and prosthetic joint infection was 0.3% and 0.3%. Patients with infections (either PJI or superficial) had a longer duration of discharge (14.6 days and 13.3 days in PJI and superficial infections respectively, compared to 7.7 days in all of the study population); Bloody-purulent discharge was associated with the development of prosthetic and superficial infections.

Conclusion: Bloody purulent discharge reaching seven days postsurgical in TKA patients is highly suggestive of an underlying infection (PJI or superficial infection) but type and duration of discharge could not be used to differentiate between PJI and superficial infection. Other risk factors for PJI or superficial infection include women's gender, longer surgical duration, longer hospitalization and longer discharge duration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012868PMC
February 2021

Intraneural cavernous hemangioma: a rare case of extrafascicular left ulnar nerve tumor.

Am J Blood Res 2021 15;11(1):72-76. Epub 2021 Feb 15.

Department of Orthopedics, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Hemangiomas are benign soft tissue tumors that may be found everywhere in the human body. As one of the hemangioma types, cavernous hemangioma consists of a flat endothelium along with blood-filled spaces and may be found in the central nervous system, but rarely occurs in peripheral nerves. This article pertains to the introduction of an old female patient complaining of pain and paresthesia of the ulnar side of the left forearm and hypothenar with numbness and tingling of the fourth and fifth digits and clawing. The patient was medically treated for a month but became a surgical candidate due to the poor response to medical treatment. A 1-cm lesion was observed in the surgery with compression on the ulnar nerve in the ulnar groove. Neurologic symptoms of the patient were improved after excision of the lesion, but clawing persisted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010596PMC
February 2021

Management of orthopedic patients during COVID-19 outbreak.

Int J Burns Trauma 2020 15;10(5):181-190. Epub 2020 Oct 15.

School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Coronavirus Disease 2019 (COVID-19) pandemic was declared on March 11, 2020, which led to the massive economic and social crisis in the world. Hospitals and healthcare systems faced the most changes during this time. As for any other medical departments, orthopedic departments were affected by this situation. Trauma and musculoskeletal injuries require emergency action or even operation which would not stop due to COVID-19 crisis. Special protocols and guidelines were used to minimize infection risks in Kashani educational trauma center. Here we explain the changes and protocols in the following sections: Outpatient-Clinic, emergency department, Operation room and Orthopedic Ward. These strategies included: reducing the number of admitted patients in clinics, changing the decoration of waiting rooms, screening the patients at the entrance and personal protection equipment for staff. We also dedicated special emergency rooms for patients suspicious to COVID-19 infection and also special operation rooms and corridor for patients with COVID-19 infection. Changes in discharging protocols and continuous consultations with infectious diseases specialists brought us the ability to manage these patients. Here in the present paper, we described different strategies of the management of patients in Kashani hospital during COVID-19 outbreak. We hope that our experience of patient's management could help other physicians and hospitals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675204PMC
October 2020

Periosteal chondroma of pelvis - an unusual location.

Int J Burns Trauma 2020 15;10(4):174-180. Epub 2020 Aug 15.

Department of Radiology, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Periosteal chondroma is a slow growing benign tumor with prevalence rate of less than 2% of all chondromas. This tumor is mostly observed in clavicle, ribs and humerus and only one previous case has been reported in pelvis. Here we present an unusual case of periosteal chondroma due to uncommon presentation, location and age range. Our case is a 39 year-old male diagnosed with periosteal chondroma in pelvis. He had unspecific signs and symptoms overlapping with low back pain and disk herniation. By the time of admission he had gluteal muscle atrophy and also claudication. Differentiation of periosteal chondroma from other malignant tumors are pivotal in order to prevent aggressive and inappropriate therapies. He underwent surgical procedures and periosteal chondroma was ascertained by both radiological and Histopathological evidence. 6 months after surgery, he declared no pain, he was able to walk freely. He claimed partial paresthesia but he also declared that his paresthesia has ameliorated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486565PMC
August 2020

Intraoperative repair for iatrogenic MCL tear due to medial pie-crusting in TKA yields satisfactory mid-term outcomes.

Knee Surg Sports Traumatol Arthrosc 2020 Jul 1. Epub 2020 Jul 1.

Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Purpose: This study aimed to assess the rate of iatrogenic mid-substance superficial medial collateral ligament (sMCL) tear due to the medial pie-crusting technique during varus deformity total knee arthroplasty and compare the knee society score (KSS), range of motion (ROM), and instability rate of the repaired group to the control group with intact sMCL.

Methods: For this retrospective series of prospectively collected data, the multiple needle puncturing technique was performed for 653 out of the 1768 knees during algorithmic medial soft-tissue release. Iatrogenic tear was observed in 35 knees (5%); hence, repair with running locking nonabsorbable braided suture was performed. Patients were visited and reviewed both clinically and radiographically at 6 weeks, 3 months, 6 months, 12 months, and annually thereafter. Chi-square, ANOVA, Mann-Whitney, independent and paired t test were used to analyze the variables. P value < 0.05 was considered statistically significant.

Results: 85% of the repaired sMCL had stable joints with a mean KSS of 88 ± 3 and a mean ROM of 103 ± 11 degrees (°). The other five patients (15%) with mean KSS of 40 ± 8 and mean ROM of 81° ± 5° had an instability and needed to undergo a revision surgery. The control group had a mean KSS of 86 ± 15 and mean ROM of 107° ± 8°; however, 7 knees had an instability and needed a revision surgery. No significant difference was observed in terms of KSS (P = 0.86) and ROM (P = 0.64) between the control and repaired groups.

Conclusion: The mid-substance sMCL tear is an important intraoperative complication of medial pie-crusting. Repairing this iatrogenic tear with nonabsorbable suture had satisfying clinical outcomes regarding the postoperative knee ROM and KSS in comparison to the control group. However, there is a chance of failure, which should be perceived by the surgeons.

Level Of Evidence: Therapeutic studies, investigating the results of treatment, Level III.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00167-020-06126-xDOI Listing
July 2020

Evaluation of the Stability of the Subjects with Anterior Cruciate Injuries Reconstruction.

J Knee Surg 2020 Jun 8. Epub 2020 Jun 8.

Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Anterior cruciate ligament (ACL) is the most frequently injured ligament in the knee and is often injured during sport-related activities. ACL injuries influence the abilities of the subjects during standing and walking. Although early surgical intervention is preferred treatment for the majority of knee surgeons, the effect of this approach on postural stability of patients is not fully understood. Therefore, the aim of this study was to determine the difference between stability of ACL-reconstructed subjects before and after surgery. A group of 15 consecutive ACL injured patients participated in this study. Postural stability of the patients was evaluated 1 week before and 6 months after surgery (ACL reconstruction with hamstring autograft). A Kistler force plate was used to evaluate center of pressure (COP) sway during quiet standing. The mean values of the COP parameters were obtained in pre and postsurgery conditions. Paired sample -test was used to evaluate the difference between the stability parameters of the two conditions. The significant point was set at 0.05. The mean value of path length of COP velocity in mediolateral (ML) direction was 1,485.57 ± 479.42 mm and 2,641.33 ± 996.26 mm before and after surgery, respectively (-value = 0.01). Although the mean value of COP velocity in anteroposterior and ML directions increased after surgery, the difference was only significant for velocity in ML direction (-value = 0.049). The results of this study showed that the standing stability of those with ACL reconstruction decreased significantly after ACL reconstruction, which may be due to the effects of the surgery on sensory mechanism of ACL and inability of patients to return to their previous deep sense perception and knee proprioception.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0040-1710374DOI Listing
June 2020

Improvement in osseointegration of tricalcium phosphate-zircon for orthopedic applications: an in vitro and in vivo evaluation.

Med Biol Eng Comput 2020 Aug 27;58(8):1681-1693. Epub 2020 May 27.

New Technologies Research Center, Amirkabir University of Technology, Tehran, 15875-4413, Iran.

Similar to metallic implant, using the compact bio-nanocomposite can provide a suitable strength due to its high stiffness and providing sufficient adhesion between bone and orthopedic implant. Therefore, using zirconia-reinforced calcium phosphate composites with new generation of calcium silicate composites was considered in this study. Additionally, investigation of microstructure, apatite formation, and mechanical characteristic of synthetic compact bio-nanocomposite bones was performed. Desired biodegradation, optimal bioactivity, and dissolution of tricalcium phosphate (TCP) were controlled to optimize its mechanical properties. The purpose of this study was to prepare the nanostructured TCP-wollastonite-zirconia (TCP-WS-Zr) using the space holder (SH) technique. The X-ray diffraction technique (XRD) was used to confirm the existence of favorable phases in the composite's structure. Additionally, the effects of calcination temperature on the fuzzy composition, grain size, powder crystallinity, and final coatings were investigated. Furthermore, the Fourier-transform infrared spectroscopy (FTIR) was used for fundamental analysis of the resulting powder. In order to examine the shape and size of powder's particles, particle size analysis was performed. The morphology and microstructure of the sample's surface was studied by scanning electron microscopy (SEM), and to evaluate the dissolution rate, adaptive properties, and the comparison with the properties of single-phase TCP, the samples were immersed in physiological saline solution (0.9% sodium chloride) for 21 days. The results of in vivo evaluation illustrated an increase in the concentration of calcium ion release and proper osseointegration ratio, and the amount of calcium ion release in composite coatings was lower than that in TCP single phase. Nanostructured TCP-WS-Zr coatings reduced the duration of implant fixation next to the hardened tissue, and increased the bone regeneration due to its structure and dimensions of the nanometric phases of the forming phases. Finally, the animal evaluation shows that the novel bio-nanocomposite has increasing trend in healing of defected bone after 1 month.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11517-020-02157-1DOI Listing
August 2020

A porous polymeric-hydroxyapatite scaffold used for femur fractures treatment: fabrication, analysis, and simulation.

Eur J Orthop Surg Traumatol 2020 Jan 16;30(1):123-131. Epub 2019 Aug 16.

New Technologies Research Center, Amirkabir University of Technology, Tehran, 15875-4413, Iran.

Background: One of the most common fractures in the skeleton happens in the femur. One of the important reasons for this fracture is because it is the longest bone in the body and osteoporosis affect this part a lot. The geometric complexity and anisotropy properties of this bone have received a lot of attention in the orthopedic field.

Methods: In this research, a femur designed using 3D printing machine using the middle part of the hip made of polylactic acid-hydroxyapatite (PLA-HA) nanocomposite containing 0, 5, 10, 15, and 25 wt% of ceramic nanoparticle. Three different types of loadings, including centralized loading, full-scale, and partially loaded, were applied to the designed femur bone. The finite element analysis was used to analyze biomechanical components.

Results: The results of the analysis showed that it is possible to use the porous scaffold model for replacement in the femur having proper strength and mechanical stability. Stress-strain analysis on femoral implant with biometric HA and PLA after modeling was performed using the finite element method under static conditions in Abaqus software.

Conclusion: Three scaffold structures, i.e., mono-, hybrid, and zonal structures, that can be fabricated using current bioprinting techniques are also discussed with respect to scaffold design.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00590-019-02530-3DOI Listing
January 2020

A Large Primary Subcutaneous Hydatid Cyst in Proximal Thigh: An Unusual Localization.

Adv Biomed Res 2018 27;7:50. Epub 2018 Mar 27.

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Primary muscular hydatidosis is a very rare condition with an incidence of 1%-4% in endemic regions. This case report describes an unusual location of hydatid cyst in the sartorius muscle and the application of imaging in its preoperative diagnosis, choosing a treatment strategy, and monitoring.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.228622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887698PMC
March 2018

Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty.

Adv Biomed Res 2018 30;7. Epub 2018 Jan 30.

Department of Orthopedic Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA.

Materials And Methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group ( = 46) and debridement alone including removing of all osteophytes was performed on the control group ( = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP.

Results: The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months).

Conclusions: PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/abr.abr_154_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812092PMC
January 2018

Relationship between Bone Mineral Density and Serum Vitamin D with Low Energy Hip and Distal Radius Fractures: A Case-Control Study.

Arch Bone Jt Surg 2017 Jan;5(1):22-27

Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The main purpose of this study was to determine the relationship between serum vitamin D and the status of bone mineral density in patients with low-energy hip and distal radius fracture.

Methods: This retrospective case-control study was performed between January 2013 and January 2014. Participants aged 55 years or older were divided to case group including 85 patients with low-energy hip fracture and 83 patients with low-energy distal radius fractures, and 82 subjects as a matched control group. Bone mineral density was measured with dual energy X-ray absorptiometry and serum sample was obtained to check vitamin D, calcium, phosphorus, alkaline phosphatase, and protein.

Results: Study subjects for final evaluation consisted of 78 in hip and distal radius fracture groups and 80 in control group. There were no significant differences in the mean serum levels of calcium, phosphorus and alkaline phosphatase between the three groups. The overall mean serum level of vitamin D3 was significantly different among the three groups. Similar results were observed with hip and spine t-score between the groups.

Conclusion: There is not only a direct relation between serum vitamin D and the risk of low energy hip and distal radius fractures, but also a significant relation between low bone density in hip and spine area with low serum calcium was observed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339351PMC
January 2017

Variations in ESR and CRP in total knee arthroplasty and total hip arthroplasty in Iranian patients from 2009 to 2011.

Adv Biomed Res 2016 30;5:148. Epub 2016 Aug 30.

Department of Orthopedics, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Implantation of joint prosthesis, either in the knee or in the hip, may cause some problems such as an infection, so that a timely treatment is essential. In this respect, discovering a marker detecting the incidence of an infection is one of the requirements of arthroplasty. The present study was conducted to determine variations of two markers in arthroplasty and infection incidence in Iranian patients.

Materials And Methods: This prospective study was carried out in Isfahan's educational treatment centers from 2009 to 2011 on patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) surgical operations. The erythrocyte sedimentation rate (ESR) was measured by Sed rate device (Lena) and C-reactive protein (CRP) by autoanalyzer device (Erba) with the unit of ng/dL. The patients underwent ESR and CRP tests the day before operation, the day of operation, and 1, 2, 5, and 15 days and 1, 3, 6, and 12 months after operation.

Results: Mean ESR increased during the first 5 days then decreased gradually lasting for 3 months. After 1 year it increased to a level higher than before the operation. The variations in ESR values were 19.1 ± 12.9 before the operation and 21.14 ± 10.8 after 1 year with significant difference (P < 0.001). The level of CRP had an upward trend from the first day after operation and reached its maximum on the second day, then had a downward trend up to 1 month after the operation; however, it did not reach its preoperative level during 1 year.

Conclusion: ESR and CRP and their variations can be suitable factors to detect probable infections in patients undergoing TKA and THA operations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.187403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025920PMC
September 2016

Iranian Joint Registry (Iranian National Hip and Knee Arthroplasty Registry).

Arch Bone Jt Surg 2016 Apr;4(2):192-6

Shahid Beheshti University of Medical Sciences, Knee and Sport Medicine Education and Research Center, Tehran, Iran.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852051PMC
April 2016

Causes and rates of revision total knee arthroplasty: Local results from Isfahan, Iran.

Adv Biomed Res 2015 29;4:111. Epub 2015 May 29.

Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Knee replacement is one of the most frequently performed surgical procedures in the world. Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the rates and causes of revision TKA in Kashani Hospital (Isfahan, Iran) from 2011 to 2013.

Materials And Methods: We assessed all primary TKA and revision TKA procedures performed from 2011 to 2013 for the rate and causes of failures. Demographic data, duration from primary TKA to revision TKA and underlying diagnosis for primary TKA were also assessed.

Results: Overall, 353 primary TKA procedures carried out in this period. The overall revisions following primary TKA in this period was 24 cases, indicating a revision burden of 6.8%. The most common cause of revision TKA was infection, which was in 16 cases (44.4%). Other causes included patellar complications, mechanical loosening of both tibia and femur, mechanical loosening of tibia, instability, and periprosthetic fracture. The main revision procedures were all component revision, tibial component revision, isolated tibial insert exchange and patellar tendon repair. The most common revision procedure was two stage all component revision, which was carried out in 13 subjects (36.1%).

Conclusion: Local indications for revision TKA are mainly similar to those in other large centers. As compared with other centers, with considering the follow-up time, revision burden is relatively higher in this center.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.157829DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513314PMC
August 2015

Scaphoid nonunion fracture and results of the modified Matti-Russe technique.

Adv Biomed Res 2015 11;4:39. Epub 2015 Feb 11.

Medical Students Research Centre, Isfahan University of Medical Science, Isfahan, Iran.

Background: The best treatment for scaphoid nonunion fractures is still controversial. The main aim of this study was to determine the results of the modified Matti-Russe method of surgery on scaphoid nonunion.

Materials And Methods: In this prospective interventional study, 30 patients with nonunion scaphoid fracture recruited from clinics of the Isfahan University of Medical Sciences between October 2007 and March 2011 underwent the modified Matti-Russe method of surgery. Union rate was evaluated four and six months after the procedure. Mayo wrist score (MWS) was calculated for the subjects six months after surgery.

Results: Mean age of the subjects was 25.9 ± 7.8 years, ranging from 16 to 35 years. Twenty-seven (90%) were men, and three (10%) were women. Four and six months after surgery, 10 (33%) and 26 (86.7%) subjects had a united fracture. Mean MWS was 75.0 ± 8.8 in all the subjects, ranging from 54 to 90 six months after surgery. Three subjects (10%) were grouped as excellent, 9 (30%) good, 16 (53.3%) satisfactory, and 3 (6.7%) poor.

Conclusion: A fracture or nonunion of the scaphoid bone can be a complex and troubling injury, but the modified Matti-Russe method showed satisfactory results six months after surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2277-9175.151248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358040PMC
March 2015

Results of pronator quadratus repair in distal radius fractures to prevent tendon ruptures.

Indian J Orthop 2014 Jul;48(4):399-403

Department of Orthopaedics, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Distal radius fractures are one of the the most common adult fractures encountered during the clinical practice of an orthopedic surgeon.12 Although several methods of treatment are suggested for these fractures, there are still controversies about the best treatment approach in the literature. Volar plating of distal radius fracture is a method of treatment which has become increasingly popular. One of the complications of this technique is flexor tendon rupture. The purpose of this study was to evaluate the protectiveness of complete repair of pronator quadratus muscle against flexor tendon rupture.

Materials And Methods: From September 2010 to September 2012, a consecutive series of 157 patients who were younger than 60 years with unstable distal radius fractures were included in the study. A standard volar approach to the distal radius was carried out. The radial and distal ends of pronator quadratus muscle were meticulously elevated from the radius and after volar plate fixation of the fracture, pronator quadratus muscle was restored to its normal insertion. We achieved full coverage of the plate with this muscle and followed the patients postoperatively.

Results: A total of 135 patients were studied. The mean age of patients was 34 ± 10 years (range 20-60 years). One 55-year-old diabetic female patient with flexor tendon rupture was identified. The flexor pollicis longus tendon had ruptured 16 months after surgery.

Conclusions: Pronator quadratus repair should be done in distal radius fracture to protect flexor tendons.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0019-5413.136275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137519PMC
July 2014

Plantar fasciitis.

J Res Med Sci 2012 Aug;17(8):799-804

Department of Orthopedics, Kashani Hospital, Medical University of Isfahan, Iran.

Heel pain, mostly caused by plantar fasciitis (PF), is a common complaint of many patients who requiring professional orthopedic care and are mostly suffering from chronic pain beneath their heels. The present article reviews studies done by preeminent practitioners related to the anatomy of plantar fasciitis and their histo-pathological features, factors associated with PF, clinical features, imaging studies, differential diagnoses, and diverse treatment modalities for treatment of PF, with special emphasis on non-surgical treatment. Anti-inflammatory agents, plantar stretching, and orthosis proved to have highest priority; corticosteroid injection, night splints and extracorporeal shock wave therapy were of next priority, in patients with PF. In patients resistant to the mentioned treatments surgical intervention should be considered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687890PMC
August 2012

Efficacy of tibial proximal osteotomy in correction of lower limb alignment indexes in patients with osteoarthritis in medial compartment of knee.

Med Arh 2012 ;66(1):58-60

Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Ntroduction: Tibial proximal osteotomy is one of the treatments for patients with knee compartment osteoarthritis. Studies showed 80% good prognosis in five years follow up after osteotomy. Almost always this method is used for pure medial knee compartment osteoarthritis that has a varus deformity. THE AIM of all methods is reforming varus deformity and lower limb alignment to gain 3 to 5 degree extra reformation and take knee in 10 degree valgus. One of the main etiologies for patients inconvenience and no decreasing in their pain is overcorrection or undercorrection, but unfortunately these can't be noticed. Therefore we must make sure that additional stress on the medial joint line was eliminated and regeneration of cartilage was facilitated or at least occurrence of osteochondritis was decreased. So we aimed to determine the efficacy of tibial proximal osteotomy in lower limb alignment indexes in patients with osteoarthritis in medial compartment of knee.

Material And Methods: This study is a clinical trial study that has done in Alzahra University Hospital of Isfahan Medical Science University in Iran since June 2010 till February in 2011. Patients had pain, pure medial knee compartment osteoarthritis and varus deformities were determined for study. Patients who wouldn't come for control, those who had no convenience for giving their data or osteoarthritis of all three compartments were excluded from study. Number of patients has determined 40 persons according to previous studies. Sampling occurred convenient. Before any surgical processes, the AP x-ray radiography was applied for alignment view. The demographic and radiographic data was registered. Six months later we applied AP x-ray radiography again and obtained data and analysis them with SPSS software and T-Paired statistical method.

Results: The mean of anatomical limb angle before and after surgical process were 5.1 +/- 3.4 varus and 11.9 +/- 3.4 degree valgus, respectively,so with T-test there was a significant difference between them (P < 0.001). The mean of mechanical limb angle before and after surgical process were 12.6 +/- 3.4 varus and 4.75 +/- 3.5 degree valgus, respectively. Therefor with T-test, there was significant difference between them (P < 0.001).

Conclusion: Results were achieved from this study showed that Tibial proximal osteotomy is appropriate treatment for young and middle age patients with progressive deformity, symptomatic varus knee. Key words: Tibial proximal osteotomy, Knee, Osteoarthritis, Varus deformity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5455/medarh.2012.66.58-60DOI Listing
May 2012
-->