Background: Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs as a result of a... more Background: Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs as a result of a vascular supply disruption that could lead to hip osteoarthritis. Recently, several joint-preserving procedures have been suggested to improve the outcome of AVN, including hip arthroscopy. This systematic review aimed to investigate the role of hip arthroscopy to preserve hip joints suffering from AVN. Methods: This review was conducted to collect data on hip arthroscopy from the available literature for the management of AVN. The collected articles included those that were focused mainly on the management of AVN assisted by arthroscopy and published up to 2020 that were searched in four databases using such keywords as "Avascular Necrosis", "AVN", and "Osteonecrosis" in combination with "Hip Arthroscopy" or "Arthroscopic Hip Surgery". Results: In total, 13 articles met the eligibility criteria, and no severe complications were reported after arthroscopy in patients with AVN. Moreover, the Harris scores were higher than 79 after the operation. The majority of the assessments showed that the use of arthroscopy was effective in the diagnosis and treatment of patients with AVN, except for one study, which had been performed on patients with stage IV AVN. Conclusion: The findings supported the idea that hip arthroscopy is effective in the treatment of AVN. This approach is becoming more popular for the diagnosis and treatment of hip disorders.
International Journal of Preventive Medicine, 2018
This study aimed Persian translation and validation of the hip disability and osteoarthritis outc... more This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire. The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF-36. Internal consistency was tested using Cronbach's alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test-retest reproducibility. Patients had mean (standard deviation) age of 39 (17). Test-retest ICC in whole was 0.95 ( = 0.014) showing excellent reliability. ICC was 0.92 for the "pain" subscale ( = 0.02), 0.81 for the "symptom" subscale ( = 0.002), 0.81 for the "function of daily living (FDL)" ( = 0.022), 0.88 for the "function of sports and recreational activities" ( = 0.006), but it was 0.62 ( = 0.1) for the "quality of life (QOL)." Cronbach's alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF-36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF-36 ( = 0.64, = 0.0001), whereas the t correlation with the mental component summary domain was weak ( = 0.16, = 0.04). The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.
Introduction: A supracondylar fracture are common in children with the average age of is 5-8 year... more Introduction: A supracondylar fracture are common in children with the average age of is 5-8 years. It is especially important to pay attention to pain control in these children because of lots of pain. This study was design to compare the analgesic effect of oral ibuprofen vs acetaminophen in children with supracondylar fractures who undergoing non-surgical treatment.Material & Methods: This triple-blind clinical trial was conducted on children with supracondylar fracture referred to the Emergency Department of Emam Reza and Hosheminejad Hospital. Children’s pain were assessed 2, 4 and 12 hours after taking the drug by VAS (Visual Analog Scale) criteria, which was explained by researcher to their parents. Results: In this study, 64 children with a mean age of 5.7±1.7 years were studied. 31 children in the acetaminophen group and 33 children in the ibuprofen group were evaluated. The mean pain score reduction within 12 hours of drug administration showed no difference between the tw...
Background: Foot function index (FFI) is a worthy subjective patient reported outcome measures (P... more Background: Foot function index (FFI) is a worthy subjective patient reported outcome measures (PROM) tool for evaluation of the outcomes of medical interventions on foot and ankle. This study was conducted to assess the validity of the Persian version of the foot function index (FFI). Methods: After translating the original FFI into Persian, back-translation was performed on the agreed Persian version and the final version was established. A total of 113 Persian-speaking patients with foot and ankle problems were enrolled in this study and were asked to fill in the FFI. Results: The Cronbach's alpha for subsections of FFI and MOXFQ was above 0.8 and 0.7, respectively, while it was 0.95 and 0.93 for total FFI and MOXFQ, respectively. The ICC for all subsections of MOXFQ and FFI was above 0.7. The Pearson's correlation coefficient for all subsections of FFI and MOXFQ was significant (P<0.01). Conclusion: The Persian version of FFI is valid and reproducible in Persian speaking population. Level of evidence: IV.
Background The decision regarding total ankle replacement (TAR) is challenging in patients with i... more Background The decision regarding total ankle replacement (TAR) is challenging in patients with inflammatory arthritis (IA) regarding more inferior bone quality, large bone cysts, and increased risk of infections. This systematic review and meta-analysis aimed to compare the functional outcome, revision rate, complication rate, and survival rate of TAR between IA (including rheumatoid arthritis [RA]) and noninflammatory arthritis (NIA) (primary and posttraumatic). Methods After reviewing the full texts, 30 articles fulfilled all inclusion criteria from 1985 until 2021, comparing TAR results. The eligible studies included 5508 patients, of whom 1565 patients had IA and 3943 patients had NIA. At the time of surgery, the average age was 58 years in the IA group and 63 in the NIA group. The average follow-up was 67.2 months in the IA group and 67 months in the NIA group. The outcome measures were the American Orthopaedic Foot and Ankle Society (AOFAS) score and the rate of complications...
Objective To compare the effects of ankle integral and conventional physiotherapy on pain, range ... more Objective To compare the effects of ankle integral and conventional physiotherapy on pain, range of motion, balance, disability, and treatment effectiveness in patients with chronic ankle instability (CAI). Design Two-arm, parallel-group, randomized, double-blind, controlled trial. Participants 60 patients with unilateral CAI. Intervention integral physiotherapy (n = 30) or conventional physiotherapy (n = 30). Outcomes Visual Analog Scale (VAS), dorsiflexion and plantarflexion range of motion, Star Excursion Balance Test (SEBT), Single Leg Hop (SLH) test, Foot and Ankle Outcome Score (FAOS), Lower Extremity Functional Score (LEFS), global rating of change, were gathered pre and post-intervention. Results The ANOVA results revealed statistically significant interaction for FAOS, and LEFS outcome measures ( P < 0.05) and the mean change results showed there were a favorable clinical difference incline toward the integral group (meanintegral = 20.14 (14.95–25.37), meanConventional =...
Background Hyperlipidemia is associated with tendon disorders and biomechanical changes through t... more Background Hyperlipidemia is associated with tendon disorders and biomechanical changes through tissue deposition. In the present study, we seek the relation of plantar fasciitis (PF) with lipid profile parameters and fasting blood sugar (FBS) levels. Methods In a case-control study, we enrolled 68 patients with a clinical diagnosis of PF in the case group and 136 individuals without PF in the control group. Patients’ height, weight, body mass index (BMI), FBS, lipid profile including low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, and triglyceride (TG) laboratory tests were also checked as the main study variables to be compared between the two groups. The mean difference of each variable between the two case and control groups was tested using an independent t-test. Correlation coefficient analyses were used to calculate the correlation of patients’ BMI with lipid profile and FBS levels to evaluate the BMI variable as a confounder. Results Patient...
Category: Ankle; Ankle Arthritis Introduction/Purpose: The decision regarding total ankle replace... more Category: Ankle; Ankle Arthritis Introduction/Purpose: The decision regarding total ankle replacement is challenging in inflammatory arthritis patients regarding more inferior bone quality, large bone cysts, and increased risk for infections. This systematic review aimed to compare the short and long-term results of total ankle replacement, including the revision rate and the patient-reported outcomes between inflammatory rheumatoid arthritis (RA) versus non-inflammatory ankle osteoarthritis (OA). Methods: All published clinical studies on total ankle arthroplasty were searched in the databases. We extracted the data, specifically the American Orthopaedic Foot & Ankle Society (AOFAS) improvement, complication rate, and the reoperation rate. The results were also analyzed based on the prosthesis type. Results: In total, 34 trials were included in our study. Out of 5,078 patients, the underlying condition was rheumatoid arthritis in 1,327 patients and was non-inflammatory osteoarthrit...
Background American Orthopedic Foot and Ankle Society Score (AOFAS) is a reliable and reproducibl... more Background American Orthopedic Foot and Ankle Society Score (AOFAS) is a reliable and reproducible measurement tool which is commonly used for the assessment of foot and ankle conditions. In this study we aimed to translate and assess the psychometric properties of the Persian version of AOFAS questionnaire. Methods In this study, we enrolled 53 patients with ankle and hindfoot conditions. Our study was conducted according to five staged cross-cultural adaption steps including translation, synthesis, back translation, expert committee review, and pretesting. After that reliability of the subjective parts calculated by Cronbach's alpha and the intraclass correlation coefficient (ICC) and the reliability of the objective items estimated using Cohen's kappa test. Also, construct validity was assessed by testing the Persian AOFAS against the SF-36 questionnaire. Results Chronbach's alpha coefficient was 0.696, which was considered acceptable. Furthermore, the test-retest rel...
A new technique in spring ligament reconstruction using medial half of posterior tibial tendon is... more A new technique in spring ligament reconstruction using medial half of posterior tibial tendon is demonstrated as a means of supporting the arch. In addition a new concept of double bundle PTT reconstruction based on anatomical attachments of original PTT is presented with the goal of obtaining the full function of PTT.
Hallux valgus surgery has many potential complications apart from those inherent to all surgical ... more Hallux valgus surgery has many potential complications apart from those inherent to all surgical procedures. These include recurrence, malunion, nonunion, avascular necrosis, and hallux varus. The effective management of these problems requires a careful clinical and radiographic evaluation. Although nonsurgical management is often effective, operative intervention is also not infrequently indicated. Recurrent hallux valgus is a complex problem frustrating to both the patient and surgeon. Often, a deformity may recur if the initial surgery was not sufficiently powered to correct the primary problem. Success treating this problem is predicated on selecting the appropriate procedure based upon the unique features of the deformity, which requires careful clinical and radiographic analysis for accurate characterization. The most common malunion types are dorsiflexion and shortening iatrogenic deformities. In this scenario, patients may complain of metatarsalgia due to stress transfer fr...
Two stage total hip arthroplasty revision surgery includes foreign material debridment, insertion... more Two stage total hip arthroplasty revision surgery includes foreign material debridment, insertion of antibiotic impregnated cement spacer, and finally, reimplantation of the prosthesis. This review has aimed to evaluate the efficacy of antibiotic impregnated cement spacers in infection control and eradication in arthroplasties. A total of 85 articles on total hip arthroplasty were used in this narrative literature review. High concentrations of the antibiotic in targeted drug delivery by means of using antibiotic impregnated cement spacers is effective against infections while reduces the side effects of systemic antibiotic therapy. This results in prevention of bone and muscle atrophy as well as size discrepancy. Also, antibiotic impregnated cement spacers reduce dead space and help stabilize the limb in total hip arthroplasty. Despite all reported drawbacks, antibiotic impregnated cement spacers seem effective in eradicationg infections, although a consensus has not been yet achie...
Bone disorders are of significant worry due to their increased prevalence in the median age. Scaf... more Bone disorders are of significant worry due to their increased prevalence in the median age. Scaffold-based bone tissue engineering holds great promise for the future of osseous defects therapies. Porous composite materials and functional coatings for metallic implants have been introduced in next generation of orthopedic medicine for tissue engineering. While osteoconductive materials such as hydroxyapatite and tricalcium phosphate ceramics as well as some biodegradable polymers are suggested, much interest has recently focused on the use of osteoinductive materials like demineralized bone matrix or bone derivatives. However, physiochemical modifications in terms of porosity, mechanical strength, cell adhesion, biocompatibility, cell proliferation, mineralization and osteogenic differentiation are required. This paper reviews studies on bone tissue engineering from the biomaterial point of view in scaffolding. Level of evidence: I.
Iranian Orthopedic Community as a part of the national health system feels deeply responsible to ... more Iranian Orthopedic Community as a part of the national health system feels deeply responsible to take part in the battle against the new coronavirus (COVID-19) pandemic. Although we might not be considered the front-line defenders, we do have a key role in this challenge. As the crisis continues to grow in Iran, the risk of contracting the virus increases with subsequent increase in the number of seriously ill and dying patients. The shortage of ventilators and personal protective equipment (PPE) is a main concern that may even worsen as the number grows. In response to the burden on the health system, the elective part of our practice has to be suspended for now so that the resources can be deployed to more critical patients. There is a social responsibility to preserve vital resources for those who are in greater need. Moreover, we follow the recommended social distancing by postponing elective surgeries which should help reduce further spread of this disease. The recommendations ...
About 15 % of all musculoskeletal tuberculosis (TB) have hip involvement. Early anti-tubercular d... more About 15 % of all musculoskeletal tuberculosis (TB) have hip involvement. Early anti-tubercular drug therapy and other conservative treatment including short-term traction and mobilization programs could prevent hip joint destruction. Reactivation of TB accounts for a significant of active TB incidence, especially in the developed countries with a low TB prevalence. The risk of TB activation for population with the latent form of disease is about 5-10%. According to the existing literature surgery in tubercular hip arthritis would be safe once sufficient debridement and precise anti tubercular chemotherapy has been done.
Background: Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs as a result of a... more Background: Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs as a result of a vascular supply disruption that could lead to hip osteoarthritis. Recently, several joint-preserving procedures have been suggested to improve the outcome of AVN, including hip arthroscopy. This systematic review aimed to investigate the role of hip arthroscopy to preserve hip joints suffering from AVN. Methods: This review was conducted to collect data on hip arthroscopy from the available literature for the management of AVN. The collected articles included those that were focused mainly on the management of AVN assisted by arthroscopy and published up to 2020 that were searched in four databases using such keywords as "Avascular Necrosis", "AVN", and "Osteonecrosis" in combination with "Hip Arthroscopy" or "Arthroscopic Hip Surgery". Results: In total, 13 articles met the eligibility criteria, and no severe complications were reported after arthroscopy in patients with AVN. Moreover, the Harris scores were higher than 79 after the operation. The majority of the assessments showed that the use of arthroscopy was effective in the diagnosis and treatment of patients with AVN, except for one study, which had been performed on patients with stage IV AVN. Conclusion: The findings supported the idea that hip arthroscopy is effective in the treatment of AVN. This approach is becoming more popular for the diagnosis and treatment of hip disorders.
International Journal of Preventive Medicine, 2018
This study aimed Persian translation and validation of the hip disability and osteoarthritis outc... more This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire. The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF-36. Internal consistency was tested using Cronbach&amp;amp;#39;s alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test-retest reproducibility. Patients had mean (standard deviation) age of 39 (17). Test-retest ICC in whole was 0.95 ( = 0.014) showing excellent reliability. ICC was 0.92 for the &amp;amp;quot;pain&amp;amp;quot; subscale ( = 0.02), 0.81 for the &amp;amp;quot;symptom&amp;amp;quot; subscale ( = 0.002), 0.81 for the &amp;amp;quot;function of daily living (FDL)&amp;amp;quot; ( = 0.022), 0.88 for the &amp;amp;quot;function of sports and recreational activities&amp;amp;quot; ( = 0.006), but it was 0.62 ( = 0.1) for the &amp;amp;quot;quality of life (QOL).&amp;amp;quot; Cronbach&amp;amp;#39;s alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF-36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF-36 ( = 0.64, = 0.0001), whereas the t correlation with the mental component summary domain was weak ( = 0.16, = 0.04). The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.
Introduction: A supracondylar fracture are common in children with the average age of is 5-8 year... more Introduction: A supracondylar fracture are common in children with the average age of is 5-8 years. It is especially important to pay attention to pain control in these children because of lots of pain. This study was design to compare the analgesic effect of oral ibuprofen vs acetaminophen in children with supracondylar fractures who undergoing non-surgical treatment.Material & Methods: This triple-blind clinical trial was conducted on children with supracondylar fracture referred to the Emergency Department of Emam Reza and Hosheminejad Hospital. Children’s pain were assessed 2, 4 and 12 hours after taking the drug by VAS (Visual Analog Scale) criteria, which was explained by researcher to their parents. Results: In this study, 64 children with a mean age of 5.7±1.7 years were studied. 31 children in the acetaminophen group and 33 children in the ibuprofen group were evaluated. The mean pain score reduction within 12 hours of drug administration showed no difference between the tw...
Background: Foot function index (FFI) is a worthy subjective patient reported outcome measures (P... more Background: Foot function index (FFI) is a worthy subjective patient reported outcome measures (PROM) tool for evaluation of the outcomes of medical interventions on foot and ankle. This study was conducted to assess the validity of the Persian version of the foot function index (FFI). Methods: After translating the original FFI into Persian, back-translation was performed on the agreed Persian version and the final version was established. A total of 113 Persian-speaking patients with foot and ankle problems were enrolled in this study and were asked to fill in the FFI. Results: The Cronbach's alpha for subsections of FFI and MOXFQ was above 0.8 and 0.7, respectively, while it was 0.95 and 0.93 for total FFI and MOXFQ, respectively. The ICC for all subsections of MOXFQ and FFI was above 0.7. The Pearson's correlation coefficient for all subsections of FFI and MOXFQ was significant (P<0.01). Conclusion: The Persian version of FFI is valid and reproducible in Persian speaking population. Level of evidence: IV.
Background The decision regarding total ankle replacement (TAR) is challenging in patients with i... more Background The decision regarding total ankle replacement (TAR) is challenging in patients with inflammatory arthritis (IA) regarding more inferior bone quality, large bone cysts, and increased risk of infections. This systematic review and meta-analysis aimed to compare the functional outcome, revision rate, complication rate, and survival rate of TAR between IA (including rheumatoid arthritis [RA]) and noninflammatory arthritis (NIA) (primary and posttraumatic). Methods After reviewing the full texts, 30 articles fulfilled all inclusion criteria from 1985 until 2021, comparing TAR results. The eligible studies included 5508 patients, of whom 1565 patients had IA and 3943 patients had NIA. At the time of surgery, the average age was 58 years in the IA group and 63 in the NIA group. The average follow-up was 67.2 months in the IA group and 67 months in the NIA group. The outcome measures were the American Orthopaedic Foot and Ankle Society (AOFAS) score and the rate of complications...
Objective To compare the effects of ankle integral and conventional physiotherapy on pain, range ... more Objective To compare the effects of ankle integral and conventional physiotherapy on pain, range of motion, balance, disability, and treatment effectiveness in patients with chronic ankle instability (CAI). Design Two-arm, parallel-group, randomized, double-blind, controlled trial. Participants 60 patients with unilateral CAI. Intervention integral physiotherapy (n = 30) or conventional physiotherapy (n = 30). Outcomes Visual Analog Scale (VAS), dorsiflexion and plantarflexion range of motion, Star Excursion Balance Test (SEBT), Single Leg Hop (SLH) test, Foot and Ankle Outcome Score (FAOS), Lower Extremity Functional Score (LEFS), global rating of change, were gathered pre and post-intervention. Results The ANOVA results revealed statistically significant interaction for FAOS, and LEFS outcome measures ( P < 0.05) and the mean change results showed there were a favorable clinical difference incline toward the integral group (meanintegral = 20.14 (14.95–25.37), meanConventional =...
Background Hyperlipidemia is associated with tendon disorders and biomechanical changes through t... more Background Hyperlipidemia is associated with tendon disorders and biomechanical changes through tissue deposition. In the present study, we seek the relation of plantar fasciitis (PF) with lipid profile parameters and fasting blood sugar (FBS) levels. Methods In a case-control study, we enrolled 68 patients with a clinical diagnosis of PF in the case group and 136 individuals without PF in the control group. Patients’ height, weight, body mass index (BMI), FBS, lipid profile including low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, and triglyceride (TG) laboratory tests were also checked as the main study variables to be compared between the two groups. The mean difference of each variable between the two case and control groups was tested using an independent t-test. Correlation coefficient analyses were used to calculate the correlation of patients’ BMI with lipid profile and FBS levels to evaluate the BMI variable as a confounder. Results Patient...
Category: Ankle; Ankle Arthritis Introduction/Purpose: The decision regarding total ankle replace... more Category: Ankle; Ankle Arthritis Introduction/Purpose: The decision regarding total ankle replacement is challenging in inflammatory arthritis patients regarding more inferior bone quality, large bone cysts, and increased risk for infections. This systematic review aimed to compare the short and long-term results of total ankle replacement, including the revision rate and the patient-reported outcomes between inflammatory rheumatoid arthritis (RA) versus non-inflammatory ankle osteoarthritis (OA). Methods: All published clinical studies on total ankle arthroplasty were searched in the databases. We extracted the data, specifically the American Orthopaedic Foot & Ankle Society (AOFAS) improvement, complication rate, and the reoperation rate. The results were also analyzed based on the prosthesis type. Results: In total, 34 trials were included in our study. Out of 5,078 patients, the underlying condition was rheumatoid arthritis in 1,327 patients and was non-inflammatory osteoarthrit...
Background American Orthopedic Foot and Ankle Society Score (AOFAS) is a reliable and reproducibl... more Background American Orthopedic Foot and Ankle Society Score (AOFAS) is a reliable and reproducible measurement tool which is commonly used for the assessment of foot and ankle conditions. In this study we aimed to translate and assess the psychometric properties of the Persian version of AOFAS questionnaire. Methods In this study, we enrolled 53 patients with ankle and hindfoot conditions. Our study was conducted according to five staged cross-cultural adaption steps including translation, synthesis, back translation, expert committee review, and pretesting. After that reliability of the subjective parts calculated by Cronbach's alpha and the intraclass correlation coefficient (ICC) and the reliability of the objective items estimated using Cohen's kappa test. Also, construct validity was assessed by testing the Persian AOFAS against the SF-36 questionnaire. Results Chronbach's alpha coefficient was 0.696, which was considered acceptable. Furthermore, the test-retest rel...
A new technique in spring ligament reconstruction using medial half of posterior tibial tendon is... more A new technique in spring ligament reconstruction using medial half of posterior tibial tendon is demonstrated as a means of supporting the arch. In addition a new concept of double bundle PTT reconstruction based on anatomical attachments of original PTT is presented with the goal of obtaining the full function of PTT.
Hallux valgus surgery has many potential complications apart from those inherent to all surgical ... more Hallux valgus surgery has many potential complications apart from those inherent to all surgical procedures. These include recurrence, malunion, nonunion, avascular necrosis, and hallux varus. The effective management of these problems requires a careful clinical and radiographic evaluation. Although nonsurgical management is often effective, operative intervention is also not infrequently indicated. Recurrent hallux valgus is a complex problem frustrating to both the patient and surgeon. Often, a deformity may recur if the initial surgery was not sufficiently powered to correct the primary problem. Success treating this problem is predicated on selecting the appropriate procedure based upon the unique features of the deformity, which requires careful clinical and radiographic analysis for accurate characterization. The most common malunion types are dorsiflexion and shortening iatrogenic deformities. In this scenario, patients may complain of metatarsalgia due to stress transfer fr...
Two stage total hip arthroplasty revision surgery includes foreign material debridment, insertion... more Two stage total hip arthroplasty revision surgery includes foreign material debridment, insertion of antibiotic impregnated cement spacer, and finally, reimplantation of the prosthesis. This review has aimed to evaluate the efficacy of antibiotic impregnated cement spacers in infection control and eradication in arthroplasties. A total of 85 articles on total hip arthroplasty were used in this narrative literature review. High concentrations of the antibiotic in targeted drug delivery by means of using antibiotic impregnated cement spacers is effective against infections while reduces the side effects of systemic antibiotic therapy. This results in prevention of bone and muscle atrophy as well as size discrepancy. Also, antibiotic impregnated cement spacers reduce dead space and help stabilize the limb in total hip arthroplasty. Despite all reported drawbacks, antibiotic impregnated cement spacers seem effective in eradicationg infections, although a consensus has not been yet achie...
Bone disorders are of significant worry due to their increased prevalence in the median age. Scaf... more Bone disorders are of significant worry due to their increased prevalence in the median age. Scaffold-based bone tissue engineering holds great promise for the future of osseous defects therapies. Porous composite materials and functional coatings for metallic implants have been introduced in next generation of orthopedic medicine for tissue engineering. While osteoconductive materials such as hydroxyapatite and tricalcium phosphate ceramics as well as some biodegradable polymers are suggested, much interest has recently focused on the use of osteoinductive materials like demineralized bone matrix or bone derivatives. However, physiochemical modifications in terms of porosity, mechanical strength, cell adhesion, biocompatibility, cell proliferation, mineralization and osteogenic differentiation are required. This paper reviews studies on bone tissue engineering from the biomaterial point of view in scaffolding. Level of evidence: I.
Iranian Orthopedic Community as a part of the national health system feels deeply responsible to ... more Iranian Orthopedic Community as a part of the national health system feels deeply responsible to take part in the battle against the new coronavirus (COVID-19) pandemic. Although we might not be considered the front-line defenders, we do have a key role in this challenge. As the crisis continues to grow in Iran, the risk of contracting the virus increases with subsequent increase in the number of seriously ill and dying patients. The shortage of ventilators and personal protective equipment (PPE) is a main concern that may even worsen as the number grows. In response to the burden on the health system, the elective part of our practice has to be suspended for now so that the resources can be deployed to more critical patients. There is a social responsibility to preserve vital resources for those who are in greater need. Moreover, we follow the recommended social distancing by postponing elective surgeries which should help reduce further spread of this disease. The recommendations ...
About 15 % of all musculoskeletal tuberculosis (TB) have hip involvement. Early anti-tubercular d... more About 15 % of all musculoskeletal tuberculosis (TB) have hip involvement. Early anti-tubercular drug therapy and other conservative treatment including short-term traction and mobilization programs could prevent hip joint destruction. Reactivation of TB accounts for a significant of active TB incidence, especially in the developed countries with a low TB prevalence. The risk of TB activation for population with the latent form of disease is about 5-10%. According to the existing literature surgery in tubercular hip arthritis would be safe once sufficient debridement and precise anti tubercular chemotherapy has been done.
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