Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15515
John Mohd, N. A. Bhat, Z. A. Lone, T. Bhat, Mohammad Farooq Butt, Abdul Ghani, Bias Dev, Sanjeev Gupta
Background: Degloving soft tissue injuries (DSTIs) are defined as detachment of skin and its appendages from underlying muscle fascia. The present study aimed to assess the outcome of open circumferential DSTIs of lower limbs using a staged protocol by utilizing the stored skin graft harvested from degloved skin flaps. Methods: This retrospective study included 12 patients with open circumferential lower limb degloving injuries (Arnez types three and four), with a minimum final follow-up of two years. All the patients were treated using a staged protocol, which included harvesting skin grafts from the degloved skin flaps, followed by refrigerator storage of the graft and stay sutures for the flap. The refrigerator-stored graft was then used to cover the raw areas left after secondary debridement. Results: The mean wound area per patient that required skin grafting was 1082.9 ± 679.0 cm2 , and mean area of the wound covered by refrigerator-preserved skin graft per patient was 798.7 ± 350.0 cm2 . One patient needed a latissimus dorsi flap, and three patients with whole limb degloving had to undergo skin grafting for the remnant raw area harvested from the contralateral thigh. None of the patients ended up with amputation. Conclusion: Despite being rare, open DSTIs are very complex injuries with no definitive guidelines for management, especially Arnez type three and four injuries. The staged protocol presented in the present series potentially answers the dilemma. However, larger multi-centric trials are needed to study the outcome of the discussed staged protocol.
{"title":"Open Soft Tissue Degloving Injuries of Lower Limbs Managed by a Staged Protocol Using Preserved Autologous Skin Graft","authors":"John Mohd, N. A. Bhat, Z. A. Lone, T. Bhat, Mohammad Farooq Butt, Abdul Ghani, Bias Dev, Sanjeev Gupta","doi":"10.18502/jost.v10i2.15515","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15515","url":null,"abstract":"Background: Degloving soft tissue injuries (DSTIs) are defined as detachment of skin and its appendages from underlying muscle fascia. The present study aimed to assess the outcome of open circumferential DSTIs of lower limbs using a staged protocol by utilizing the stored skin graft harvested from degloved skin flaps. \u0000Methods: This retrospective study included 12 patients with open circumferential lower limb degloving injuries (Arnez types three and four), with a minimum final follow-up of two years. All the patients were treated using a staged protocol, which included harvesting skin grafts from the degloved skin flaps, followed by refrigerator storage of the graft and stay sutures for the flap. The refrigerator-stored graft was then used to cover the raw areas left after secondary debridement. \u0000Results: The mean wound area per patient that required skin grafting was 1082.9 ± 679.0 cm2 , and mean area of the wound covered by refrigerator-preserved skin graft per patient was 798.7 ± 350.0 cm2 . One patient needed a latissimus dorsi flap, and three patients with whole limb degloving had to undergo skin grafting for the remnant raw area harvested from the contralateral thigh. None of the patients ended up with amputation. \u0000Conclusion: Despite being rare, open DSTIs are very complex injuries with no definitive guidelines for management, especially Arnez type three and four injuries. The staged protocol presented in the present series potentially answers the dilemma. However, larger multi-centric trials are needed to study the outcome of the discussed staged protocol.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"57 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15513
Ravindra Chauhan, Ashish Pande, Dilip S. Shaktawat, Aditya Dwivedi, Shijo Thomas
Background: The soft tissue in the shoulder plays a significant role in anterior shoulder instability, leading to humeral head displacement from the glenoid fossa. Arthroscopic Bankart repair is a widely accepted method to restore the labrum to the joint rim. This study aims to evaluate the clinical outcomes of Bankart repair by knotless suture anchors at medium-term follow-up, assess the functional outcomes of the knotless suture anchor method for recurrent anterior glenohumeral instability, and conduct clinical assessment using the Rowe score at 6-week, 3-month, 6-month, and 12-month intervals in patients. Methods: In this retrospective study, patients who underwent arthroscopic Bankart repair using a 2.8 mm knotless suture anchor (MINI-VIM PK® ) were enrolled. They were assessed for shoulder stability, range of motion (ROM), and functional outcomes using the Rowe scale at the baseline, 6-week, 3-month, 6-month, and 12-month follow-up intervals as part of the planned early efficacy measures. All the statistical analyses were performed using SPSS software. Results: The mean age of the subjects was 28.10 ± 6.14. In this trial, 51 patients (69.86%) were diagnosed with recurrent shoulder dislocation on the left side, and 22 patients (30.14%) on the right side. The Rowe score demonstrated a significant improvement (P < 0.0001), increasing from 44.73 ± 1.64 to 95.62 ± 18.33 at the 12-month follow-up period. This indicated better clinical outcomes and reduced recurrence of instability with the use of knotless suture anchors. Conclusion: The use of knotless suture anchors demonstrated reduced recurrence rates, improved post-operative shoulder motion, and increased stability without adding complexity to the procedure.
{"title":"Functional Outcome of Arthroscopic Bankart Repair with Knotless Suture Anchor: A Retrospective Observational Study","authors":"Ravindra Chauhan, Ashish Pande, Dilip S. Shaktawat, Aditya Dwivedi, Shijo Thomas","doi":"10.18502/jost.v10i2.15513","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15513","url":null,"abstract":"Background: The soft tissue in the shoulder plays a significant role in anterior shoulder instability, leading to humeral head displacement from the glenoid fossa. Arthroscopic Bankart repair is a widely accepted method to restore the labrum to the joint rim. This study aims to evaluate the clinical outcomes of Bankart repair by knotless suture anchors at medium-term follow-up, assess the functional outcomes of the knotless suture anchor method for recurrent anterior glenohumeral instability, and conduct clinical assessment using the Rowe score at 6-week, 3-month, 6-month, and 12-month intervals in patients. \u0000Methods: In this retrospective study, patients who underwent arthroscopic Bankart repair using a 2.8 mm knotless suture anchor (MINI-VIM PK® ) were enrolled. They were assessed for shoulder stability, range of motion (ROM), and functional outcomes using the Rowe scale at the baseline, 6-week, 3-month, 6-month, and 12-month follow-up intervals as part of the planned early efficacy measures. All the statistical analyses were performed using SPSS software. \u0000Results: The mean age of the subjects was 28.10 ± 6.14. In this trial, 51 patients (69.86%) were diagnosed with recurrent shoulder dislocation on the left side, and 22 patients (30.14%) on the right side. The Rowe score demonstrated a significant improvement (P < 0.0001), increasing from 44.73 ± 1.64 to 95.62 ± 18.33 at the 12-month follow-up period. This indicated better clinical outcomes and reduced recurrence of instability with the use of knotless suture anchors. \u0000Conclusion: The use of knotless suture anchors demonstrated reduced recurrence rates, improved post-operative shoulder motion, and increased stability without adding complexity to the procedure.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141117721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14964
Seyed Houssein Saeed-Banadaky, Mazyar Malekzadeh, Abbas Abdoli Tafti
Background: Surgical site hematoma is one of the factors that influence the results of the carpal tunnel release (CTR) and patients’ satisfaction; therefore, this study was designed to evaluate the effects of using Penrose drain to reduce the operation site hematoma and improve the results of surgery. Methods: Patients with a diagnosis of carpal tunnel syndrome (CTS) were randomly divided into intervention and control groups and then were evaluated by pain with the visual analog scale (VAS) and pinch power. The Penrose drain was placed for the intervention group and removed after two days. Three months after surgery, all patients were re-evaluated by VAS and pinch power. Results: Out of 46 patients, Penrose drains were placed for 21 patients. According to the results, the VAS and pinch power evaluations were better in patients with Penrose drain (P = 0.001) but in patients without Penrose drain, only the VAS evaluation results were improved, but a decrease in pinch power was detected. Conclusion: CTR surgery with or without the Penrose drain decreases pain in patients after three months of operation. CTR with Penrose drain improves pinch power and also decreases the pain, but in patients without Penrose drain, pinch power was reduced after this period.
{"title":"Penrose Drain for Carpal Tunnel Release: A Randomized Controlled Trial","authors":"Seyed Houssein Saeed-Banadaky, Mazyar Malekzadeh, Abbas Abdoli Tafti","doi":"10.18502/jost.v10i1.14964","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14964","url":null,"abstract":"Background: Surgical site hematoma is one of the factors that influence the results of the carpal tunnel release (CTR) and patients’ satisfaction; therefore, this study was designed to evaluate the effects of using Penrose drain to reduce the operation site hematoma and improve the results of surgery. \u0000Methods: Patients with a diagnosis of carpal tunnel syndrome (CTS) were randomly divided into intervention and control groups and then were evaluated by pain with the visual analog scale (VAS) and pinch power. The Penrose drain was placed for the intervention group and removed after two days. Three months after surgery, all patients were re-evaluated by VAS and pinch power. \u0000Results: Out of 46 patients, Penrose drains were placed for 21 patients. According to the results, the VAS and pinch power evaluations were better in patients with Penrose drain (P = 0.001) but in patients without Penrose drain, only the VAS evaluation results were improved, but a decrease in pinch power was detected. \u0000Conclusion: CTR surgery with or without the Penrose drain decreases pain in patients after three months of operation. CTR with Penrose drain improves pinch power and also decreases the pain, but in patients without Penrose drain, pinch power was reduced after this period.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"94 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140433690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14962
Subrat Mohapatra, Anantharamakrishnan Ganesh, Nego Zion
Background: Neck pain is the most common complaint that we deal with in orthopedics, most of which are information technology (IT) professionals. These individuals have vocational mismanagement which leads to high incidence of forward head posture (FHP). Methods: A cross-sectional study was carried out from January 2019 to June 2019 during which a total of 300 patients were taken into study. Clinical assessment of neck pain, head posture, range of motion (ROM), and radiological assessment of craniovertebral angle (CVA) and anterior head translation (AHT) was done. Results: Out of 300 patients, the majority of the patients were men. On average, men used computers for 9.6 hours compared to 9.2 hours for women. The average CVA was higher in women (58.8). The average AHT was more in men (22.9). Conclusion: As compared with the previous literature, our study showed that 84.3% of male and 92.91% of female participants had FHP. CVA was lower, while AHT was higher in both groups than the usual range. The mean AHT in our sample was 18.8 mm, which was found to be aberrant in the prior research studies. In our study, we have found a negative correlation between the CVA and AHT, resulting in FHP, which can furthermore lead to early changes of cervical spondylosis in IT employees, probably due to long hours of desktop usage resulting in fixed postural habit.
{"title":"Assessment of Forward Head Posture in Information Technology Employees with Neck Pain: A Cross-Sectional Study","authors":"Subrat Mohapatra, Anantharamakrishnan Ganesh, Nego Zion","doi":"10.18502/jost.v10i1.14962","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14962","url":null,"abstract":"Background: Neck pain is the most common complaint that we deal with in orthopedics, most of which are information technology (IT) professionals. These individuals have vocational mismanagement which leads to high incidence of forward head posture (FHP). \u0000Methods: A cross-sectional study was carried out from January 2019 to June 2019 during which a total of 300 patients were taken into study. Clinical assessment of neck pain, head posture, range of motion (ROM), and radiological assessment of craniovertebral angle (CVA) and anterior head translation (AHT) was done. \u0000Results: Out of 300 patients, the majority of the patients were men. On average, men used computers for 9.6 hours compared to 9.2 hours for women. The average CVA was higher in women (58.8). The average AHT was more in men (22.9). \u0000Conclusion: As compared with the previous literature, our study showed that 84.3% of male and 92.91% of female participants had FHP. CVA was lower, while AHT was higher in both groups than the usual range. The mean AHT in our sample was 18.8 mm, which was found to be aberrant in the prior research studies. In our study, we have found a negative correlation between the CVA and AHT, resulting in FHP, which can furthermore lead to early changes of cervical spondylosis in IT employees, probably due to long hours of desktop usage resulting in fixed postural habit.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"11 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The commonest benign bone tumors, osteochondromas, which can be solitary or multiple involving the metaphyseal region of long bones, rarely present in the axial skeleton, such as pelvic girdle, which warrants surgical excision in case of symptoms arising out of pressure effects. Case Report: In this study, we are herewith reporting an unusual case of pubic tubercle osteochondroma, which is solitary and pedunculated in a 37-year-old woman. She has had the swelling for the past 15 years, which was asymptomatic except for mild hydroureteronephrosis, which was an incidental diagnosis; however, we managed the patient with surgical excision of the tumor with elaborate preoperative radiological imaging using both X-ray and computed tomography (CT) scan. Histopathological examination confirmed the diagnosis of osteochondroma. Conclusion: Asymptomatic pelvic osteochondroma should be considered in patients with incidental swelling in the groin region, especially women who may be reluctant to seek medical attention due to social stigma.
背景：骨软骨瘤是最常见的良性骨肿瘤，可单发或多发，累及长骨的骨骺区，很少出现在骨盆腰等轴向骨骼中，一旦出现受压症状，就需要进行手术切除。病例报告：本研究报告了一例不寻常的耻骨结节骨软骨瘤病例，患者为 37 岁女性，单发且有蒂。患者在过去 15 年中一直有肿物，除轻度肾积水外无任何症状，肾积水是偶然诊断出的；然而，我们在术前使用 X 光和计算机断层扫描（CT）进行了精心的放射成像检查，并通过手术切除了肿瘤。组织病理学检查证实了骨软骨瘤的诊断。结论腹股沟区域偶然肿胀的患者，尤其是因社会耻辱感而不愿就医的女性患者，应考虑无症状盆腔骨软骨瘤。
{"title":"Pubic Tubercle Osteochondroma","authors":"Prem Kumar Kothimbakkam, Arun Chandru Kumar, Anantharamakrishnan Ganesh, Vijayashankar Murugesan","doi":"10.18502/jost.v10i1.14971","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14971","url":null,"abstract":"Background: The commonest benign bone tumors, osteochondromas, which can be solitary or multiple involving the metaphyseal region of long bones, rarely present in the axial skeleton, such as pelvic girdle, which warrants surgical excision in case of symptoms arising out of pressure effects. \u0000Case Report: In this study, we are herewith reporting an unusual case of pubic tubercle osteochondroma, which is solitary and pedunculated in a 37-year-old woman. She has had the swelling for the past 15 years, which was asymptomatic except for mild hydroureteronephrosis, which was an incidental diagnosis; however, we managed the patient with surgical excision of the tumor with elaborate preoperative radiological imaging using both X-ray and computed tomography (CT) scan. Histopathological examination confirmed the diagnosis of osteochondroma. \u0000Conclusion: Asymptomatic pelvic osteochondroma should be considered in patients with incidental swelling in the groin region, especially women who may be reluctant to seek medical attention due to social stigma.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"2 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Schwannoma, the most common primary neural tumor of the upper extremity, arises from Schwann cells of the nerve sheet. The tumor is usually painless and slow-growing. Symptomatic masses could be treated through intra- or extra-capsular excision. Herein, we aim to evaluate the long-term results of surgical treatment of 12 cases of upper extremity Schwannoma. Methods: Twelve cases of confirmed Schwannoma who were treated in Imam Khomeini University Hospital, Tehran, Iran, from 2011 to 2022, were included in our case series. All operations were done using loupe magnification or under a microscope. Age, sex, location of the mass, size of the tumor, affected nerve, histological diagnosis, and clinical follow-up, including the neurological status of the patients, were documented. Results: Twelve patients with a mean age of 44 years were included. Seven (58.3%) were men and five (41.66%) were women. The mean follow-up period was 45 months (range: 6-135). The hand was the most common location of involvement and the digital nerve was the most frequent origin of Schwannoma. Postoperative evaluation showed no tumor recurrence and pain resolved in all twelve patients (100%). Sensory dysfunction resolved completely in 5 out of 8 patients who reported sensory impairment preoperatively (62.5%) and no motor function improvement was seen in the patient with motor deficit. Conclusion: Adequate operative techniques can lead to complete tumor removal without neurological loss or recurrence. Neural function improvement in most cases is achieved. New neurologic impairment after excision of Schwannoma is rare.
{"title":"Schwannoma of the Upper Extremity: A Clinical Series","authors":"Hossein Azaditalab, Abdolnaser Farzan, Hossein Hamdollahzade, Ramin Shayan-Moghadam, Mosayeb Soleymani","doi":"10.18502/jost.v10i1.14967","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14967","url":null,"abstract":"Background: Schwannoma, the most common primary neural tumor of the upper extremity, arises from Schwann cells of the nerve sheet. The tumor is usually painless and slow-growing. Symptomatic masses could be treated through intra- or extra-capsular excision. Herein, we aim to evaluate the long-term results of surgical treatment of 12 cases of upper extremity Schwannoma. \u0000Methods: Twelve cases of confirmed Schwannoma who were treated in Imam Khomeini University Hospital, Tehran, Iran, from 2011 to 2022, were included in our case series. All operations were done using loupe magnification or under a microscope. Age, sex, location of the mass, size of the tumor, affected nerve, histological diagnosis, and clinical follow-up, including the neurological status of the patients, were documented. \u0000Results: Twelve patients with a mean age of 44 years were included. Seven (58.3%) were men and five (41.66%) were women. The mean follow-up period was 45 months (range: 6-135). The hand was the most common location of involvement and the digital nerve was the most frequent origin of Schwannoma. Postoperative evaluation showed no tumor recurrence and pain resolved in all twelve patients (100%). Sensory dysfunction resolved completely in 5 out of 8 patients who reported sensory impairment preoperatively (62.5%) and no motor function improvement was seen in the patient with motor deficit. \u0000Conclusion: Adequate operative techniques can lead to complete tumor removal without neurological loss or recurrence. Neural function improvement in most cases is achieved. New neurologic impairment after excision of Schwannoma is rare.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"13 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14965
Pezhman Shahbazi, Gholamreza Ghorbani Amjad
Background: One of the proposed methods to reduce the risk of infection after joint replacement is the use of disinfectant solutions at the end of the surgery. Differing results have been reported regarding the effects of diluted povidone-iodine (betadine) washing solution and normal saline in reducing the risk of periprosthetic joint infection (PJI). The purpose of this retrospective cohort study is to compare the outcomes of diluted betadine solution with normal saline in bilateral knee replacement surgery. Methods: Patients who were referred to Ba’ath Hospital, Hamedan, Iran, from 2019 to 2021 for bilateral knee joint replacement were included. For each patient, one knee was washed with diluted betadine (35%), and the other with normal saline for 3 minutes before closing the wound. Demographic information, risk factors, and the rate of PJI three months after the surgery were collected and analyzed. Results: Out of 320 patients, 177 (55.3%) were women, and the most common underlying disease was type 2 diabetes with a frequency of 20.0%. Out of 640 operated knees, 17 cases (2.7%) of PJI occurred after surgery, of which 11 (4.3%) were washed with normal saline (P = 0.326). The multivariate regression analysis showed that being male (P = 0.028), diabetes (P = 0.030), high blood pressure (P = 0.019), and an increase in each body mass index (BMI) unit (P = 0.030) increased the chance of infection. Conclusion: Intraoperative irrigation with diluted betadine solution in bilateral knee replacement surgery can reduce the risk of infection, especially in patients with underlying diseases and obesity.
{"title":"Comparative Analysis of Dilute Povidone Iodine (Betadine) versus Normal Saline in Bilateral Knee Joint Replacement Surgery: A Retrospective Cohort Study","authors":"Pezhman Shahbazi, Gholamreza Ghorbani Amjad","doi":"10.18502/jost.v10i1.14965","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14965","url":null,"abstract":"Background: One of the proposed methods to reduce the risk of infection after joint replacement is the use of disinfectant solutions at the end of the surgery. Differing results have been reported regarding the effects of diluted povidone-iodine (betadine) washing solution and normal saline in reducing the risk of periprosthetic joint infection (PJI). The purpose of this retrospective cohort study is to compare the outcomes of diluted betadine solution with normal saline in bilateral knee replacement surgery. \u0000Methods: Patients who were referred to Ba’ath Hospital, Hamedan, Iran, from 2019 to 2021 for bilateral knee joint replacement were included. For each patient, one knee was washed with diluted betadine (35%), and the other with normal saline for 3 minutes before closing the wound. Demographic information, risk factors, and the rate of PJI three months after the surgery were collected and analyzed. \u0000Results: Out of 320 patients, 177 (55.3%) were women, and the most common underlying disease was type 2 diabetes with a frequency of 20.0%. Out of 640 operated knees, 17 cases (2.7%) of PJI occurred after surgery, of which 11 (4.3%) were washed with normal saline (P = 0.326). The multivariate regression analysis showed that being male (P = 0.028), diabetes (P = 0.030), high blood pressure (P = 0.019), and an increase in each body mass index (BMI) unit (P = 0.030) increased the chance of infection. \u0000Conclusion: Intraoperative irrigation with diluted betadine solution in bilateral knee replacement surgery can reduce the risk of infection, especially in patients with underlying diseases and obesity.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"56 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14969
Reza Zandi, S. Talebi, Shirin Sheibani, Abolfazl Ghadiri
Background: After the spine, the hip is the most common site that can be infected with extrapulmonary tuberculosis (TB). In the early stages, patients present with complaints of pain around the hip, and after a while, they might experience deformities, shortening, and limited movements. Because hip TB mimics the symptoms of other hip diseases like rheumatoid arthritis (RA) and osteoarthritis, diagnosis is difficult. Here, we aimed to report a rare case of hip TB secondary to pulmonary TB and the result of the total hip arthroplasty (THA). Case Report: A 41-year-old man presented to the orthopedic clinic with a complaint of progressive pain in the right hip. After laboratory tests, imaging, and sputum culture, active TB infection and advanced arthritis of the hip joint were detected. A subluxation/ dislocation stage of arthritis and an acetabular protrusion were present, leading to the restriction of movements. After receiving medical therapy, we performed THA for the patient Conclusion: The patient’s right hip reached a normal range of motion (ROM) without pain in the 18-month follow-up. Since TB can mimic the symptoms of many common diseases, considering hip TB along with other diagnoses can aid in reducing possible complications and improving patients' lives.
{"title":"Total Hip Arthroplasty for Acetabular Protrusion in a Patient with Active Tuberculosis Infection: A Case Report","authors":"Reza Zandi, S. Talebi, Shirin Sheibani, Abolfazl Ghadiri","doi":"10.18502/jost.v10i1.14969","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14969","url":null,"abstract":"Background: After the spine, the hip is the most common site that can be infected with extrapulmonary tuberculosis (TB). In the early stages, patients present with complaints of pain around the hip, and after a while, they might experience deformities, shortening, and limited movements. Because hip TB mimics the symptoms of other hip diseases like rheumatoid arthritis (RA) and osteoarthritis, diagnosis is difficult. Here, we aimed to report a rare case of hip TB secondary to pulmonary TB and the result of the total hip arthroplasty (THA). \u0000Case Report: A 41-year-old man presented to the orthopedic clinic with a complaint of progressive pain in the right hip. After laboratory tests, imaging, and sputum culture, active TB infection and advanced arthritis of the hip joint were detected. A subluxation/ dislocation stage of arthritis and an acetabular protrusion were present, leading to the restriction of movements. After receiving medical therapy, we performed THA for the patient \u0000Conclusion: The patient’s right hip reached a normal range of motion (ROM) without pain in the 18-month follow-up. Since TB can mimic the symptoms of many common diseases, considering hip TB along with other diagnoses can aid in reducing possible complications and improving patients' lives.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14970
Farzad Amouzadeh Omrani, K. Ghamsari, Mojtaba Baroutkoub, Sina Afzal, S. Kokly
Background: Only 3% of all proximal tibial fractures result in an avulsion fracture of the tibial tuberosity. It is often seen in youngsters between the ages of 3 and 6 and is less frequent after puberty. Case Report: A 15-year-old boy was presented with severe left knee pain following a high jump. X-ray and computed tomography (CT) scan showed a tibial tuberosity fracture with joint surface involvement. The damaged part was fixed with a 4.5mm cannulated screw and washer, reinforced with 2 SwiveLock anchors. In the sixth week, full weight bearing and full range of motion (ROM) were obtained. Conclusion: The primary objective in managing tibial tubercle fractures is the restoration of both the extensor mechanism and the integrity of the joint surface in cases where they have been compromised.
{"title":"Avulsion Fracture of the Tibial Tuberosity in Adolescents: A Rare Case and Surgical Fixation Technique","authors":"Farzad Amouzadeh Omrani, K. Ghamsari, Mojtaba Baroutkoub, Sina Afzal, S. Kokly","doi":"10.18502/jost.v10i1.14970","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14970","url":null,"abstract":"Background: Only 3% of all proximal tibial fractures result in an avulsion fracture of the tibial tuberosity. It is often seen in youngsters between the ages of 3 and 6 and is less frequent after puberty. \u0000Case Report: A 15-year-old boy was presented with severe left knee pain following a high jump. X-ray and computed tomography (CT) scan showed a tibial tuberosity fracture with joint surface involvement. The damaged part was fixed with a 4.5mm cannulated screw and washer, reinforced with 2 SwiveLock anchors. In the sixth week, full weight bearing and full range of motion (ROM) were obtained. \u0000Conclusion: The primary objective in managing tibial tubercle fractures is the restoration of both the extensor mechanism and the integrity of the joint surface in cases where they have been compromised. \u0000 ","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"26 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-24DOI: 10.18502/jost.v10i1.14968
Arash Sherafat Vaziri, Sina Javidmehr, Fardis Vosoughi, Erfan Babaei Nejad, Kaveh Same
During the past two decades, the use of robotic arms in knee arthroplasty has changed from a concept to a reality. These systems promise precision and accuracy while shortening the required learning curve. Although still largely in the early stages, there are currently several commercially available platforms with varying degrees of flexibility. The available models can be classified into several categories based on their mode of operation (whether the system requires imaging input) and degree of autonomy. The present study aimed to review the existing body of literature and provide an outlook of the current landscape. The strengths and weaknesses of the implementation of such systems in knee arthroplasty are also discussed.
{"title":"On Robotic Surgery in Knee Arthroplasty: Beginning of a New Era","authors":"Arash Sherafat Vaziri, Sina Javidmehr, Fardis Vosoughi, Erfan Babaei Nejad, Kaveh Same","doi":"10.18502/jost.v10i1.14968","DOIUrl":"https://doi.org/10.18502/jost.v10i1.14968","url":null,"abstract":"During the past two decades, the use of robotic arms in knee arthroplasty has changed from a concept to a reality. These systems promise precision and accuracy while shortening the required learning curve. Although still largely in the early stages, there are currently several commercially available platforms with varying degrees of flexibility. The available models can be classified into several categories based on their mode of operation (whether the system requires imaging input) and degree of autonomy. The present study aimed to review the existing body of literature and provide an outlook of the current landscape. The strengths and weaknesses of the implementation of such systems in knee arthroplasty are also discussed.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":"23 S4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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