مجله جراحی استخوان و مفاصل ایران
سال هفدهم شماره 2 (پیاپی 65، بهار 1398)

The aim of this study was to assess the incidence and patterns of meniscus tear accompanying the posterior cruciate ligament (PCL) lesion.

81 patients with a diagnosis of chronic PCL tear that underwent PCL reconstruction surgery were included in the study. The patients’ files were reviewed. The location and grade of cartilage damage, the location and pattern of meniscus tears, the interval between diagnosis and surgical procedure, and the treatment method were collected.

The average interval between the incidence of trauma and surgery was 16.73±33.1 months. The interval between the incidence of trauma and surgery in patients with meniscal tear was 24.6±4.86 months and in patients without meniscal tear was 12.76±2.1 months Meniscal tear was detected in 27 patients (33.3). It was in medial meniscus in 19 (23.5%) and in lateral menisci in eight (9.9%) patients. The most common site of meniscal tear was root tear and mostly avulsion of meniscus root. Of these, 6 patients had posterior root avulsion of medial menisci. Cartilage lesions were detected in 14 patients (17.3%).

Based on the present study. The most common pattern of meniscal tear in cases of PCL tear is posterior medial meniscus avulsion tear. Such a tear deteriorates overtime.

Giant cell tumor (GCT) is a benign bone tumor that may present with invasion and even metastasis in some cases. Despite several techniques for surgical excision of the tumor, its post-operative recurrence is still a critical challenge for orthopaedic surgeons. Therefore, this study aimed to evaluate the result of the surgical treatment of GCTby curettage, burring, alcohol and cementation to reduce the risk of recurrence.

This cross-sectional study was conducted on participants referring to two university hospitals with the diagnosis of GCT in a 12 years period. The subjects underwent surgery using curettage, burring, alcohol irrigation, and cementation. Regular follow-ups were carried out every three months in the first year, and then every six months in the second year and annually from then on.. The recurrence-free survival rate was analyzed by the Kaplan-Meier method.

Surgery was performed on 28 patients. The most common tumor site was distal femur, and the most pre-operative and post-operative complaints were pain and limitation of motion, respectively. At the end of the study, local recurrence was observed in only four cases, and lung metastasis was found in one case. The results showed that recurrence-free survival was 91.7% in 21 and 76% in 108 months according to Kaplan-Meier analysis .

Although using the above-mentioned protocol seems to reduce the risk of local recurrence in patients with GCTs, complete excision of the tumor is also a crucial factor influencing the rate of local recurrence.

Acceleration of bone healing is one of the most challenging issues in orthopedic science. This study aimed to evaluate bone healing process with the application of fish bone powder and human lyophilized platelet (prepared with a novel protocol) in the rabbit animal model.

  This study was carried out on 20 male New Zealand white rabbits (12 month old), divided into four equal groups as control, fish bone powder, lyophilized platelet and a combination of fish bone powder and lyophilized platelet. After exposing the radius, a bone segment (10 mm) was cut from the bone, and the empty space was left empty in the control group but filled with the mentioned biomaterials in other groups. Radiographs of each rabbit were taken on the 14th, 28th, 42nd, and 56th post-operative days to evaluate bone formation, union and remodeling of the bone defect. All animals were euthanized on the 56th post-operative day for histopathological evaluation.

Radiological evaluation showed a significant difference between the lyophilized platelet group (P=0.02) and the control (P=0.007) and the fish bone powder (P=0.005) on 56th post-operative day, where the lyophilized platelet group was superior, compared to other groups. Moreover, the histopathological evaluation revealed a significant difference between the control group (P=0.01), the fish bone powder (P=0.03) and lyophilized platelet group (P=0.01), where treatment groups were superior, compared to the control group on 56th post-operative day. Nonetheless, there was no evidence of graft rejection in all groups.

According to the results of the study, using lyophilized platelet could accelerate the bone healing process in rabbit and has the potential for use in medicine.

Rheumatoid arthritis (RA) is a chronic inflammatory disease that reduces the quality of life in patients. Stress is one of the important factors involved in the onset of the disease. The present study aimed to evaluate the effect of stress inoculation training on the quality of life of patients with RA.

This randomized clinical trial had a control group and was performed on all patients with RA, referred to the specialized RA center in 2016. In total, 30 paents were selected by random sampling and were divided into two intervention and control groups using a random allocation method. In addition, the data collection tool was the SF-36 quesonnaire. The subjects in the intervenon group aended 10 stress inoculation training sessions, whereas the participants in the control group received no interventions. In the end, the two groups filled the SF-36 tool as a posest. Moreover, data analysis was performed using independent t-test and covariance.

In this study, the mean score of life quality significantly increased in the intervention group after the intervention. Therefore, the quality of life score increased after the intervention, which showed the impact of the intervenon on the decrease of stress (P<0.001) and an increase in the quality of life and its components (P<0.001).

According to the results of the study, stress inoculation training was introduced as an effective approach to increase the quality of life of patients with RA.

Inferior shoulder dislocation is a rare form of joint dislocation which is commonly associated with injury to the surrounding soft tissues. Reduction of the dislocation must be done as fast as possible to avoid complications. This is a report of an inferior shoulder dislocation who presented with brachial vein contusion and brachial plexus injury. The dislocation was reduced in emergency room, and arm sling applied. All the symptoms resolved within four weeks after treatment.Inferior shoulder dislocation is rare, it is usually associated with injury to contiguous structures. High index of suspicion towards neuro vascular injury is needed for early diagnosis and treatment.

Regenerative medicine is a field of medicine that uses the body’s ability in healing the tissues or damaged body parts. This area is extensively used in orthopedics, specifically in the treatment of disc destructive diseases, as well as injuries and inflammation of the tendons, joints, and ligaments. The most commonly used product in this field is platelet-rich plasma (PRP). In this research, we reviewed human clinical studies conducted to evaluate the role of PRP in spinal diseases.