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Sharafatvaziri A, Esfandiari S, Vosoughi F, Shayan-Moghadam R, Soleymani M. Patellectomy, an old treatment in patellar fracture which is still alive: A case report. Int J Surg Case Rep 2024; 118:109604. [PMID: 38615464 PMCID: PMC11033151 DOI: 10.1016/j.ijscr.2024.109604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Comminuted patella fractures comprise 55 % of patellar fractures. In spite of advances in internal fixation of patella, patellectomy remains an effective treatment in comminuted fractures. In the shadow of different efficient methods of internal fixation, little attention is paid to patellectomy as an old treatment in patellar fracture which is a treatment option in circumstances like comminuted fractures and osteomyelitis. PRESENTATION OF CASE A 54-year-old male presented with complaint of knee pain and limited range of motion. The patient experienced patella fracture four years ago and several sessions of surgery have been performed on his patella including tension band wiring, partial patellectomy, and arthroscopic release. Lastly, pain and severe limited range of motion, convinced us to perform total patellectomy. The result is satisfactory after one year; flexion is up to 90° and no limping or extension lag is observed. The only complaint is mild anterior knee pain. DISCUSSION Patella has two important biomechanical functions including linking and displacement. Preserving even a single fragment of the patella substantially improves linking and displacement function of the patella. Total patellectomy is reserved for conditions like failed internal fixation, comminuted fractures, and patellar osteomyelitis. Although function of the knee cannot be thoroughly restored after removing of the patella, total patellectomy can lead to a relative satisfaction in performing activities of daily living. CONCLUSION In spite of various types of treatment for patellar fracture, total patellectomy, is still an efficient treatment option in circumstances like comminuted fractures, failed internal fixation, and osteomyelitis.
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Affiliation(s)
- Arash Sharafatvaziri
- Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Investigation Performed at the Department of Orthopaedic Surgery, Shariati Hospital, Tehran, Iran
| | - Soodabeh Esfandiari
- Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shayan-Moghadam
- Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mosayeb Soleymani
- Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Investigation Performed at the Department of Orthopaedic Surgery, Shariati Hospital, Tehran, Iran.
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Vosoughi F, Mafhoumi A, Gouravani M, LaPrade RF, Sherafat Vaziri A, Movahedinia M, Keyhani S. Hypermobile lateral meniscus: A systematic review of current treatment options. Knee Surg Sports Traumatol Arthrosc 2024; 32:843-863. [PMID: 38431797 DOI: 10.1002/ksa.12102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The reliable data on the incidence of hypermobile lateral meniscus (HLM) and its clinical manifestations, diagnostic methods and therapeutic approaches are limited. This systematic study aimed to review available treatment options for HLM and the outcomes of each approach. METHODS A systematic search was performed in four electronic databases (PubMed, EMBASE, Scopus, Web of Science) to identify studies in which arthroscopically confirmed cases of HLM were treated surgically or nonsurgically, and the required data comprising study characteristics, patient data, treatment approaches and outcome measures were extracted from eligible studies. RESULTS Twenty studies with a total of 212 patients (138 males and 74 females) and 219 knees were included. The most frequently reported symptoms were locking sensations, knee pain, giving way and snapping. Treatments used by the studies were: radiofrequency energy in two studies; arthroscopic partial meniscectomy in one study; open surgery in two studies; and arthroscopic meniscal repair in 17 studies. Eleven studies used an all-inside repair method and an inside-out meniscal repair was reported in eight studies. Three studies reported the usage of posterior arthroscopy for therapeutic or diagnostic approaches. Evaluation of symptom resolution was the main outcome measurement for which almost all of the studies stated relief of symptoms after intervention. CONCLUSION Despite the lack of definite consensus about the most appropriate intervention for HLM, therapeutic preference was directed towards arthroscopic all-inside and inside-out repair techniques. Although the surgeon's decision remains the key factor in choosing the most suitable treatment option for each individual, posterior arthroscopic meniscal repair may be considered as a better option for HLM treatment according to the findings of this review. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Fardis Vosoughi
- Department of Orthopedic and Trauma Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Asma Mafhoumi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran, Iran
| | - Mahdi Gouravani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Sohrab Keyhani
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vosoughi F, Vaziri AS, Shayan-Moghadam R, Nejad EB. Subtrochanteric fracture of the femur following knee replacement surgery: A case series and review of the literature. Int J Surg Case Rep 2024; 114:109143. [PMID: 38096703 PMCID: PMC10762360 DOI: 10.1016/j.ijscr.2023.109143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Knee arthroplasties as an effective intervention is primarily performed in patients with primary osteoarthritis and rheumatoid arthritis. Risk of hip fracture may be either decreased or increased in patients with Knee arthroplasties. There is conflicting evidence in this regard. Over the years, some studies have reported the occurrence of hip fractures following this operation as a rare but severe complication. The aim of the present case series was to report diagnosis and treatment of the mentioned five cases. CASE PRESENTATION During a period of two years, five patients with a diagnosis of a subtrochanteric fracture and history of total knee arthroplasty who referred to hospital were selected to include in the present case series. CLINICAL DISCUSSION: the presence of RA and treatment with glucocorticoids, a reduction of BMD following knee replacement surgery, and ultimately, an increase in physical activity and movement after the arthroplasty due to the improvement of preoperational pain, may all contribute in a complex manner to the observed outcome of increased fracture risk in the hip following TKA. CONCLUSION In summary, special care including using medications to improve BMD should be taken to minimize the risk of such an event.
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Affiliation(s)
- Fardis Vosoughi
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical sciences, Tehran, Iran
| | - Arash Sharafat Vaziri
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shayan-Moghadam
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical sciences, Tehran, Iran
| | - Erfan Babaei Nejad
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical sciences, Tehran, Iran.
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Vaziri AS, Moradkhani G, Karimpour M, Tahmasebi MN, Esfandiary S, Vosoughi F, Hosseini SR. Management of tibial nonunion and osteoarthritis using a 3D-printed titanium cone: A case report. Trauma Case Rep 2023; 48:100937. [PMID: 37810537 PMCID: PMC10550753 DOI: 10.1016/j.tcr.2023.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
The use of customized 3D-printed structures has been gaining popularity in non-union management, as it allows for bypassing the defect while promoting osseointegration. Additionally, porous titanium implants minimize stress shielding due to their stiffness and elastic modulus being closer to that of bone. The interconnected channels increase the surface area and provide space for cell adhesion and proliferation. This study presents the case of a 62-year-old female patient with concomitant knee osteoarthritis recalcitrant aseptic atrophic nonunion in the tibial proximal metaphysis. Due to the small distance between the nonunion site and the joint line, nonunion treatment had to be included in the treatment plan, as it would result in a lack of mechanical stability of the tibial component, and techniques such as plating were not an option. A customized 3D-printed porous titanium cone was used to bypass the fracture site and support the stem used with the CCK prosthesis, allowing for simultaneous nonunion and osteoarthritis management.
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Affiliation(s)
- Arash Sharafat Vaziri
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Moradkhani
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Morad Karimpour
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Soodabeh Esfandiary
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Reihaneh Hosseini
- Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
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Vaziri AS, Karimpour M, Tahmasebi MN, Hosseini SR, Moradkhani G, Javidmehr S, Vosoughi F. Ipsilateral Concurrent Knee Arthroplasty and Tibial Osteotomy with 3D-Printed Patient-Specific Instrumentation: A Case Report. JBJS Case Connect 2023; 13:01709767-202312000-00021. [PMID: 37917765 DOI: 10.2106/jbjs.cc.23.00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
CASE A 70-year-old woman presented with knee pain and instability and was diagnosed with advanced knee osteoarthritis and bifocal tibial deformities. The complexity of the case challenged our team to perform a significant sagittal correction (>60°) and restore her ability to walk independently. We performed ipsilateral total knee arthroplasty and anterior closed wedge tibial osteotomy using virtual planning and 3D-printed patient-specific instrumentation. CONCLUSION Using 2 separate 3D-printed patient-specific cutting guides for this patient with a complex deformity and managing the whole planning process in close collaboration between the surgeons and engineers resulted in a satisfactory postoperative outcome, optimal implant positioning and leg alignment, and minimal soft-tissue damage.
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Affiliation(s)
- Arash Sharafat Vaziri
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Morad Karimpour
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Reihaneh Hosseini
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Moradkhani
- School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Sina Javidmehr
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and trauma surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Aghakhani A, Shoshtarian Malak J, Karimi Z, Vosoughi F, Zeraati H, Yekaninejad MS. Predicting the COVID-19 mortality among Iranian patients using tree-based models: A cross-sectional study. Health Sci Rep 2023; 6:e1279. [PMID: 37223657 PMCID: PMC10200963 DOI: 10.1002/hsr2.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background and Aims To explore the use of different machine learning models in prediction of COVID-19 mortality in hospitalized patients. Materials and Methods A total of 44,112 patients from six academic hospitals who were admitted for COVID-19 between March 2020 and August 2021 were included in this study. Variables were obtained from their electronic medical records. Random forest-recursive feature elimination was used to select key features. Decision tree, random forest, LightGBM, and XGBoost model were developed. Sensitivity, specificity, accuracy, F-1 score, and receiver operating characteristic (ROC)-AUC were used to compare the prediction performance of different models. Results Random forest-recursive feature elimination selected following features to include in the prediction model: Age, sex, hypertension, malignancy, pneumonia, cardiac problem, cough, dyspnea, and respiratory system disease. XGBoost and LightGBM showed the best performance with an ROC-AUC of 0.83 [0.822-0.842] and 0.83 [0.816-0.837] and sensitivity of 0.77. Conclusion XGBoost, LightGBM, and random forest have a relatively high predictive performance in prediction of mortality in COVID-19 patients and can be applied in hospital settings, however, future research are needed to externally confirm the validation of these models.
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Affiliation(s)
- Amirhossein Aghakhani
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Jaleh Shoshtarian Malak
- Department of Digital Health, School of MedicineTehran University of Medical SciencesTehranIran
| | - Zahra Karimi
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Fardis Vosoughi
- Department of Orthopedics and Trauma Surgery, Shariati Hospital and School of MedicineTehran University of Medical SciencesTehranIran
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
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Keyhani S, Movahedinia M, Sherafat Vaziri A, Soleymanha M, Vosoughi F, Tahami M, LaPrade RF. Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques. EFORT Open Rev 2023; 8:189-198. [PMID: 37097043 PMCID: PMC10155121 DOI: 10.1530/eor-22-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Various uses of posterior knee arthroscopy have been shown, including all-inside repair of posterior meniscal lesions, posterior cruciate ligament (PCL) reconstruction or PCL avulsion fixation, extensile posterior knee synovectomy for pigmented villonodular synovitis or synovial chondromatosis, posterior capsular release in the setting of knee flexion contractures, and loose bodies removal. Posterior arthroscopy provides direct access to the posterior meniscal borders for adequate abrasion and fibrous tissue removal. This direct view of the knee posterior structures enables the surgeon to create a stronger biomechanical repair using vertical mattress sutures. During PCL reconstruction, posterior arthroscopy gives the surgeon proper double access to the tibial insertion site, which can result in less acute curve angles and the creation of a more anatomic tibial tunnel. Moreover, it gives the best opportunity to preserve the PCL remnant. Arthroscopic PCL avulsion fixation is more time-consuming with a larger cost burden compared to open approaches, but in the case of other concomitant intra-articular injuries, it may lead to a better chance of a return to pre-injury activities. The high learning curve and overcaution of neuromuscular injury have discouraged surgeons from practicing posterior knee arthroscopy using posterior portals. Evidence for using posterior portals by experienced surgeons suggests fewer complications. The evidence suggests toward learning posterior knee arthroscopy, and this technique must be part of the education about arthroscopy. In today's professional sports world, where the quick and complete return of athletes to their professional activities is irreplaceable, the use of posterior knee arthroscopy is necessary.
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Affiliation(s)
- Sohrab Keyhani
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Movahedinia
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Sherafat Vaziri
- Center of Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Soleymanha
- Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Tahami
- Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Robert F LaPrade
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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8
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Keyhani S, Movahedinia M, LaPrade RF, Qoreishy M, Vosoughi F. Long-term clinical results of using a posteromedial all-inside and anteromedial inside-out approach to repair unstable or irreducible bucket-handle medial meniscal tears. J Orthop Traumatol 2023; 24:12. [PMID: 37024629 PMCID: PMC10079791 DOI: 10.1186/s10195-023-00691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND In irreducible bucket-handle medial meniscal tears (BHMMTs), the displaced central fragment is rotated 180° or more, meaning reduction is impossible without derotation of the tear. In chronic cases, the rotated meniscus is deformed and degenerated; thus, the issue of reproducibility and repairability arises. This study presents the clinical outcomes of chronic irreducible and unstable locked BHMMTs. Radiological outcomes were also evaluated using magnetic resonance imaging (MRI). METHODS This is a retrospective study of 37 patients with 11 cases of irreducible BHMMT and 26 cases of reducible but unstable chronic BHMMT who underwent operations between 2011 and 2016. Posterior arthroscopy was performed after temporary meniscus fixation using a provisional needle fixation technique. After the posterior repair with vertical mattress sutures was completed using an all-inside technique, the classic outside-in technique was performed for the anterior third of the meniscus. The Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scores were obtained from all patients before surgery and at the latest follow-up. Radiological evaluations were performed using MRI before surgery and at 6 months postoperatively. RESULTS Between 2011 and 2016, a total of 37 consecutive patients with irreducible and chronic BHMMTs underwent surgery. The average postoperative follow-up was 7.2 ± 1.4 years (mean ± SD). Postoperative Lysholm (89.57 ± 2.7) and IKDC (87.22 ± 3.2) scores improved significantly at the last follow-up when compared with the pre-operative scores (38.44 ± 4.5 and 23.52 ± 7.8, respectively). According to the Tegner activity scale, patients' postoperative activity levels remained unchanged compared to preoperative levels at the last follow-up. CONCLUSION Posterior knee arthroscopy with the all-inside posterior suture and inside-out anteromedial suture technique presented in this study yielded excellent clinical outcomes when used to repair chronic irreducible or unstable BHMMTs. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Sohrab Keyhani
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Mohammad Movahedinia
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.
| | - Robert F LaPrade
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, USA
| | - Mohamad Qoreishy
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sharafat Vaziri A, Aghaghazvini L, Jahangiri S, Tahami M, Borazjani R, Tahmasebi MN, Rabie H, Mamaghani HJ, Vosoughi F, Salimi M. Determination of Normal Reference Values for Meniscal Extrusion Using Ultrasonography During the Different Range of Motion: A Pilot, Feasibility Study. J Ultrasound Med 2022; 41:2715-2723. [PMID: 35137975 DOI: 10.1002/jum.15955] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES It is essential to know the normal extrusion measures in order to detect pathological ones. In this study, we aimed to define some normal reference values for meniscal extrusion in the normal knees during different ranges of motion. METHODS The amount of anterior and posterior portion of meniscal extrusion among 21 asymptomatic volunteers (42 knees) were tracked in 0, 45, and 90° of knee flexion using an ultrasound machine. The repeated measures analysis of variance (ANOVA) was used to show the interaction between the amounts of meniscal extrusion and the different degrees of knee flexion. RESULTS The anterior portion of the lateral menisci at full knee extension (0.59 ± 1.40) and the posterior portion of the medial menisci during 90° flexion (3.06 ± 2.36) showed the smallest and the highest mean amount of extrusion, respectively. The normal average amounts of anterior extrusion were 1.12 ± 1.17 and 0.99 ± 1.34 mm for medial and lateral menisci, respectively. The posterior meniscal normal extrusions were significantly increasing in both medial and lateral menisci during the survey (F = 20.250 and 11.298; both P values <.001) as they were measured 2.37 ± 2.16 and 1.53 ± 2.18 mm in order. CONCLUSIONS The medial meniscus can extrude 1.74 ± 1.84 mm normally while this amount was 1.26 ± 1.82 mm for the lateral meniscus. These measures commonly increased with the rising of knee flexion motion. Likewise, the posterior portion showed more extrusion than the anterior portion on both sides. These measures commonly increased with higher knee flexion.
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Affiliation(s)
- Arash Sharafat Vaziri
- Fellowship of Knee, Sport and Reconstruction Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Soodeh Jahangiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Tahami
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roham Borazjani
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Naghi Tahmasebi
- Knee, Sport and Reconstruction Surgery, Knee Surgery Fellowship Program, Orthopaedic Surgery Department, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Rabie
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fardis Vosoughi
- Fellowship of Knee, Sport and Reconstruction Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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Vosoughi F, Makuku R, Tantuoyir MM, Yousefi F, Shobeiri P, Karimi A, Alilou S, LaPorte R, Tilves C, Nabian MH, Yekaninejad MS. A systematic review and meta-analysis of the epidemiological characteristics of COVID-19 in children. BMC Pediatr 2022; 22:613. [PMID: 36273121 PMCID: PMC9587668 DOI: 10.1186/s12887-022-03624-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several individual studies from specific countries have reported rising numbers of pediatric COVID-19 cases with inconsistent reports on the clinical symptoms including respiratory and gastrointestinal symptoms as well as diverse reports on the mean age and household exposure in children. The epidemiological characteristics of COVID-19 in children are not fully understood, hence, comprehensive meta-analyses are needed to provide a better understanding of these characteristics. METHODS This review was conducted in Medline, Scopus, Cochrane library, Embase, Web of Science, and published reports on COVID-19 in children. Data were extracted by two independent researchers and a third researcher resolved disputes. STATA software and the random-effect model were used in the synthesis of our data. For each model, the heterogeneity between studies was estimated using the Q Cochrane test. Heterogeneity and publication bias were calculated using the I2 statistic and Egger's/Begg's tests. RESULTS The qualitative systematic review was performed on 32 articles. Furthermore, the meta-analysis estimated an overall rate of involvement at 12% (95% CI: 9-15%) among children, with an I2 of 98.36%. The proportion of household exposure was calculated to be 50.99% (95% CI: 20.80%-80.80%) and the proportion of admitted cases was calculated to be 45% (95% CI: 24%-67%). Additionally, the prevalence of cough, fatigue, fever and dyspnea was calculated to be 25% (95% CI: 0.16-0.36), 9% (95% CI: 0.03-0.18), 33% (95% CI: 0.21-0.47) and 9% (95% CI: 0.04-0.15), respectively. It is estimated that 4% (95% CI: 1-8%) of cases required intensive care unit admission. CONCLUSIONS The pediatric clinical picture of COVID-19 is not simply a classic respiratory infection, but unusual presentations have been reported. Given the high incidence of household transmission and atypical clinical presentation in children, we strongly recommend their inclusion in research and population-based preventive measures like vaccination as well as clinical trials to ensure efficacy, safety, and tolerability in this age group.
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Affiliation(s)
- Fardis Vosoughi
- Department of Orthopedics and Trauma Surgery, Shariati Hospital, and, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Rangarirai Makuku
- Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Avenue, Tehran, Iran
| | - Marcarious M Tantuoyir
- Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran. .,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. .,Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana.
| | - Farbod Yousefi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Alilou
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ronald LaPorte
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Curtis Tilves
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mohammad Hossein Nabian
- Department of Orthopedics and Trauma Surgery, Shariati Hospital, and, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Center for Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Avenue, Tehran, Iran.
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11
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Zargarbashi R, Mahmoudi E, Khalaj K, Vosoughi F, Mollaeian M, Baghbani S. Periscapular Fibromatosis With Intrathoracic Invasion in a 3-Year-Old Boy. Orthopedics 2022; 45:e276-e279. [PMID: 35700428 DOI: 10.3928/01477447-20220608-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Fibromatosis is an extremely rare tumor that arises from the myofascial tissue and has high rates of infiltration and recurrence. Fibromatosis of the chest wall is even less common, and wide surgical resection is the preferred treatment alternative to radiation therapy, chemotherapy, and systemic treatments. We report the case of a 3-year-old boy with radiologically and pathologically confirmed fibromatosis of the periscapular region who underwent wide resection. We discuss diagnosis, treatment options, and technical pearls for a desmoid tumor of the chest wall. The resection should go through healthy tissue because of the infiltrative nature of the tumor. Although visceral involvement did not occur in this case, surgeons should be aware of its possibility, and surgery should be performed by a multidisciplinary team, including a pediatric orthopedic surgeon, a thoracic surgeon, and an anesthesiologist. [Orthopedics. 2022;45(5):e276-e279.].
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12
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Zargarbashi R, Vosoughi F, Milan N. Wide resection as a solution to excruciating pain in intraneural hemangioma: Follow-up of a previously published case report. Int J Surg Case Rep 2022; 98:107562. [PMID: 36057251 PMCID: PMC9436751 DOI: 10.1016/j.ijscr.2022.107562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ramin Zargarbashi
- Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nesa Milan
- Center of Orthopedic Trans-disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran.
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13
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Vahidi K, Shamabadi A, Nabian MH, Vosoughi F, Panjavi B, Zargarbashi R. Clinical, radiological, pedobarographic, and quality of life outcomes of the Ponseti treatment for clubfoot: a prospective study. Foot (Edinb) 2022; 52:101921. [PMID: 36037761 DOI: 10.1016/j.foot.2022.101921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/28/2022] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Talipes equinovarus, also known as clubfoot, is a congenital anomaly that affects one newborn per 1000 live births. Its standard treatment strategy is Ponseti casting management. This study aims to report the long-term outcomes of the Ponseti treatment in Iran. METHODS A prospective cohort study was enrolled to evaluate clinical outcomes, radiological results, pedobarographic measurements, and quality of life after the Ponseti treatment in patients with clubfoot who were followed for at least five years. RESULTS In this study, 25 clubfeet of 18 patients were included. Significant reductions in Pirani, Dimeglio, and CAP scores, improved ankle dorsiflexion, and acceptable pedobarographic indices were observed in this study. From the radiological evaluation indices, the calcaneal pitch and lateral talus-first metatarsal angles were significantly reduced. After five years of treatment, patients' quality of life was favorable, which was better in females. This study showed that the results of the Ponseti treatment remained acceptable after five years. CONCLUSIONS The Ponseti management for clubfoot in the long term appears to maintain significant improvements. However, the recurrence rate - albeit without disruption to daily activities - cannot be ignored.
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Affiliation(s)
- Kamyar Vahidi
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Shamabadi
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Nabian
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Pediatric Surgery and Orthopedics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Panjavi
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Pediatric Surgery and Orthopedics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Zargarbashi
- Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Pediatric Surgery and Orthopedics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Tahami M, Vaziri AS, Tahmasebi MN, Ahmadi MA, Akbarzadeh A, Vosoughi F. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. BMC Musculoskelet Disord 2022; 23:753. [PMID: 35932028 PMCID: PMC9354278 DOI: 10.1186/s12891-022-05662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Corona virus infectious pandemic makes outdoors rehabilitation a potential hazard. Patient education to perform simple home-based exercises seems to be an interesting and sometimes a mandatory option. This study provides a comparison between the conventional and home-based virtual rehabilitation after surgical repair of medial meniscus root tears. METHODS In this prospective study, all patients who underwent medial meniscus posterior root repair with a modified trans-tibial pull-out technique from March 2019 to March 2021 were evaluated. Those who underwent surgery after December 2019 were trained to perform self-rehabilitation. The rest had undergone outdoors specialized rehabilitation according to a unified protocol and these were used as a historical control group. All patients were followed up for a minimum of 2 year after surgery. Final Lysholm scores were utilized to compare functional outcomes after considering the effect of age, body mass index and time from surgery by multivariate linear regression analysis. RESULTS Forty-three consecutive patients with medial meniscal root tears were studied. Thirty-nine (90.7%) were women and 4 (9.3%) were men. The mean age of participants was 53.2 ± 8.1 years. The total Lysholm knee score, and all its items were significantly improved in both groups at a two-year follow-up (p < 0.05), except the "Using cane or crutches" item (p = 0.065). Nevertheless, the final Lysholm knee score improvement was higher in patients who performed outdoors specialized rehabilitation and in patients with shorter time-to-surgery. CONCLUSION Regardless of age and gender, home-based rehabilitation after meniscal root repair with the modified trans-tibial pull-out technique improved the patients' function at a two-year follow-up. Nonetheless, this effect was still significantly lower than that of the outdoors specialized rehabilitation. Future work is required to clarify basic protocols for home-based tele-rehabilitation programs and determine clinical, radiological and functional results. LEVEL OF EVIDENCE Level IV, therapeutic, historically controlled study.
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Affiliation(s)
- Mohammad Tahami
- Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Sharafat Vaziri
- Department of Orthopedic and Trauma Surgery, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Department of Orthopedic and Trauma Surgery, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Ahmadi
- Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Armin Akbarzadeh
- Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fardis Vosoughi
- Department of Orthopedic and Trauma Surgery, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Vosoughi F, Vosoughi F, Kalantar SH. Open knee dislocation, triple intra-articular fractures and patellar tendon rupture: case report of a knee disaster treated with aggressive irrigation/debridement, early anatomic reduction and internal fixation. BMC Musculoskelet Disord 2022; 23:431. [PMID: 35534818 PMCID: PMC9082914 DOI: 10.1186/s12891-022-05268-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Open knee fracture-dislocation is a rare orthopedic injury. However, the importance of its correct management could not be overstated. To the best of our knowledge, this is the fifth study reporting a case with simultaneous Hoffa fracture and knee dislocation and the 1st study describing a patient with open plateau fracture-dislocation accompanied with Hoffa fracture, patella fracture, and patellar tendon tear. In addition, this report is noticeable as our case had no gross ligament injury unlike frequent association of knee dislocation with knee collateral ligament damage. Case presentation In this study, we describe a 34-year-old motorcyclist referred to our center following a motor car accident. Further work-up revealed an open irreducible posterolateral knee dislocation, type 5 Hohl and Moore plateau fracture, lateral femoral condyle Hoffa’s fracture, patellar fracture, and patellar tendon tear of his right knee. During an open reduction, it turned out that an entrapped lateral meniscus prevented the joint to be reduced by closed means. After applying a temporary external fixator, the patient was finally managed with open reduction and internal fixation. Conclusion Irreducible knee dislocation needs further work up to rule out any interposed soft tissue into the joint. Aggressive irrigation/ debridement, early anatomic reduction, and internal fixation may help reduce open fracture complications including infection, non-union, and stiffness.
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Affiliation(s)
- Farzad Vosoughi
- Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopedic and Trauma Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Shariati hospital, Tehran, Iran
| | - Seyed Hadi Kalantar
- Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. .,Orthopedic Surgery Department, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, 1419733141, Tehran, Iran.
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16
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Hazrati E, Vosoughi F, Chamanara M, Teymourian H. Effect of Dexmedetomidine infusion during hip fracture surgery on hemodynamic parameters and blood loss: A triple-blinded Randomized Clinical Trial. Injury 2022; 53:551-554. [PMID: 34802700 DOI: 10.1016/j.injury.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/31/2021] [Accepted: 11/07/2021] [Indexed: 02/02/2023]
Abstract
Introduction In this study, we aim to assess the intra-operative effect of dexmedetomidine administration on the hemodynamic parameters and bleeding volume during hip fracture surgery. Patients and methods we designed and implemented a triple-blinded randomized clinical trial to objectively compare the effects of 0.5 µg/kg/h infusion of dexmedetomidine with placebo (equal amount of normal saline) during hip fracture surgery. All included cases were between 30 and 70 years old and underwent surgery for fixation of a proximal femur fracture from September 26, 2020 until February 15, 2021. They were all ASA class I or II with preoperative hemoglobin levels of 10 mg/dL or higher. Surgical blood loss and hemodynamic parameters were documented. Results 76 patients were enrolled. There were no significant differences in baseline patient characteristics. The bleeding rate was 620 ± 190.0 mL for the normal saline group and 476 ± 177.98 mL in the dexmedetomidine group (P = 0.04). No significant effect on hemodynamic parameters was observed. Conclusion Based on the current study, intravenous infusion of dexmedetomidine during hip fracture surgery under general anesthesia reduced the amount of intraoperative bleeding without causing any significant hemodynamic disturbances. Registration number IRCT20191222045857N1 (Iranian Registry of Clinical Trials).
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Affiliation(s)
- Ebrahim Hazrati
- Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran.
| | - Fardis Vosoughi
- Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Chamanara
- Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Houman Teymourian
- Department of Anesthesiology, School of Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences.
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17
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Keyhani S, Vaziri AS, Vosoughi F, Verdonk R, Movahedinia M. Overview of Posterior knee arthroscopy in the medial meniscal repair: technical note. J ISAKOS 2022; 7:33-38. [DOI: 10.1016/j.jisako.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
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18
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Zargarbashi R, Hashem Zadeh A, Vosoughi F. Chronic excruciating forearm pain in a child with intra-neural hemangioma: A challenging case report. Int J Surg Case Rep 2021; 89:106561. [PMID: 34864264 PMCID: PMC8646995 DOI: 10.1016/j.ijscr.2021.106561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/30/2021] [Accepted: 10/30/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Cavernous hemangioma is a rare form of hemangioma. It usually arises in the central nervous system, but the tumor has also been reported in the liver, retina and skin with a lower prevalence. Its occurrence into the peripheral nerves has only been reported a few times. Herein, we report an extremely rare case of intra-neural hemangioma in the ulnar nerve and discuss the complications we faced following surgery. CASE PRESENTATION We present a 6-year-old boy with history of severe progressive left forearm pain in the last two years. Imaging studies revealed a soft tissue mass and histopathological exam was in favor of a cavernous hemangioma. Patient underwent surgery to excise the tumor. Despite temporary response, he began to experience excruciating pain shortly after surgery which caused him to adopt bizarre postures. CLINICAL DISCUSSION In the more common form of nerve involvement in a hemangioma, the nerve is displaced and surrounded by the tumor. However, in cases with intra-neural involvement, the nerve would have to be sacrificed. This case report brings some rare but important characteristics of a hemangioma in to attention, such as the intra-neural location, possibility of recurrence and aggravating pain with bizarre positions as a result. CONCLUSION In cases of intra-neural hemangioma, there is a chance that the patient experiences recurrence and/or excruciating pain following surgery. The orthopedic surgeon should be prepared for the possibility of nerve transfer, repeat surgeries and the need for prolonged palliative pain suppression modalities in the approach to intra-neural hemangioma.
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Affiliation(s)
- Ramin Zargarbashi
- Department of Pediatric Orthopedy, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Hashem Zadeh
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Fellowship of Knee Sport and Reconstruction Surgery, Department of Orthopaedic and Trauma Surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran..
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19
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Shobeiri P, Presedo A, Karimi A, Momtazmanesh S, Vosoughi F, Nabian MH. Orthopedic management of myelomeningocele with a multidisciplinary approach: a systematic review of the literature. J Orthop Surg Res 2021; 16:494. [PMID: 34389028 PMCID: PMC8361640 DOI: 10.1186/s13018-021-02643-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Myelomeningocele (MMC) is the most common and severe form of spina bifida and imposes a significant burden on patients and the healthcare system. Recently, the multidisciplinary management of MMC has become popular. Herein, we aimed to review the orthopedic management, outcomes, and complications of the of patients with MMC eyeing a multidisciplinary approach. Methods We searched PubMed and EMBASE to find relevant studies published before August 2020. All studies that included clinical management of MMC patients and published earlier than 2000 were considered for review on the condition that they reported at least one orthopedic intervention and the rate of complications. We excluded review articles, case reports, case series, letters, commentaries, editorials, and conference abstracts. The primary and secondary goals of our review were to report the outcomes and complication rates of multidisciplinary management for MMC patients. Results Twenty-six studies included data for the management of 229,791 patients with MMC and were selected. Sixteen studies reported multidisciplinary management in addition to orthopedic management. From those, 11 (42.31%) included urologic management, 13 (50%) neurosurgical management, 11 (42.31%) neurologic management, and 5 (19.23%) gastrointestinal management. All studies included postnatal operations and related management. No randomized clinical trial was found in our search. Conclusion Orthopedic approaches play a key role in MMC management by alleviating spinal deformities, particularly scoliosis, and hip, foot, and ankle complications. However, the most appropriate management, whether surgical or non-surgical, may vary for different patients, given disease severity and the age of patients. Graphical abstract ![]()
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Affiliation(s)
- Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana Presedo
- Department of Pediatric Orthopedics, Hôpital Robert Debre, Paris, France
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Momtazmanesh
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopedic and trauma surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Hossein Nabian
- Department of Orthopedic and trauma surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran. .,Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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20
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Yekaninejad MS, Badrooj N, Vosoughi F, Lin CY, Potenza MN, Pakpour AH. Prevalence of food addiction in children and adolescents: A systematic review and meta-analysis. Obes Rev 2021; 22:e13183. [PMID: 33403795 PMCID: PMC8244111 DOI: 10.1111/obr.13183] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/09/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
Food addiction (FA) has been as a construct that is associated with childhood obesity. However, relatively little is known regarding the prevalence of FA among children and adolescents. An instrument designed to assess FA among youth, the Yale Food Addiction Scale for Children and Adolescents (YFAS-C), has been developed and used to estimate FA prevalence among pediatric populations. The present systematic review and meta-analysis aimed to synthesize the results of FA prevalence among youth. Using keywords related to FA and children to search PubMed, Embase, Scopus, and Web of Science, we identified and analyzed 22 cross-sectional studies. No longitudinal studies were identified in the search. Meta-analysis with Freeman-Tukey Double Arcsine transformation was conducted to estimate FA prevalence. Meta-regression was applied to understand whether weight status (i.e., data from community samples vs. overweight/obese samples) is associated with FA. Eligible studies (N = 22) were analyzed using 6,996 participants. The estimated FA prevalence was 15% (95% CI 11-19%) for all samples, 12% (95% CI 8-17%) for community samples, and 19% (95% CI 14-26%) for overweight/obese samples. Meta-regression indicated that weight status was associated with FA severity (p = 0.002) and marginally with FA prevalence (p = 0.056). Healthcare providers should consider and address the high FA prevalence among pediatric population.
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Affiliation(s)
- Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Badrooj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mac N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, Connecticut, USA.,Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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21
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Tahmasebi MN, Vaziri AS, Vosoughi F, Tahami M, Khalilizad M, Rabie H. Low post-arthroplasty infection rate is possible in developing countries: long-term experience of local vancomycin use in Iran. J Orthop Surg Res 2021; 16:199. [PMID: 33731164 PMCID: PMC7968172 DOI: 10.1186/s13018-021-02344-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 03/09/2021] [Indexed: 02/01/2023] Open
Abstract
Background Utilizing intrawound vancomycin powder in TKA surgery has yielded rather contrasting results in the current literature. Furthermore, CDC criteria, although effective in general, are not specifically designed for post-TKA infections. Here, we present a 7-year experience of vancomycin use in primary TKA in a high-volume tertiary knee center in Iran. Also, new criteria are proposed to detect suspected superficial post-TKA infections. Methods This is a retrospective analysis of primary total knee arthroplasties performed in a tertiary knee center, from March 2007 to December 2018, by a single senior knee surgeon. All patients with follow-up periods of less than 1 year were excluded from the study. Since March 2011, all patients received vancomycin (powder, 1 g) before water-tight closure of the joint capsule. A comparison was made between this group and historical control subjects (operated from March 2007 to March 2011). Results Altogether, 2024 patients were included in the study. The vancomycin and the control groups included 1710 and 314 cases respectively. Patients were mostly women (male to female ratio, 1 to 4), with a mean age of 65.20 (SD = 10.83) years. In the vancomycin group, the rate of suspected SII (1.87%) and PJI (0.41%) was significantly lower than the control group (P = 0.002). Conclusions Our experience shows that application of local vancomycin during TKA surgery could be a reasonable infection prevention measure, although prospective randomized studies are required to evaluate its efficacy.
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Affiliation(s)
- Mohammad Naghi Tahmasebi
- Knee, Sport and Reconstruction Surgery, Knee Surgery Fellowship Program, Orthopaedic Surgery Department, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Sharafat Vaziri
- Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Tahami
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopaedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Khalilizad
- Fellowship of Knee, Sport and Reconstruction Surgery, Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamid Rabie
- Department of Orthopaedic Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Mazandaran, Iran
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22
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Tahami M, Sharafat Vaziri A, Naghi Tahmasebi M, Vosoughi F, Khalilizad M, Safari R. Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature. jost 2021. [DOI: 10.18502/jost.v6i4.5567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Multi-ligament knee injury (MLKI) combined with a comminuted tibial tubercle avulsion fracture in the literature has been reported as a very rare condition. To the best of our knowledge, there was no case report of this condition associated with open proximal tibia fractures.
Case Report: A 32-year-old man was referred to our center, with a comminuted tibial tubercle fracture, patella alta, fracture of the tibia at the proximal meta-diaphyseal junction, a Segond fracture, and proximal tibiofibular dislocation on X-ray images. Further assessment of intra-articular pathologies was performed during the operation and complete tear of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tear were identified. Radial tear of the body and anterior root avulsion of medial meniscus were also noted. All of the extra-articular and intra-articular injuries were addressed surgically, except ACL and PCL tear, which were postponed to a second stage. Proximal tibiofibular dislocation was not approached surgically. The rehabilitation protocol included 6 weeks of non-weight-bearing followed by 6 weeks of crutch-assisted partial weight-bearing ambulation, and forbidden active knee extension during the first 6 weeks and allowing the patient to perform passive flexion of the knee to 90 degrees starting from the second week. Following the rehabilitation program, the patient achieved near-full range of motion (ROM) by the end of 6 months of clinical follow-up.
Conclusion: By means of our specific surgical technique and post-operative rehabilitation protocol, we led the patient with this specific condition to have fracture union and near-normal ROM by the end of 6 months.
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Zargarbashi R, Bozorgmanesh M, Panjavi B, Vosoughi F. The path to minimizing instability in developmental dysplasia of the hip: is Capsulorrhaphy a necessity or a futile habit? BMC Musculoskelet Disord 2021; 22:199. [PMID: 33596895 PMCID: PMC7890870 DOI: 10.1186/s12891-021-04065-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background To evaluate and quantify the intraoperative effect of capsulorrhaphy on the deep seating of femoral head within the acetabulum as measured by medial joint space, a surrogate measure of acetabular-head contact. Methods In order to determine the exact effect of capsulorrhaphy, we prospectively scrutinized a consecutive sample of 18 patients with unilateral dysplastic hips aging > 18 months and followed them for a period of at least 12 months. The procedure of open reduction is described in detail. Two pediatric orthopedists carried out the operations from August 2014 to January 2019 at a tertiary pediatric hospital. Intraoperatively, AP radiographs of the pelvis were obtained before and after capsulorrhaphy. The distance between the inferomedial edge of the proximal femoral metaphysis and the lateral edge of the obturator foramen was recorded. To determine if there were differences in medial joint space due to capsulorrhaphy, a generalized linear model was run on the study sample. All patients were followed for at least 12 months to determine the rate of re-dislocation. Results Mean age (±standard deviation) of the participants was 37.5 (±24.7) months. All cases underwent Salter osteotomy, 5 cases needed femoral shortening (27.8%) and none needed derotational osteotomy. Capsulorrhaphy lead to a statistically significant decrease in the mean medial joint space from 1.59 cm before (95% CI: 1.12–2.05) to 0.76 cm after (95% CI: 0.50–1.02) the capsulorrhaphy (P < 0.001). When we took the effect of age into account the corresponding figures were 1.47 (95% CI: 1.22–1.75) and 0.67 (95% CI: 0.39–0.94), respectively (P < 0.001). After follow up periods of 1 to 5.5 years, none of the patients experienced instability or re-dislocation. Conclusions Capsulorrhaphy, independently, of age was associated with a 1-cm decrease in the mean medial hip joint space and a more deeply seated femoral head. Furthermore, this study presents a successful experience with capsulorrhaphy to prevent hip instability.
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Affiliation(s)
- Ramin Zargarbashi
- Department of Pediatric Orthopedics, Children's Medical Center and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Bozorgmanesh
- Department of Orthopedic Surgery, Vali-e-Asr Hospital, Arak University of Medical Science, Arak, Iran
| | - Behnam Panjavi
- Department of Pediatric Orthopedics, Children's Medical Center and school of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Jalal Street, Shariati Hospital and school of medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Malekianzadeh B, Vosoughi F, Zargarbashi R. Orofaciodigital syndrome type II (Mohr syndrome): a case report. BMC Musculoskelet Disord 2020; 21:793. [PMID: 33256699 PMCID: PMC7702708 DOI: 10.1186/s12891-020-03825-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022] Open
Abstract
Background Orofacial digital syndrome is a rare genetic disorder with oral cavity, facial and digits anomalies. Orofacial digital syndrome type II, also called the “Mohr syndrome” is a very rare subtype that has been reported scarcely in Asia especially in Japanese patients. Case presentation The case is an Iranian 5-year old girl who had been admitted for orthopedic surgery. She surprisingly had pre and postaxial polydactyly of all the four limbs concurrent with syndromic face and most of the features of Orofaciodigital syndrome type II. Conclusion Mohr syndrome, anesthesia and surgical considerations are discussed in this case report. It is recommended to consider these considerations and the possibility of OFDS in every child with pre and postaxial polydactyly of the four limbs and to try to distinguish type II from other types of ODFS.
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Affiliation(s)
- Bita Malekianzadeh
- Anesthesiology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Zargarbashi
- Department of Pediatric Orthopedy, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. .,Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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Sharafatvaziri A, Shayan-Moghadam R, Tahmaseb MN, Tahami M, Vosoughi F. Comminuted Patellar Fracture: A Summary of the Latest Updates. jost 2020. [DOI: 10.18502/jost.v5i4.4379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The article's abstract is not available.
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Aghaghazvini L, Tahmasebi MN, Gerami R, Vaziri AS, Rasuli B, Tahami M, Vosoughi F. Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies. J Ultrasound 2020; 23:259-263. [PMID: 32524280 DOI: 10.1007/s40477-020-00488-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/29/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE MRI is now the modality of choice for evaluating articular cartilage. Nevertheless, it has some general drawbacks. Some patients cannot undergo MRI, and in others US scan could be the first examination and cartilage should be evaluated. Ultrasound could be a useful method for detecting trochlear cartilage low-grade lesions. In this study, our goal was to evaluate the efficacy of ultrasonography in detecting these lesions. METHODS All patients referred to our hospital, from July 2018 to July 2019, who were arthroscopic candidates due to sport-related pathologies, underwent ultrasound scan 1 day prior to surgery. Ultrasound assessment was performed by an expert radiologist, with a 13-MHz probe, located transversely proximal to the patella in different degrees of knee flexion to assess trochlear lesion grade and thickness. Arthroscopic examination of all patients was performed by an experienced orthopedic knee surgeon (second author). Sensitivity and specificity of ultrasound were calculated. RESULTS A total of 48 patients were involved in the study with a mean age of 33.2 years (SD: 9.7), between 19 and 51 years of age. Patients were 81% male (39 patients). The sensitivity of ultrasound in grading of trochlear cartilage lesion was 100%, meanwhile its specificity was 88.2% (30 cases had normal cartilage while this figure was 34 in arthroscopy). CONCLUSION Sonography is a low-cost, accessible diagnostic tool with high sensitivity and specificity for early detection of trochlear cartilage pathologies. It can play an important role as an outpatient diagnostic workup in patients with anterior knee pain.
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Affiliation(s)
- Leila Aghaghazvini
- Musculoskeletal Radiology, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naghi Tahmasebi
- Knee, Sport and Reconstruction Surgery, Chairman of Orthopaedic Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Gerami
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Sharafat Vaziri
- Knee, Sport and Reconstruction Surgery, Department of Orthopaedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Rasuli
- Department of Radiology, Jame-jam Imaging Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Tahami
- Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Jalal Street, Tehran, Iran.
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Saberi H, Vosoughi F, Derakhshanrad N, Yekaninejad M, Khan ZH, Kohan AH, Parvaneh S, Ghahari S, Agheli F, Vosoughi F. Development of Persian version of the Spinal Cord Independence Measure III assessed by interview: a psychometric study. Spinal Cord 2018; 56:980-986. [DOI: 10.1038/s41393-018-0160-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 11/09/2022]
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Sadeghi Fazel F, Derakhshanrad N, Yekaninejad MS, Vosoughi F, Derakhshanrad A, Saberi H. Predictive Value of Braden Risk Factors in Pressure Ulcers of Outpatients With Spinal Cord Injury. Acta Med Iran 2018; 56:56-61. [PMID: 29436796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 06/08/2023] Open
Abstract
Pressure Ulcers (PUs) remain among the most common complications after traumatic spinal cord Injuries (SCIs). The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI). Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients. This cross-sectional study was performed from June 2013 to December 2015 on 163 consecutive referred outpatients with chronic traumatic SCI in our tertiary SCI rehabilitation clinic. We assessed pressure induced skin injuries as well as their Braden risk factors and analyzed their association with stage and location of Pressure Ulcer (PU) and calculated prevalence of PU. One hundred and sixty-three patients out of 580 were found to have active pressure sores, with a prevalence of 28.1%. In the multiple models, only the Braden scale had significant association with the presence of active pressure sore. Patients with severe and moderate Braden scores were 2.36 and 1.82 times, more at risk of pressure sore development, as compared with those having mild scores (P≤0.01). It may be deduced that in various stages of SCI rehabilitation, the Braden scale may be calculated, and patients with moderate and severe risks (according to Braden sale) may need more attention and/or inpatient care for PU prevention.
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Affiliation(s)
- Fariba Sadeghi Fazel
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Health Management, Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Nazi Derakhshanrad
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardis Vosoughi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Asal Derakhshanrad
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooshang Saberi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Saberi H, Derakhshanrad N, Yekaninejad M, Vosoughi F, Davatgaran K. Epidemiology of Spinal Cord Injury in Iran: Discrepancy with International and Previous Institutional Reports. Neuroepidemiology 2015; 46:83. [PMID: 26684325 DOI: 10.1159/000442255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/05/2015] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hooshang Saberi
- Brain and Spinal Injuries Research Center (BASIR), Imam Khomeini Hospital, Tehran, Iran
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Derakhshanrad N, Vosoughi F, Yekaninejad MS, Moshayedi P, Saberi H. Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury. Spinal Cord 2015; 53:860-5. [DOI: 10.1038/sc.2015.136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/26/2015] [Accepted: 07/01/2015] [Indexed: 11/09/2022]
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