Comparison of two skin closure techniques in open carpal tunnel release: a randomized controlled trial on postoperative pillar pain and scar quality.

Background: Pillar pain and scar-related discomfort are common complications following open carpal tunnel release (CTR). While surgical approaches have been widely studied, the influence of skin closure techniques on postoperative pillar pain remains unclear. This study aimed to compare the effect of two different skin closure methods, subcuticular absorbable monocryl sutures versus interrupted non-absorbable nylon sutures, on postoperative pillar pain and scar quality.

What is the best cutoff point of leukocyte esterase for diagnosis of periprosthetic joint infections? a systematic review and meta-analysis.

Background: Periprosthetic joint infection (PJI) is a significant complication following total joint arthroplasty that demands rapid, accurate diagnosis. The leukocyte esterase (LE) test shows promise, but studies vary in cut-off values and omit the centrifugation's effect. In this study, we assessed the sensitivity and specificity of the LE test across different cut-off values, both with and without centrifugation.

Can preoperative lower limb alignment angles predict necessary soft tissue release during total knee arthroplasty for varus knees? A retrospective cohort study.

Purpose: A proper balance of soft tissues is essential in total knee arthroplasty (TKA) for varus knees, but assessing soft tissue tension preoperatively is challenging. This study aimed to determine whether lower limb alignment angles can predict the necessary degree of soft tissue release.

Methods: A retrospective cohort study was conducted on 953 patients with varus knees (> 10°) who underwent primary TKA from 2018 to 2020.

Practice Trends in Primary Total Knee Arthroplasty among Members of the Iranian Society of Knee Surgery, Arthroscopy, and Sports Traumatology.

Objectives: The survey conducted at the 2024 biennial meeting of the Iranian Society of Knee Surgery, Arthroscopy, and Sports Traumatology (ISKAST) aimed to assess practice trends among ISKAST members in primary total knee arthroplasty (TKA), thereby providing a benchmark for future studies.

Methods: The session moderator presented multiple-choice questions via an audience response system to 94 registered ISKAST members. Responses were collected centrally and subsequently displayed to the audience after a brief interval.

Approach to Residual Anterolateral Rotatory Knee Instability After Anterior Cruciate Ligament Reconstruction.

» Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely regarded for its excellent results in restoring tibiofemoral anterior laxity to near-normal levels.» However, some operated patients may still experience anterolateral rotatory instability, leading to dissatisfaction and feelings of instability. After ruling out injuries to the posteromedial corner, lateral collateral ligament, and posterolateral corner, the focus should shift to the anterolateral ligament (ALL) and Kaplan fibers.

Distribution of phenotypes of coronal plane alignment of the knees and functional phenotypes in the healthy young Iranian population: A cross-sectional study.

Purpose: The functional phenotypes and the coronal plane alignment knee (CPAK) classification have recently been introduced. This study aimed to describe the phenotypes of normal knees in the healthy young Iranian population based on these systems.

Methods: This cross-sectional study included 402 knees in 201 healthy young adults.

Investigating Injuries to the Anterolateral Corner of the Knee: Imaging Insights Into Kaplan Fibers and the Anterolateral Ligament in Anterior Cruciate Ligament Tears.

Background: The intricate relationship between anterolateral ligament (ALL) and Kaplan fibers (KF) injuries in acute traumatic anterior cruciate ligament (ACL) tears presents a diagnostic challenge. Understanding these associations is crucial for enhancing therapeutic strategies and patient outcomes.

Purpose: To elucidate the prevalence of ALL and KF injuries among patients with acute ACL tears and examine their correlations with other imaging findings.

Arthroscopic Repair of the Medial Meniscal Root Tear: A Simple Surgical Technique.

Medial meniscal root tears pose significant challenges in orthopaedic practice, disrupting knee biomechanics and predisposing to degenerative changes. This article introduces an arthroscopic repair technique tailored for posterior root tears of the medial meniscus. The procedure involves meticulous preoperative evaluation, arthroscopic identification, and suture anchor fixation to restore normal knee mechanics.

Efficacy and Safety of Aspiration and Intra-Articular Injection of Tranexamic Acid in Acute Knee Hemarthrosis of Adult Haemophilic Patients: A Randomized Clinical Trial Study.

Introduction: Hemarthrosis, particularly in the knee, accounts for most bleeding episodes in haemophilia. While joint aspiration has proven effective, the role of intra-articular (IA) tranexamic acid (TXA) in managing acute hemarthrosis remains unexplored.

Aim: To assess the efficacy and safety of knee aspiration followed by IA TXA injection in acute haemophilic knee hemarthrosis.

Tenodesis in Flail Foot: A New Surgical Technique.

Flail foot is a condition characterized by a significant weakness in ankle dorsiflexion, resulting in limited or no active mobility in the ankle. To address this issue, we described a novel approach called tenodesis, which has been developed for ankle joint stabilization. This technique utilizes the patient's tendons to minimize potential complications.

Functional outcomes may vary over time after patellar tendon and knee intra-articular heterotopic ossification excision: A case report.

Introduction: Heterotopic ossification (HO) is the formation of mature bone in soft tissue, often occurring after fractures and trauma. Patients with HO experience pain, joint stiffness, and other complications. Treatment aims to improve function; surgical procedures have succeeded in 83.

A Half-century Experience of Running Journal Clubs and applying Interactive Teaching-learning Methods at Orthopedic Department of Tehran University of Medical Sciences.

Journal club is crucial in medical professions education, especially residency training. Critical evaluation allows learners to read, understand, and apply the evidence to bridge the gap between research and practice. Academic members of the Tehran University of Medical Sciences (TUMS) Orthopedic Department have held about 2,300 weekly sessions for around 50 years, even in times of crises, to review the latest publications in orthopedics and sometimes linked their journal clubs to hospitalized cases.

Does body mass index (BMI) significantly influence aseptic loosening in primary total knee arthroplasty? Insights from a long-term retrospective cohort study.

Background: Total knee arthroplasty (TKA) offers substantially improved function for patients with severe osteoarthritis, but long-term success can be overshadowed by aseptic loosening, a complication with a multifactorial etiology. This study aims to investigate the association between BMI and the rate of aseptic loosening and other complications in patients undergoing primary TKA.

Methods: This retrospective cohort study examined 354 TKA patients, evenly categorized by BMI (≤ 30 kg/m² and > 30 kg/m²).

Innovative Percutaneous Quadricepsplasty for Knee Extension Contracture in Arthrogryposis: A Case Report.

Case: A 15-year-old male patient diagnosed with arthrogryposis presented with a left knee extension contracture. He underwent an innovative percutaneous quadricepsplasty performed arthroscopically. Subsequent to the procedure, the patient was enrolled in an aggressive physiotherapy program.

Current Evidence Does Not Support the Use of Tibial Stem Extension in Total Knee Arthroplasty of Obese Patients: A Systematic Review.

Background: Obesity rates have been increasing globally, leading to a higher incidence of knee osteoarthritis and a surge in primary and revision total knee arthroplasty (TKA). The debate continues on the impact of obesity on TKA success, particularly regarding the use of stemmed tibial components in obese patients. This systematic review aimed to compare the effectiveness of stemmed tibial components versus standard keeled tibial components in obese patients undergoing TKA.

Biomechanical study of effect of tibial posteromedial defect depth and area on primary TKA implant stability.

Background: Medial tibial defects are common in patients who underwent primary total knee arthroplasty for varus deformity. Previous clinical studies have categorized tibial defects according to the depth of the defects and recommended different ways of addressing them. This study aimed to perform a biomechanical FE analysis to investigate the role of depth and surface area of the medial tibial plateau defects in the stability of the tibial component in primary TKA implants.

Vascular injury during lateral close-wedge distal femoral osteotomy: A case report and review of surgical principles.

Introduction: Knee malalignment can increase the risk of osteoarthritis. Osteotomies can correct limb deformities, but they come with the risk of complications such as cortical hinge fracture, hardware failure, pain syndrome, and infection. Vascular injury is rare, but it can lead to bleeding, limb ischemia, and swelling.

Simultaneous Tunnel Grafting and Anterior Cruciate Ligament Reconstructions Revision Using Double Suspensory Fixation: A Single-Stage Solution.

The anterior cruciate ligament (ACL) is often vulnerable to sports-related injuries, leading to numerous ACL reconstructions (ACLRs) annually in the United States. Although largely successful, these procedures face the risk of recurrent instability due to graft failure. ACLR failures are typically attributed to technical errors and patient-related factors, with improper positioning of the tibial and femoral tunnels as the most common technical mistake.

Arthroscopic ACL Avulsion Fixation With Adjustable Loop Length Cortical Endobutton.

Various surgical management techniques have been introduced to treat anterior cruciate ligament avulsion fractures. There is disagreement among orthopedic surgeons about which fixation device to use during arthroscopy. Recently, there has been an increase in the use of arthroscopic techniques for fixation, and different devices such as sutures, screws, and fiber wires are being considered.

Treatment of Simultaneous Femoral Supracondylar Nonunion and Tibial Plateau Malunion along with Stiff Knee in a Young Patient: A Case Report.

A 41-year-old man underwent Total Knee Arthroplasty with NexGen Legacy Constrained Condylar Knee (LCCK) system to treat his nonunion of distal femur, stiff knee, and malunion of tibia plateau. The treatment involved femoral and tibial stems and PS polyethylene. As a result, his knee range of motion improved, and he no longer experienced pain.

Distal Kaplan Fiber Tenodesis Surgical Technique.

Anterior cruciate ligament tears are a common knee injury, and even after reconstruction, some patients may still experience instability in their knee. To address this, extra-articular reinforcement may be necessary to prevent anterior translation and internal rotation of the tibia. Kaplan fibers (KFs), which are the attachments of the iliotibial band to the distal femur, can help improve anterolateral rotatory stability in the knee, especially in greater degrees of knee flexion.