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Research in Orthopedic Science - Volume:8 Issue: 2, May 2021

Journal of Research in Orthopedic Science
Volume:8 Issue: 2, May 2021

  • تاریخ انتشار: 1400/04/20
  • تعداد عناوین: 8
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  • Maedeh Taghizadeh Kerman, Ali Yalfani*, Ahmad Ebrahimi Atri, Seyyed Hamed Mousavi Pages 57-64
    Background

    Changes in knee muscle activity remain years after Anterior Cruciate Ligament (ACL) surgery. However, the literature on the successful or unsuccessful recovery of lower limb muscle activation during jump landing is controversial. 

    Objectives

    The present review intended to compare the surface Electromyography (EMG) of knee muscle activity in healthy and Anterior Cruciate Ligament Reconstruction (ACLR) groups in jump landing tasks.

    Methods

    PubMed, Embase, and Web of Science databases were searched papers from 1990 to 2020 using the keywords “anterior cruciate ligament or ACL, EMG or Electromyography or Muscle activation, Landing or Jumping or Hopping”. After screening the titles, abstracts, and full text of the collected articles, 7 studies met the inclusion criteria of this review. The Critical Appraisal Skills Program tool was used for the quality assessment of the included papers.

    Results

    The present research results suggested earlier onset muscle activity for quadriceps and hamstring in ACLR subjects, compared to healthy subjects. Furthermore, the ratio of activation of quadriceps/hamstring in the ACLR group was higher than that in the healthy individuals considering the type of rehabilitation, the time elapsed from surgery, and gender. The methodological quality of the observational studies ranged from 6 to 8 out of 12 that reflects the overall quality of the methodology.

    Conclusion

    According to this review, we can conclude that the ACLR group exhibited different neuromuscular strategies in the pre-landing phase that might increase the recurrent risk of ACL injury.

    Keywords: Anterior Cruciate Ligament, Electromyography, Reconstruction, Muscle
  • Kaveh Gharanizadeh, Hamed Tayyebi*, Abbas Esmaeli, Maziar Rajei, Mohamadreza Heidarikhoo, Mehdi Siahpoosh Pages 65-70
    Background

    Femoral neck fracture nonunion is a frequent and challenging complication, with several surgical options. 

    Objectives

    The present study reported the outcome of valgus osteotomy for treating femoral neck nonunion in patients aged <65 years.

    Methods

    This case series research included young patients who underwent valgus osteotomy for treating femoral neck nonunion or device failure of the index surgery. The fixation of the osteotomy site was performed using either a dynamic hip screw or a fixed angle blade. The union of the neck and osteotomy site (subtrochanteric region) was evaluated by monitoring callus formation in the postoperative radiographs. Limb length discrepancy, Pauwels’ angle, and the neck-shaft angle were evaluated before the surgery and at the last follow-up. Postoperative complications were extracted from the explored patients’ profiles. 

    Results

    Twenty patients with a Mean±SD age of 27.2±10.8 years were examined in this study‎. The Mean±SD follow-up time of the patients was 6.1±3.9 years. The femoral neck was united in 18 patients in a Mean±SD period of 5.1±2.3 months. The Mean±SD limb length discrepancy was measured as 1.3±0.8 cm before and 0.5±0.7 cm after the ‏osteotomy. The Mean±SD Pauwels’ angle was calculated as 65.5±16.9º before and 32.4±16.2º after the osteotomy. The Mean±SD neck-shaft angle was computed to be 121.9±22.8º before and 144.5±17.7º after the osteotomy. Revision surgery was performed for 6 (30%) patients. This measure included device removal in 4 and total hip arthroplasty in 2 patient.

    Conclusion

    Valgus osteotomy is a safe and efficient technique for managing femoral neck nonunion. Therefore‎, this approach is suggested as a good alternative for total hip arthroplasty, particularly in young and active patients‎.

    Keywords: Femoral neck fracture, Nonunion, Genu valgum, Valgus osteotomy
  • Hooman Shariatzade, Alireza Saied, Mohsen Barkam*, Peyman Hashemi, Masoud Hasanikhah, Mohammadreza Heidarikhoo, Mazyar Rajei, Somayeh Barkam Pages 71-76
    Background

    Kienbock’s disease is a rare and debilitating condition. The decision for surgical intervention majorly depends on the extent of the carpal collapse. Therefore, the accurate measurement of carpal collapse is of critical importance. 

    Objectives

    The current study assessed the inter and intra-observer reliability of the three most frequent methods in measuring carpal height and determining carpal collapse. 

    Methods

    Fifty-Nine photocopied radiograms were reviewed by three observers (one senior orthopedic resident, one fellowship-trained hand surgeon, and one senior radiology resident) at 3 consecutive time points. Besides, one-week intervals were considered between the evaluations. The evaluated measures included the Carpal Height Ratio (CHR), Revised Carpal Height Ratio (RCHR), and Capitate-Radius (CR) index. The reliability of the measurements in determining the carpal height was examined using the Intraclass Correlation Coefficient (ICC). The agreement of the measures on determining the presence or absence of the carpal collapse was assessed by Cohen’s Kappa (K) value.

    Results

    The overall inter and intra-observer reliability of the CR index in quantifying the carpal collapse was measured as 0.863 and 0.942, respectively. The overall inter and intra-observer reliability of CHR in quantifying the carpal collapse was computed to be 0.615 and 0.891, respectively. The overall inter and intra-observer reliability of RCHR in quantifying the carpal collapse equaled 0.412 and 0.792, respectively. The overall K for determining the presence or absence of a carpal collapse was calculated as 0.776, 0.683, and 0.549 for CR index, CHR, and RCHR, respectively.

    Conclusion

    The CR index is the most reliable approach to measure carpal height. Furthermore, it is appropriate for determining the presence or absence of carpal collapse.

    Keywords: Kienbock’s disease, Carpal collapse, Inter-observer reliability, Intra-observer reliability
  • Hossein Akbari Aghdam, Mohammad Dehghani, Parisa Karimi* Pages 77-82
    Background

    In this article, the prevalence of recurrent anterior dislocation of the shoulder and the effect of factors such as age, occupation, primary cause and gender on it have been investigated.

    Objectives

    This study aimed to investigate the factors related to the frequency of recurrent anterior shoulder dislocation in clients of the Orthopedic Ward of Kashani Hospital, Isfahan City, Iran, in 2017-2018.

    Methods

    The present research is a cross-sectional study. The study population comprised all patients with traumatic and anterior shoulder dislocation referred to Kashani Hospital during 2017-2018. The sampling method in the present study was census. The patients were asked by phone or in person after their presence about the recurrences of dislocations between the beginning of 2017 and the end of 2018. The obtained data were analyzed in SPSS version 25.

    Results

    Out of 256 patients, 22% had a recurrence of dislocation. The recurrence rate of dislocation in less than 20 years patients was 40%, and in 20 to 40 years was 63%. The highest recurrence rate of dislocation was reported in the age group of 20 to 40 years in the present study. Based on the present study results, the recurrence rate of dislocation in the age-group of 20-40 years was significantly higher than in other groups. There was no significant relationship between gender and recurrence of dislocation in the subjects (P>0.05). Significance was observed in the primary cause and type of occupation in recurrence of dislocation (P<0.05).

    Conclusion

    The recurrence rate of dislocation in the patients who suffered from dislocations for the first time was 22%. Based on the results, the rate of recurrence of dislocation in the present study was lower than the rate of recurrence of dislocation in similar studies.

    Keywords: Shoulder Dislocation, Recurrent, predicting factor
  • Mohsen Mardani-Kivi, Ardeshir Shirangi, Aryan Mardani-Kivi, Zahra Haghparast Ghadim-Limudahi, Amin Izadi* Pages 83-94
    Background

    Choose a proper therapeutic approach for various shoulder joint involvements is still a significant challenge. 

    Objectives

    The study aimed to assess the knowledge and attitude of orthopedic surgeons in managing patients with shoulder problems.

    Methods

    In a cross-sectional survey, a questionnaire consisted of 2 different parts was directly presented to orthopedic surgeons. Part 1 investigated the experience of shoulder surgeries, and part 2 evaluated their knowledge and attitude toward 4 patients with different scenarios.

    Results

    The surgeons were divided into 2 groups: shoulder surgeons (n=17) and general orthopedic surgeons (n=192). The first scenario is about a 21-year-old male with first anterior shoulder dislocation. In this scenario, shoulder surgeons chose surgical intervention more than general surgeons (88.21% vs 33.54%, P<0.05). The second scenario presents a 55-year-old male with shoulder osteoarthritis and complete and repairable rupture of supraspinatus and rupture of the long head of the biceps tendon. Shoulder surgeons chose total shoulder arthroplasty (43.8%) and arthroscopic rotator cuff repair (37.5%). But, only 21.87% of general orthopedic surgeons choose these two items together. The third scenario is a 65-year-old male with supraspinatus and infraspinatus tendon rupture. Sixteen of 17 shoulder surgeons answered this case, and 100% chose surgical interventions (62.5% arthroscopic and 37.5% open repair). On the other hand, 180 general surgeons of 192 answered this case scenario, and only 41.11% chose surgical treatment. The fourth scenario presents a 52-year-old female with refractor adhesive capsulitis. Arthroscopic capsular release and manipulation was the most frequent answer among shoulder surgeons compared to general surgeons (64.71% vs 31.38%). 

    Conclusion

    It seems that an advanced course of shoulder surgeries is necessary to improve the knowledge of general orthopedic surgeons about shoulder diseases and treatment choices.

    Keywords: Shoulder Injuries, Orthopedic surgeons, Shoulder
  • Hooman Shariatzade, Mohsen Barkam*, Alireza Saied, Alireza Akbarzadeh Arab Pages 95-100

    Ganglion cysts of the dorsal wrist are generally attached to the scapholunate interosseous ligament, and surgical removal could injure this ligament. Such injury could rarely result in postoperative scapholunate instability. To date, a few cases of scapholunate instability following the excision of the dorsal ganglion cyst of the wrist have been reported. In this report, we present a 23-year-old man with scapholunate instability following the surgical resection of the dorsal ganglion cyst of his wrist. The instability was treated with open reduction and reconstruction. One year follow-up of the patient was event-free. The patient had no pain and limitation and resumed his preoperative activities. According to this case, the iatrogenic or pre-existing nature of scapholunate instability following the surgical excision of the dorsal ganglion cyst of the wrist‎‏ cannot be determined. However, the patients should be informed of this complication before undergoing surgery.

    Keywords: Ganglion cyst, Wrist, Scapholunate instability, Joint Instability
  • Seyed Mani Mahdavi, Shayan Amiri*, Farshad Safdari Pages 101-106

    Spinal deformities secondary to Myasthenia Gravis (MG) are rarely reported and mainly include scoliosis. In this study, we report a case of hyperlordosis with MG origin, which has not been reported earlier. The patient was a 12-year-old boy who underwent thymectomy at the age of three, and the disease was well-controlled afterward. One year ago, the patient presented with fatigue and severe low back pain associated with walking, while his parents noticed his buttocks jut out more than normal. The radiologic evaluation revealed a hyperlordosis of 100º. The patient was treated with a Milwaukee brace and lordosis exercises. One year after the treatment, an improvement of 27º was observed in the hyperlordosis of the patient. While bracing does not typically treat a neuromuscular deformity, the present case reveals the value of bracing in the treatment of hyperlordosis with MG origin.‎

    Keywords: Myasthenia gravis, Hyperlordosis, Spine deformity
  • Salman Ghaffari, Mehran Razavipour, Iman Sadeghian*, Shahin Talebi Pages 107-110

    Chronic osteomyelitis is a severe and persistent condition that engages bone and bone marrow. The infection can be limited to the bone, or it can propagate to the bone marrow, the periosteum, and the surrounding soft tissues. It represents a major financial every health system and impacts the quality of life of the affected patients. Diagnosing chronic osteomyelitis remains difficult. Accordingly, laboratory and imaging studies are necessary in this respect. A 49-year-old man after high energy trauma underwent debridmant and fixation. After 3 years’ patient admitted in infection ward with fever presentation. The clinical examination didnchr('39')t reveal any sign of localization of fever. Chronic osteomyelitis is not always associated with fever in this situation Other diagnoses should be considered after role out other disease osteomyelitis.

    Keywords: chronic osteomyelitis, Hodgkin lymphoma, left tibia fibula