Publications by authors named "Seyyed Morteza Kazemi"

15 Publications

  • Page 1 of 1

Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial.

Biol Trace Elem Res 2020 Sep 25. Epub 2020 Sep 25.

School of Public Health, Department of Nutrition and Food Science, Texas Woman's University, Denton Campus, Denton, TX, 76204, USA.

We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron-vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9.
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http://dx.doi.org/10.1007/s12011-020-02400-8DOI Listing
September 2020

Predictive Factors Associated with Anterolateral Ligament Injury in the Patients with Anterior Cruciate Ligament Tear.

Indian J Orthop 2020 Sep 1;54(5):655-664. Epub 2020 Jun 1.

Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The earlier studies did not assess the associated factors of anterolateral ligament injury, comprehensively. We sought to evaluate the independent predictive factors of anterolateral ligament injury in the patients with anterior cruciate ligament tear. Ultrasound scan has an emerging role in the diagnosis of anterolateral ligament injury.

Materials And Methods: We included 198 patients with anterior cruciate ligament tear in this study. All the patients underwent knee ultrasound scan to diagnose the anterolateral ligament injury. The potential predictive factors of anterolateral ligament injury were compared between the patients with anterolateral ligament injury and the patients with the intact anterolateral ligament.

Results: In all the patients, the anterolateral ligament was seen in the tibial and femoral portions using the ultrasound scan. One hundred and ten patients (55.6%) had anterolateral ligament injury and the anterolateral ligament was intact in 88 patients (44.4%). The lateral collateral ligament injury was significantly associated with the anterolateral ligament injury ( < 0.001). In addition, the iliotibial band injury had a significant relationship with the anterolateral ligament injury ( = 0.001). An increased lateral tibial slope was significantly associated with the anterolateral ligament injury ( = 0.031). Furthermore, the bone contusion of the lateral femoral condyle had a significant relationship with the anterolateral ligament injury ( = 0.004).

Conclusion: The independent predictors of anterolateral ligament injury included the lateral collateral ligament injury, iliotibial band injury, bone contusion of the lateral femoral condyle, and an increased lateral tibial slope.
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http://dx.doi.org/10.1007/s43465-020-00159-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429582PMC
September 2020

A Comparison between Oblique and Vertical Incisions on the Hamstring Tendon Harvesting in Anterior Cruciate Ligament Reconstruction and Infrapatellar Branch Injury of the Saphenous Nerve.

Rev Bras Ortop (Sao Paulo) 2020 Jun 27;55(3):374-379. Epub 2019 Aug 27.

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

 The present study aimed to compare the oblique and vertical incisions in hamstring tendon harvesting in anterior cruciate ligament (ACL) reconstruction and in infrapatellar branch injury of the saphenous nerve.  The present study was conducted at a tertiary referral center for 12 months. Patients with an indication of reconstruction of ACL tear were included in the study, who were then randomized into two groups (vertical [VG] and oblique [OG] groups). After excluding a few cases, 92 patients were eligible for further analysis (VG: 44; OG:  48). They were followed-up for 9 months after the surgery, and loss of sensation over the knee and over the proximal aspect of the operated leg was recorded.  The mean lengths of the incisions were 27 mm and 38 mm for the OG and VG groups, respectively. The total rate of hypoesthesia was 40% (27 patients). A total of 12 (25%) and 25 patients (56.8%) on the OG and VG groups, respectively, reported hypoesthesia symptoms. The presence of hypoesthesia in patients in the VG group was two times higher than in the OG group. No statistical correlation was observed between the nerve injury and age, gender, education, and delay from injury to reconstruction.  Oblique incision, which showed lower risk of nerve damage, might be more recommended for graft harvesting. Patients who underwent reconstruction of the ACL in the OG group had a lower incidence of peri-incisional hypoesthesia when compared to those in the VG group.
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http://dx.doi.org/10.1055/s-0039-1692695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316540PMC
June 2020

Comparing the effectiveness of vitamin D plus iron vs vitamin D on depression scores in anemic females: Randomized triple-masked trial.

Med J Islam Repub Iran 2019 3;33:64. Epub 2019 Jul 3.

Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

Low levels of 25-hydroxyvitamin D (25(OH)D) have been related to depression and anxiety. It seems that anemia is associated with vitamin D deficiency. We aimed to evaluate the effects of iron-vitamin D co-supplementation versus vitamin D alone on depression scores in anemic females with low levels of serum 25-hydroxyvitamin D. This randomized controlled trial was conducted on eighty premenopausal females who were recruited between May 2015 and October 2015 from primary health care centers. Women with anemia and low concentrations of 25(OH)D were randomized to either 1000 IU/d vitamin D plus 27 mg/d iron (D-Fe) or vitamin D plus placebo supplements (D-P) for 12 weeks. Depressive and anxious symptoms were evaluated with the Beck Depression Inventory (BDI) with subscales 1-13 and 14-21 and Beck Anxiety Inventory (BAI). To compare the groups, Mann-Whitney or chi-squared tests were used and within groups comparison was performed using Wilcoxon signed ranks test. The study was registered on www.clinicaltrial.org as NC 01876563. The serum concentrations of 25(OH)D were increased significantly in both groups at the end of the study. In both groups, there was a significant improvement in total BDI, the BDI subscale, and the BAI scores (p<0.001). No differences were found between groups (p>0.05). Although the potential positive effect of vitamin D on mental health was evident, iron plus vitamin D co-supplementation did not demonstrate any significant benefits over vitamin D alone, neither in depression score reduction nor anxiety symptoms.
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http://dx.doi.org/10.34171/mjiri.33.64DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708107PMC
July 2019

Patient Satisfaction Following Total Knee Arthroplasty: Comparison of Short-Term Results in Rheumatoid Arthritis and Osteoarthritis.

Arch Bone Jt Surg 2019 Jan;7(1):61-66

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

Background: Due to the obvious differences in the natural course of rheumatoid arthritis (RA) and osteoarthritis (OA), different functional outcomes might be expected after Total Knee Arthroplasty (TKA) in these distinct patients. Although several studies have reported the objective outcome of TKA in RA and OA patients, few studies have compared post-operative patient-satisfaction levels.

Methods: In this clinical cohort study 171 patients (RA: n=33, OA: n=138) who underwent TKA with posterior stabilizing knee prosthesis were included. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS) were used to evaluate and compare patients' satisfaction 6 and 12 months after TKA relative to their preoperative state and to make an assessment between two groups.

Results: Both of patient-reported scoring systems showed a statistically significant improvement for OA and RA patients at 6 and 12 months after surgery, relative to their preoperative scores. The results of the OKS and KOOS did not show statistically significant improvement from 6 to 12 months n RA patients. Unlike RA group, OKS and KOOS revealed further improvement between 6 and 12 months for the osteoarthritic patients.

Conclusion: OA patients had continuous improvement in their satisfaction in the first year after TKA with a gentle upward curve. In contrast, in RA patients, recovery was faster and greater in the first six months after surgery and slowed down in the second six months. Patient-reported outcome scores were not significantly different between two groups at the end of the first year.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372268PMC
January 2019

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

The Effect of Sagittal Femoral Bowing on the Femoral Component Position in Total Knee Arthroplasty.

Arch Bone Jt Surg 2017 Jul;5(4):250-254

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

In the current study, we investigated that how sagittal femoral bowing can affect the sagittal alignment of the femoral component in total knee arthroplasty (TKA). There were 25 patients underwent TKA. Long leg radiography in lateral view was performed. The sagittal femoral bowing (SFB) and component alignment in relation to the sagittal mechanical axis and distal anterior cortical line (DACL) were measured. Finally, the correlation of component alignment and SFB was examined. Mean SFB was 7±2.7 degrees. The component was in flexion position in relation to mechanical axis and DACL as 8.4±2.9 degrees and 1.7±0.9 degrees, respectively. The flexion alignment of the component was significantly correlated with SFB. Mechanical alignment of the limb in both coronal and sagittal axes should be preserved in TKA. SFB can significantly increased the flexion alignment of the femoral component.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592367PMC
July 2017

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

Pseudo-patella baja after total knee arthroplasty.

Med Sci Monit 2011 May;17(5):CR292-6

Akhtar Orthopaedic Research Center, Shahid Beheshti Medical University, Tehran, Iran.

Background: One of the complications of total knee arthroplasty (TKA) which has not yet been directly addressed is pseudo-patella baja (PPB). True patella baja (PB) is present when the length of the patellar tendon becomes shorter. PPB is present when the patella tendon is not shortened, but the level of the joint line is elevated. This study was conducted to assess PPB in TKA.

Material/methods: Sixty patients who had had a primary TKA at our center between 1995 and 2005 were included. The average follow-up was 27.5 months. The Knee Society Scoring (KSS), lateral knee x-rays and the Blackburne-Peel index were used for assessments.

Results: Out of the 60 patients, 43 (72%) demonstrated no joint line elevation or patellar tendon shortening (group A). Fifteen patients (25%) had joint line elevation (group B), and both PB and PPB were present in 2 (3%) patients (group C). KSS was lower in groups B and C compared with group A, but this difference was not statistically significant. The average range of motion (ROM) in group A was significantly higher compared with either group B or C, and patients in groups B and C showed significantly more severe pain compared with group A (P<0.001).

Conclusions: PPB is not an uncommon finding after TKA and is associated with a statistically significant decrease in ROM and an increase in pain. Furthermore, KSS in the PPB group was less than in patients without PPB, although the difference was not statistically meaningful.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539587PMC
http://dx.doi.org/10.12659/msm.881770DOI Listing
May 2011

Total hip arthroplasty in advanced osteonecrosis: the short-term results by metal-on-metal hip resurfacing.

Med Sci Monit 2011 Feb;17(2):CR78-82

Akhtar Orthopaedic Hospital, Shahid Beheshti Medical University, Tehran, Iran.

Background: Characteristically, osteonecrosis affects younger patients who typically refer to the orthopedic surgeon for the first time in the third to fifth decades of life, in the late stages of the disease. Femoral metal-on-metal hip resurfacing is as an alternative to conventional total hip arthroplasty in treating osteoarthritis of the hip. Since there are already many reports regarding the successful outcome of resurfacing in advanced osteoarthritis, the purpose of this study was to analyze the clinical outcomes of this procedure in patients with osteonecrosis of the femoral head and to compare them with a matched group of patients with osteoarthritis.

Material/methods: This retrospective cohort study evaluated a consecutive series of 52 patients with end-stage osteonecrosis (28 patients) and osteoarthritis (24 patients) of the femoral head, managed by metal-on-metal hip resurfacing in a referral orthopedic center from Feb 2002 to May 2007. Pain, function and deformity were evaluated with the use of the Harris hip score after the operation. Patients were clinically followed for a mean of 41 months.

Results: The patients in the osteoarthritis group had a significantly higher mean age than those in the osteonecrosis group (47.88 ± 12.6 vs 30.86 ± 7.5, p=0.003). The clinical outcomes were similar for both groups. There was no significant difference in mean Harris hip score (p=0.347) and hip joint range of motion (p=0.346) between osteonecrosis and osteoarthritis groups after surgery.

Conclusions: On the basis of these initial findings, we recommend MOM resurfacing as a viable treatment option for patients with advanced stages of osteonecrosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524704PMC
http://dx.doi.org/10.12659/msm.881391DOI Listing
February 2011

Modified ilioinguinal approach to the acetabulum and pelvis from beneath the inguinal ligament: a subinguinal approach.

Hip Int 2010 Apr-Jun;20(2):150-5

Department of Orthopaedic Surgery, Akhtar Orthopaedic Research Center, Akhtar Orthopaedic Hospital, Shahid Beheshti Medical University (SBMU), Tehran, Iran.

The ilioinguinal approach is favoured for fractures of the anterior part of the pelvis, but it is associated with some technical difficulties and it is not suitable for some complex fractures. In 2008, a modified ilioinguinal approach was introduced by Farid Yr which afforded visualisation of the inside and outside of the pelvis. The approach involves retroperitoneal access below the inguinal ligament to preserve the integrity of the inguinal canal and allows exposure of anterior and medial wall fractures as well as the anterior hip capsule. Despite the dimensions of the procedure, closure is anatomical because repair of the inguinal canal floor is not required. We report the use of this approach in 17 patients with T-type fractures of the acetabulum, transverse fractures of acetabulum, Tile C1 pelvic fractures, malunion of the pelvis and acetabular dysplasia. The approach is recommended in complex cases of acetabular surgery (including obese or muscular patients) and complicated or old fractures in which a better exposure is required. It is useful in visualisation of the anterior wall and labrum and intra articular structures, and in viewing the internal anatomy of the pelvis and acetabulum. It may be a suitable approach for periacetabular osteotomy.
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http://dx.doi.org/10.1177/112070001002000204DOI Listing
October 2010

Congenital dislocation of the knee in a 16-year-old girl.

Orthopedics 2010 May 12;33(5). Epub 2010 May 12.

Akhtar Orthopaedic Research Center, Akhtar Orthopaedic Hospital,Tehran, Iran.

Congenital dislocation of the knee ranges from hyperextension of the knee to translation of the femur on the tibia. Treatment options include bracing, splinting, manipulation and casting, and surgery. A 16-year-old girl presented with an inability to walk, stand upright, or bend her knees. She exhibited deformity of both lower extremities. She had deformed knees from birth, and they had been put in a cast for 2 months. No other therapeutic measures were taken. The patient walked on her abnormally hyperextended knees and could hyperextend the knees to 150 degrees recurvatum. She was diagnosed with a grade III congenital dislocation of the knee, and a flexion-shortening osteotomy at the distal femur above the trochlear level was performed on her knees in 2 sessions. Postoperatively, range of motion changed from hyperextention to 80 degrees flexion. A femoral supracondylar osteotomy was also performed 2 years later, and as a result, a 15 degrees flexion and 15 degrees valgus were added to the limb. The patient is now able to stand and walk without a knee brace and has 90 degrees passive and 80 degrees active knee flexion on both sides. Congenital dislocation of the knee is a rare congenital disorder. The results of treatment are favorable if started before age 3 months, or sometimes before age 2 years, but there is no effective treatment for older, neglected cases; therefore, we believe this case report demonstrates a novel surgical approach.
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http://dx.doi.org/10.3928/01477447-20100329-22DOI Listing
May 2010

The effect of tranexamic acid on reducing blood loss in cementless total hip arthroplasty under epidural anesthesia.

Orthopedics 2010 Jan;33(1):17

Department of Orthopedics, Akhtar Orthopaedic Hospital, Tehran, Iran.

Total hip arthroplasty (THA) is associated with high intraoperative and postoperative blood loss. Antifibrinolytic drugs have been used to minimize the potential risks of bleeding and blood transfusion. Studies on the effect of tranexamic acid on decreasing blood loss in THA have revealed interesting results, but most have focused on cemented THA. Yet its benefits in THA, especially in cementless THA, have not been proved. We conducted a prospective double-blind randomized controlled study on 64 patients who were candidates for cementless THA under epidural anesthesia between 2006 and 2008. Patients were randomly assigned into study and control groups. Patients in both groups were well matched regarding preoperative characteristics. Five minutes preoperatively 32 patients of the study and control groups received 15 mg/kg tranexamic acid or normal saline intravenously respectively. Our findings showed a significantly smaller decrease in 6- and 24-hour postoperative hemoglobin levels, less intraoperative and postoperative bleeding, and less need for allogenic blood transfusion in the tranexamic acid group. Our results also revealed a higher mean of 6- and 24-hour hematocrit level and shorter hospital stay in the tranexamic acid group compared to the control group, which were not statistically meaningful. In our study no thromboembolic event was seen; except 1 patient in the control group. Our study showed that administering tranexamic acid before the start of cementless THA under epidural anesthesia can reduce intraoperative and postoperative bleeding as well as need for blood transfusion.
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http://dx.doi.org/10.3928/01477447-20091124-30DOI Listing
January 2010

Sudden peroneal nerve palsy in a varus arthritic knee.

Orthopedics 2009 Dec;32(12):920

Akhtar Orthopaedic Hospital, Elahieh, Tehran, Iran.

Peroneal nerve palsy has been reported in association with traumatic and nontraumatic causes. We encountered a 75-year-old man whose peroneal nerve palsy developed suddenly following varus deformity of the arthritic knee. A review of the literature found 1 other report describing a progressive peroneal nerve palsy associated with a varus deformity of the knee due to arthritis. Our patient had progressive intractable knee pain; 3-compartment, severe degenerative changes in the knees; varus knee malalignment and laxity; right peroneal nerve palsy; and decreased sensation to light touch and pinprick on the dorsum of the right foot. The preoperative WOMAC score was 36. Nerve conduction studies confirmed acute peroneal neuropathy with conduction block at the fibular neck and secondary axonal degeneration. Magnetic resonance imaging of the knee showed osteophytes and cysts surrounding the fibular neck. Although their compression could be responsible for the nerve palsy, the sudden process made this less possible. Thus, the patient underwent total knee arthroplasty of both knees without exploration of the nerve. At 5-month follow-up, the WOMAC score was 78. The patient walked with a cane with no varus thrust, and his right knee had no varus laxity in full extension. The peroneal nerve did not retain its function. Sensory examination and postoperative nerve conduction studies showed no improvement.
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http://dx.doi.org/10.3928/01477447-20091020-23DOI Listing
December 2009