Publications by authors named "Mehran Soleymanha"

9 Publications

  • Page 1 of 1

Treatment of Posterior Cruciate Ligament Tibial Avulsion: A New Modified Open Direct Lateral Posterior Approach.

J Knee Surg 2020 Nov 25. Epub 2020 Nov 25.

Department of Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.

The optimal operative technique for the treatment of the tibial-side avulsion injuries of the posterior cruciate ligament (PCL) is debatable. This study was aimed to evaluate the postoperative outcomes and complications if any after an open direct, posterolateral approach using cannulated cancellous screw fixation of a PCL tibial avulsion. From January 2016 to June 2018, 17 patients (14 males and 3 females) with PCL avulsion fraction treatment-who underwent open reduction and internal fixation using cannulated cancellous screws-were included in this prospective study. A direct posterolateral approach in the prone position was used in all cases. The Lysholm's knee score and International Knee Documentation Committee (IKDC) score were assessed preoperatively and during regular follow-up examinations for at least 1 year (12-20 months) postoperatively. All patients had fracture union and all of their knees were stable upon physical examination. No nerve or blood vessel injuries occurred. The mean Lysholm's scores and mean IKDC scores were improved significantly at the last follow-up. This study provides evidence that open direct posterolateral approach may be reliable for the treatment of tibial-sided bony PCL avulsion fractures. This approach can provide direct visualization of the posterior capsule and PCL avulsion site associated with good reduction and stable fixation, easy application of the screws directly from posterior to anteriorly without extensive soft tissue damage. Nevertheless, long-term follow-up is recommended.
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http://dx.doi.org/10.1055/s-0040-1721093DOI Listing
November 2020

Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study.

Arch Bone Jt Surg 2020 May;8(3):426-431

Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of medical Sciences, Tehran, Iran.

Background: Although some surgical techniques have been described for the operative treatment of unstable Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.

Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage Repair Society (ICRS)) of the femoral condyle were investigated. Surgical intervention considered in cases of stage III (4 cases) and IV (2 cases) and in stage II (10 cases) ones that were nonresponsive to conservative treatment. At the initial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.

Results: The mean preoperative IKDC score (53.4) increased significantly following surgery (84.3) (). Based on the IKDC grading system, before the operation, the knee status was graded as nearly normal, abnormal, and severely abnormal in 4, 10, and 2 patients, respectively. At final post-surgical follow up, 15 normal and 1 abnormal knee were documented (). The mean Lysholm score increased from 44.3 per operatively to 86.3 ().Tegner activity score improved from 2.8±1 pre operatively to 5.6±2 ().

Conclusion: Surgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes. In addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one appropriate for autogenous osteochondral grafting with healthy cartilage.
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http://dx.doi.org/10.22038/abjs.2019.39026.2038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358228PMC
May 2020

Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel.

J Knee Surg 2020 Apr 6;33(4):410-416. Epub 2019 Feb 6.

Department of Orthopedic Surgery, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding enterprise. Management of widened or previously malpositioned tunnels is challenging and often requires innovative approaches. The purpose of this study was to evaluate the function and clinical results of revision single-stage ACL surgery using an anterolateral tibial tunnel (ALTT). A consecutive series of knees with arthroscopic ACL revision surgery were analyzed prospectively between April 2012 and September 2015. Among the 93 patients presented with revision ACL reconstruction, 25 patients met the study inclusion criteria for the ALTT technique and were followed up for a minimum of 2 years (range: 24-51 months). The clinical results were evaluated by means of the Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner activity level scale, and the knee stability was assessed by the Lachman test, pivot shift test, and anterior drawer test. Magnetic resonance imaging (MRI) of the index knee before the surgery and 2 years after revision surgery was assessed. The mean IKDC subjective score, mean Tegner activity level scale, and mean Lysholm score significantly improved in all study participants. This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up.
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http://dx.doi.org/10.1055/s-0039-1677812DOI Listing
April 2020

Arthroscopic Treatment of Diffuse Pigmented Villonodular Synovitis of the Knee: Complete Synovectomy and Septum Removal-Midterm Results.

J Knee Surg 2019 May 4;32(5):427-433. Epub 2018 May 4.

Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

The purpose of this study was to evaluate and describe the clinical results of complete arthroscopic synovectomy through the four arthroscopic portals in the knees affected by diffuse pigmented villonodular synovitis (DPVNS). Between 2009 and 2012, 21 patients (15 men and 6 women) with the diffuse form of PVNS of the knee were enrolled in the study after qualification. The clinical diagnosis was confirmed by magnetic resonance imaging and postsurgical pathologic examination. All patients underwent complete synovectomy through posteromedial, posterolateral, anteromedial, and anterolateral portals. Each patient was evaluated before treatment and followed up for a minimum of 5 years (range: 60-79 months) using the Lysholm score and International Knee Documentation Committee (IKDC) score. Both Lysholm score and IKDC scores were significantly improved in all study participants. No cases of clinical recurrence, infection, joint stiffness, or neurovascular lesions were observed. This study showed that an attentive arthroscopic synovectomy is a safer alternative with better clinical outcomes, with no clinical recurrences.
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http://dx.doi.org/10.1055/s-0038-1646929DOI Listing
May 2019

Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view.

Knee Surg Sports Traumatol Arthrosc 2017 Feb 27;25(2):454-458. Epub 2016 Dec 27.

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

Purpose: The purpose of this study was to evaluate and describe the clinical results and outcomes of a novel method for all-inside suture repair of medial meniscus ramp lesions through posteromedial and posterolateral transseptal portals during anterior cruciate ligament (ACL) reconstruction. Further, this investigation compared the posterolateral view to the notch view for diagnosis and repair.

Methods: Between 2011 and 2014, 166 patients had ramp lesions concomitantly with ACL injury; 128 patients (107 men and 21 women) were enrolled in the study after qualification. All patients underwent repair of the posterior horn ramp lesion of the medial meniscus, using a suture hook device with PDS No. 1 through a posteromedial portal while viewing from the posterolateral transseptal portal during ACL reconstruction, with a minimum of a 2-year follow-up.

Results: Patients were followed up for a minimum of 2 years (range 24-47 months). Their average Lysholm score increased from 61.7 ± 3.2 preoperatively to 87.8 ± 3.9 at last follow-up (p < 0.001). Moreover, their average IKDC scores also improved from 53.6 ± 2.1 (pre-op) to 82.1 ± 3.5 (at last follow-up) (p < 0.001). The peroneal nerve and the popliteal neurovascular bundle were not damaged in any of the patients.

Conclusion: This study provides evidence that the posterolateral transseptal technique protects neurovascular structures. This technique may be used safely and easily for repair of the posterior horn ramp lesion of the medial meniscus during ACL reconstruction.

Level Of Evidence: IV.
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http://dx.doi.org/10.1007/s00167-016-4410-9DOI Listing
February 2017

Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures.

Arch Bone Jt Surg 2016 Jan;4(1):47-51

Department of Orthopedic Surgery, Pursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Background: The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment.

Methods: In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied.

Results: Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion. The Constant Shoulder Score and Short Form Questionnaire Score (SF-36) increased in all patients, although aged women showed lower improvement.

Conclusion: Intramedullary nail fixation in the humeral shaft fracture may be associated with high rates of non-union.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733235PMC
January 2016

A Case of Slipped Capital Femoral Epiphysis in Association With Craniopharyngioma.

Trauma Mon 2015 Aug 1;20(3):e25633. Epub 2015 Aug 1.

Department of Endocrinology, Guilan University of Medical Sciences, Rasht, IR Iran.

Introduction: Slipped capital femoral epiphysis is characterized by the slippage of the proximal femoral epiphysis on the metaphysis, which is sometimes associated with an underlying endocrine disorder. Panhypopituitarism due to craniopharyngioma has been reported several times. We report a case of craniopharyngioma recurrence leading to slipped capital femoral epiphysis.

Case Presentation: A 28-year-old man diagnosed with recurrent craniopharyngioma presented with slipped capital femoral epiphysis. He was treated with gentle manipulation, capsulotomy, and placement of one screw as fixation per side. No complications showed up in a follow-up duration of 4 months.

Conclusions: We underscored the importance of endocrinologic disorders in craniopharyngioma cases. Such disorders should be taken into consideration and be followed up.
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http://dx.doi.org/10.5812/traumamon.25633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630600PMC
August 2015

The effect of magnesium sulfate on motor and sensory axillary plexus blockade.

Anesth Pain Med 2015 Feb 1;5(1):e21943. Epub 2015 Feb 1.

Anesthesiology Research Centre, Guilan University of Medical Sciences, Rasht, Iran.

Background: Magnesium is a physiologic cation that blocks neuromuscular transmission and does not allow the nerve to be stimulated.

Objectives: This study investigates the effect of adding magnesium sulfate to lidocaine to extend the duration of sensory and motor blocks of the axillary plexus in orthopedic surgeries of the upper extremities.

Patients And Methods: This controlled randomized double-blind study was performed on patients who were candidates for orthopedic surgery of the upper extremities. A total of 60 patients between 18-60 years with ASA Class 1 or 2 participated in the study. One group received lidocaine (5 mg/kg) with magnesium sulfate 20% (3 mL) as the case group, while the second group received lidocaine (5 mg/kg) with normal saline (3 mL) as a placebo to block the axillary plexus using the trans-arterial technique. The duration of the sensory and motor block of the axillary plexus was monitored and evaluated using the pinprick and modified Bromage scale.

Results: A total of 60 patients were included in the study with 30 patients having received lidocaine plus magnesium and the other 30 patients having received lidocaine plus normal saline. The mean sensory block duration in the case group was 248.83 ± 18.36 and in control group was 204.67 ± 22.62. The mean motor block duration in the case group was 207.0 ± 16.64 and in control group was 147.33 ± 21.52 (both P < 0.0001). The mean onset of sensory block in case group was 15.5 ± 3.79 and the onset block in control group was 10.33 ± 4.13 (P < 0.0001). The mean onset of motor block in case group was 20.66 ± 4.09 and the onset block in control group was 19.73 ± 26.18 (P < 0.848).

Conclusions: The addition of magnesium sulfate to lidocaine increased the duration of motor and sensory axillary block in the upper extremities during surgeries when compared to the use of lidocaine alone.
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http://dx.doi.org/10.5812/aapm.21943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363737PMC
February 2015

Survey of 2582 cases of acute orthopedic trauma.

Trauma Mon 2014 Nov 10;19(4):e16215. Epub 2014 Sep 10.

Department of Orthopedics, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran.

Background: Orthopedic injuries are among the most common causes of mortality, morbidity, hospitalization, and economic burden in societies.

Objectives: In this research, we study the prevalence of different types of trauma requiring orthopedic surgery.

Patients And Methods: We conducted a cross-sectional study on 2582 patients with acute orthopedic injuries admitted to the orthopedic emergency ward at the Poursina Hospital (a referral center in Guilan province (northern Iran), during December 2010 through September 2011. Patients were examined and the data collection form was filled for each patient. Data were analyzed by SPSS software version 19 and were listed in tables.

Results: Of 2582 included cases, 1940 were male and 642 were female, with a mean age of 34.5 years. Most injuries were seen in the 25 to 44 year age group from rural areas. The highest frequency of trauma related to falls. On the other hand, bicycling and shooting had the lowest frequencies. There were 18 cases with limb amputation. Overall, 66.5% of patients had fractures, 5% had soft tissue lacerations, and 10% had dislocations.

Conclusions: Identification of risk factors and methods of prevention is one of the most important duties of healthcare systems. Devising plans to minimize these risk factors and familiarizing people with them is prudent.
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http://dx.doi.org/10.5812/traumamon.16215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310155PMC
November 2014