Advances in Orthopedics

The incidence of anterior cruciate ligament reconstruction (ACLR) surgeries is increasing and graft choice is important for a rapid return to activity, especially in patients older than 30 years. The aim of this study is to compare in term of quality of life and knee stability of patients who undergone ACLR using quadrupled semitendinosus (ST4) graft against patients who undergone ACLR with synthetic ligaments. Thirty-nine patients undergoing ACLR were enrolled in the study and were divided into two groups: ACLR with synthetic ligaments-LARS (group A) and ACLR with quadrupled semitendinosus graft ST4 (group B)...

BACKGROUND: The increasing number of canceled operations in patients undergoing total knee arthroplasty (TKA) due to high blood pressure readings has put a considerable burden on surgeons. In this study, we aim to assess the effect of giving antianxiety drugs preoperatively on maintaining blood pressure (BP) and blood loss for patients undergoing TKA surgery. METHODS: This retrospective case-control study included patients who underwent total knee arthroplasty and divided them into two main groups: those who had taken a 3 mg bromazepam oral tablet at the night preoperatively and the control group...

INTRODUCTION: The peroneus longus tendon is used in many orthopedic surgeries to regenerate the external ligaments of the knee. This study aims to evaluate some anatomical, biomechanical, and load-bearing properties of the peroneus longus tendon for use in cruciate ligament reconstruction. MATERIALS AND METHODS: The study design is a cross-sectional description. The study subjects were 20 samples of the peroneus longus tendon from fresh carcasses. The leg is still intact, not crushed, is well preserved, and it has never been used in research...

BACKGROUND: Early and proper screening for developmental dysplasia of the hip (DDH) is very critical to prevent catastrophic complication on the developing hip joint. Many factors (either maternal or child-related) that hinder timely DDH screening have been previously investigated. METHODS: A cross-sectional descriptive study design was adopted. 175 babies presented for DDH screening coming with their mothers were investigated. Maternal age, age group, and educational level were recorded...

BACKGROUND: Comminuted tibial pilon fractures are induced by high-energy mechanisms and are often associated with soft tissue injuries. Their surgical approach is problematic due to postoperative complications. Minimally invasive management of these fractures has a considerable advantage in preserving the soft tissue and the fracture hematoma. MATERIALS AND METHODS: We conducted a retrospective study of a series of 28 cases treated at the Orthopedic and Traumatological Surgery Department of the CHU Ibn Sina in Rabat over a period of 3 years and 9 months, from January 2018 to September 2022...

BACKGROUND: Percutaneous rupture of lumbar facet cysts (LFC) is the only nonsurgical treatment which is effective in directly reducing cysts. However, this is not yet a common procedure, and its effectiveness, including the associated complications, remains unclear. Therefore, this study aimed to evaluate the clinical outcomes of percutaneous rupture for LFC and elucidate whether this minimally invasive procedure could become an alternative to surgeries for cases resistant to conservative treatments...

BACKGROUND: Knee osteoarthritis is a common disease with increasing incidence and prevalence in western countries. It can cause severe pain and functional limitations, thereby representing a threat for patients' quality of life and a burden for national health systems. Intra-articular injections with hyaluronic acid (HA) and platelet-rich plasma (PRP) have been used for decades in order to reduce the symptoms caused by osteoarthritis. In recent years, a combination of HA and PRP has been introduced in clinical practice with the aim to minimize the clinical presentation of osteoarthritis and potentially delay articular degeneration...

While most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clinical or radiological union complications. The secondary aims were to assess supplementation effect on patient functional outcome scores and bone mineral density (BMD). A systematic search of all relevant articles was performed using the following databases: MEDLINE, Embase, Google Scholar, and Web of Science...

INTRODUCTION: This study aimed to compare the effect of intrathecal bupivacaine plus dextrose 5% and fentanyl with bupivacaine alone on the onset and duration of analgesia in patients undergoing lower-limb orthopedic surgery. MATERIALS AND METHODS: A total of 40 patients eligible for lower-limb surgery were divided into two groups by simple randomization: the control group which received only bupivacaine and the intervention group which received bupivacaine plus dextrose 5% and fentanyl...

INTRODUCTION: As surgical site infections (SSIs) after joint arthroplasty contribute to increased morbidity and mortality, they require further surgical intervention, prolonged hospitalisation, and antimicrobial treatment. The aim of our study is to examine the association between preoperative quality of life (QoL) and other predictive factors on the development of SSIs after primary arthroplasty. METHODS: This is a prospective study that enrolled 56 patients with hip and knee primary osteoarthritis who underwent joint replacement...

BACKGROUND: Simple bone cysts are benign bony lesions. Treatment strategies are varied for this particular pathology. It remains controversial as to what the ideal treatment strategy is. Recently, bony substitute injections have emerged as a potential option for treatment. This paper aimed to describe our institution's experience in using bony substitute injections to treat unicameral bone cysts. METHODS: A retrospective review of consecutive patients over an 84-month period at a tertiary paediatric hospital was performed...

INTRODUCTION: Sacroiliitis is an inflammation of one or both of the sacroiliac (SI) joints, most often resulting pain in the lower back that can extend down the legs. Pain arising from the SI joint can be difficult to diagnose and treat due to the intricate surrounding ligamentous structure, nerve innervation, and its role in transferring weight from the upper body to the lower limbs. SI joint dysfunction accounts for up to 25% of cases of lower back pain and has a debilitating effect on patient functionality...

INTRODUCTION: The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial patellofemoral ligament reconstruction, tibial tuberosity transfer (TTT), trochleoplasty, and tibial derotation osteotomy (TDO). The purpose of this systematic review is to investigate the safety and efficacy of TDO for PF instability and pain...

BACKGROUND: Topical tranexamic acid (TXA) has been widely used to reduce postoperative blood loss following total knee replacement (TKA). This study aimed to evaluate the effect of combined intramedullary, periarticular injection, and intraarticular TXA application in patients who underwent TKA as compared to those who did not. METHODS: This was a retrospective case-matched study of 111 patients. We evaluated the transfusion rate and postoperative drainage of 56 patients who underwent TKA using combined topical tranexamic acid application (directly pushed into the femoral intramedullary canal and tibia base, with periarticular soft tissue injection and injected into the knee cavity via a drain tube) and the control group of 55 patients...

INTRODUCTION: The objective of this study is to compare the effectiveness of the clavicular hook plate (HP) technique and the minimally invasive coracoclavicular (CC) fixation with a TightRope (MITR) procedure in treating acute unstable distal clavicle dislocation. METHOD: MITR (minimally invasive TightRope) group had 21 patients, and the open reduction and internal fixation (HP) group included 23 patients. Researchers compared MITR and HP (hook plate) outcomes for the treatment of acute type III AC joint dislocation in a retrospective analysis...

BACKGROUND: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are associated with moderate to severe postoperative pain (POP). POP is theoretically predictable and may be influenced by sociocultural differences. This study aimed to identify the relationship between POP and the sociocultural level of the patient undergoing THA or TKA. METHODS: Prospective study, involving informed-consenting adults conducted through consulting patient's clinical processes, preoperative and postoperative questionnaires...

BACKGROUND: Slipped capital femoral epiphysis (SCFE) remains among the most common hip disorders in the adolescent population. The management of SCFE remains controversial; however, the aim of fixation is to stabilize the physis and prevent further slippage. In situ fixation remains the gold standard; however, in the young population, it can lead to reduced femoral neck growth and complications such as leg length discrepancies. The ideal form of in situ fixation for mild to moderate SCFE would stabilize the slip and allow continued proximal femoral growth...

PURPOSE: The purpose is to evaluate knee preference and functional outcomes of patients with primary anterior cruciate ligament (ACL) repair in one knee and ACL reconstruction in the contralateral side. METHODS: All patients who underwent both procedures were retrospectively reviewed at minimum two-year follow-up. Patients were asked to complete questionnaires regarding their operated knees' preferences during rehabilitation, daily activities, sports activities, and overall function...

BACKGROUND: This study investigates the effect of injury mechanism and energy on fracture patterns and distributions. Also, it compares differences in bone fracture patterns based on injury mechanism, gender, and age. METHODS: Three thousand and sixty-six admitted patients with bone fractures were reviewed retrospectively, and the fractures were analyzed regarding age, gender, and mechanism of injury. Fractures were located in eleven bones. However, the forearm, hand, leg, and foot were considered one bone, and the fracture was then subclassified according to the anatomic position within each bone...

Background: Sciatica is a relatively common condition, with a lifetime incidence varying from 13% to 40%. The corresponding annual incidence of an episode of sciatica ranges from 1% to 5%. The exact cause of sciatica is unknown to this day; treatment methods and practices differ between individuals based on their cultural background, socioeconomic status, and religious beliefs. This study aimed to assess the knowledge and attitude toward sciatica pain among adults in Saudi Arabia. Methods: A cross-sectional study was conducted among the adult population in Saudi Arabia...