Matrix metalloproteinase inhibitor-loaded extracellular matrix macromolecules enhance cartilage regeneration and inhibit degeneration in osteoarthritis.

Background: Osteoarthritis (OA) is a prevalent joint disorder, characterized by cartilage degradation driven by matrix metalloproteinases (MMPs) and dysregulated extracellular matrix (ECM) turnover. Biological macromolecules, such as ECM-derived scaffolds, offer therapeutic potential by mimicking native cartilage composition, yet their rapid enzymatic breakdown hampers regenerative potential. We hypothesized that embedding an MMP inhibitor within ECM could mitigate MMP-driven breakdown, thereby halting OA progression, while stabilizing ECM structure and boosting chondrogenesis.

Kinematically aligned total knee arthroplasty is as effective in severe varus deformities as in mild deformities.

Purpose: This study compares the clinical outcomes and radiological measures of kinematic alignment total knee arthroplasty (KA-TKA) in patients with severe knee deformities to those with mild varus.

Methods: This retrospective cohort study included 145 patients with <10° varus malalignment and 145 patients with >10° varus. All cases underwent KA-TKA performed by a single surgeon using the same techniques between 2015 and 2022.

One-Stage Primary Total Knee Arthroplasty as the Treatment of Acute Septic Arthritis of the Native Osteoarthritic Knee: Report of 3 Cases and Review of Literature.

We present three cases of acute septic arthritis in osteoarthritic knees managed with one-stage primary total knee arthroplasty and followed for 2 years. This approach, diverging from conventional staged protocols, combines thorough debridement, immediate biomechanical restoration, and extended antibiotic therapy. Patients exhibited significant symptomatic relief, functional recovery, and no recurrent infections.

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.

Ascorbic Acid Reduces the Blood Boss After Total Knee Arthroplasty: Insights From a Randomized Controlled Trial.

Background: Blood loss is among the main complications of total knee arthroplasty (TKA) and oxidative stress, and hemolysis caused by reactive oxygen species are one of the causes of hemoglobin (Hb) drop. Ascorbic acid is a potent antioxidant that can protect against reactive oxygen species. In this study, we aim to explore the antioxidant effect of ascorbic acid on blood loss and patient-reported outcomes following outpatient TKA.

Comparison of Functional Outcomes of Two Knee Arthroplasty Techniques (Total Knee Arthroplasty and Unicompartmental Knee Arthroplasty) for the Treatment of Osteoarthritis, simultaneously done in the Same Patients.

Objectives: This study aims to provide a comprehensive comparative analysis of functional outcomes between Unicompartmental Knee Arthroplasty (UKA) and Total Knee Arthroplasty (TKA) in patients diagnosed with bilateral knee osteoarthritis. Both procedures were performed simultaneously on separate knees to evaluate their respective efficacy.

Methods: The study included 25 patients (18 women and 7 men) with a mean age of 59.

Effect of Adding Stem Extension to a Short-Keeled Knee Implant on the Risk of Tibial Loosening: a Historical Cohort Study.

Background: Short-keeled tibial implants may be at higher risk of aseptic loosening. Stem augmentation has been suggested to improve its fixation. We aimed to assess whether this technique could decrease the loosening rate of such tibial implants.

Feasibility and acceptability of a telerehabilitation intervention on patients undergoing total knee arthroplasty in Iran: randomised controlled trial protocol.

Introduction: Telerehabilitation is a promising avenue to enhance post-total knee arthroplasty (TKA) rehabilitation by improving accessibility, convenience and cost-effectiveness. Despite its potential benefits, its application in the context of TKA in Iran is in its early stages, lacking comprehensive studies on feasibility, acceptance and programme adherence. This article outlines a protocol for an open-label, parallel-group, randomised controlled trial investigating the impact of a 4 week telerehabilitation programme alongside usual care.

Progressive Late-Onset Genu Recurvatum Post-Total Knee Arthroplasty: Insights from a Spinal Stenosis-Related Case Series.

Objectives: Knee osteoarthritis is common among older individuals, necessitating Total Knee Arthroplasty (TKA) for end-stage cases. The aging population has increased TKA demand, leading to a rise in revision surgeries. Genu recurvatum, a rare complication, often requires surgical intervention, with late-onset cases linked to neuromuscular conditions.

The Outcomes of Distraction Osteogenesis over an Intramedullary Nail for the Treatment of Bone Defects in Infectious Nonunions.

Objectives: The concurrent utilization of an external fixator and intramedullary nail (IMN) for segment transportation may potentially decrease the duration of external fixator implementation and reduce associated complications. This study aimed to report the outcomes of bone transport utilizing a combination of IMN and Ilizarov frame in a cohort of individuals who had tibia or femur critical-sized bone deficiency resulting from nonunion.

Methods: The present research used a single-arm clinical trial design to enroll a series of patients presenting with critical-sized bone defects resulting from infectious nonunion of the tibia or femur.

Kinematic Alignment Technique Outperforms Mechanical Alignment in Simultaneous Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial.

Background: The aim of this study was to compare the clinical results of kinematic alignment (KA) with those of mechanical alignment (MA) in single-stage bilateral total knee arthroplasty.

Methods: In this double-blinded randomized controlled trial, 65 patients who had bilateral knee osteoarthritis underwent simultaneous bilateral total knee arthroplasty. One knee was randomly selected to be operated on with the calipered-KA technique and the other with MA.

Evaluation of the Validity and Reliability of a Persian Version of the Forgotten Joint Score in Patients Undergoing Total Hip Arthroplasty.

Objectives: The increasing number of total hip arthroplasties (THA) has led to increased patient demands and expectations, making it crucial to assess patients' ability to "forget" their implants in daily life. This study aimed to determine the reliability and validity of a Persian version of the Forgotten Joint Score (P-FJS) in THA patients.

Methods: The questionnaire was translated bidirectionally with the permission of the questionnaire designer.

Is Posterior Cruciate Ligament Needle Pie-Crusting Safe and Effective in Balancing Cruciate-Retained Total Knee Arthroplasty? A Comparative Study.

Background: There is still debate over whether to sacrifice the posterior cruciate ligament (PCL) during total knee arthroplasty (TKA). Several studies reported the costs and benefits of each approach regarding technical difficulties in PCL balancing and postoperation complications. In this study, we aimed to evaluate PCL needling as a safe method for balancing the cruciate-retained TKA (CR-TKA).

A New Concept of Using Femoral Condyles Surface for Femoral Component Alignment During Total Knee Arthroplasty: A Technical Note.

Background: Orthopedic surgeons favor an intramedullary guiding system on the femoral component during total knee arthroplasty (TKA); nevertheless, improper positioning of the entry point affects the final alignment. We have designed a new femoral cutting system for TKA that uses the distal and posterior femoral condyles as reference points for the setting of the cutting system regardless of the femoral canal. This study aims to evaluate the outcomes of this new guiding system.

Prosthetic Joint Infection After Total Knee Arthroplasty: A Rare Case Report.

In this article, a 75-year-old patient with pain in left knee and restricted range of motion following total knee arthroplasty (TKA) is presented. Serological evaluation and aspiration of knee joint suggested a fungal prosthetic joint infection. After the diagnosis was confirmed, treatment started with antifungal drugs, removing prosthesis, exhaustive debridement, and revision of TKA after efficient antifungal treatment.

Osteogenic Differentiation Effect of BMP-9 with Phenamil and Simvastatin on Intact Human Amniotic Epithelial Stem Cells.

Background: Background: Bone tissue engineering has shown to be a promising strategy for repairing bone defects without causing harmful side effects to the patient. Three main building blocks of tissue engineering, including seeding cells, scaffold, and signaling molecules, are required for adequate bone regeneration. The human amniotic membrane (hAM) is the innermost of the placental membranes.

Recent advances on small molecules in osteogenic differentiation of stem cells and the underlying signaling pathways.

Bone-related diseases are major contributors to morbidity and mortality in elderly people and the current treatments result in insufficient healing and several complications. One of the promising areas of research for healing bone fractures and skeletal defects is regenerative medicine using stem cells. Differentiating stem cells using agents that shift cell development towards the preferred lineage requires activation of certain intracellular signaling pathways, many of which are known to induce osteogenesis during embryological stages.

Fixed-Bearing Posterior-Stabilized Implant versus Constrained Condylar Knee in One-Stage Bilateral Primary Arthroplasty of the Varus Knee: A Randomized Controlled Trial with Minimum 2-year Follow-Up.

Background: Severe varus deformity of the knee poses a technical challenge in balancing the flexion-extension gaps. The use of a varus-valgus constrained prosthesis is a solution to achieve coronal plane stability. The results of constrained condylar knee (CCK) implants in primary total knee arthroplasty are not well known.

Clinical Outcome Comparison between Staged -Bilateral Versus Simultaneous Bilateral Total Knee Replacements.

Background: This retrospective study aimed to compare the clinical outcomes of patients with staged and simultaneous bilateral total knee arthroplasty (TKA).

Methods: The present study included 100 patients with a mean age of 62±3.72 years from 2014 to 2017.

A Modified Technique for Artificial Fusion in Unreconstructable Revision Total Knee Arthroplasty.

Knee arthrodesis is an acceptable treatment that leads to a stable joint with a lower rate of recurrence of infection in periprosthetic joint infections. One of the major problems in some revision cases is the bone loss that interferes with the bony union; therefore, some studies suggest artificial arthrodesis, which does not require bony union. The present descriptive retrospective study was conducted by reviewing the medical records of patients with periprosthetic joint infection complications.

Closed K-wire Fixation for the Treatment of Perilunate Dislocation and Trans-Scaphoid Perilunate Fracture Dislocations without Ligamentous Repair: Short Term Follow-Up.

Background: The purpose of this study was to evaluate the treatment outcomes of perilunate dislocations (PLDs) and transscaphoid perilunate fracture dislocations (TSPLDs) treated with operative volar approach without ligament repair or reconstruction.

Methods: A total of seven patients (10 hands) were studied during 2017-2018. We fixed scaphoid fractures thorough a volar approach and 3 k-wires were inserted to stabilize the scaphoid to the adjacent bones.

Modified patellar side harvest technique for bone-patella, tendon-bone autograft anterior cruciate ligament reconstruction; a three-year prospective cohort.

Purpose: To introduce and discuss the outcome of a modified patellar side harvest technique.

Methods: This prospective cohort was conducted on patients with torn ACL who were eligible candidates for surgical intervention. Demographics and baseline characteristics were gathered for each patient.

Polymerase Chain Reaction Assay Using the Restriction Fragment Length Polymorphism Technique in the Detection of Prosthetic Joint Infections: A Multi-Centered Study.

Background: PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) techniques have been used for the diagnosis of bacteria in some infections. In this study, we aimed to evaluate the diagnostic accuracy of PCR for the diagnosis of prosthetic joint infections (PJI) and to identify isolated microorganisms, using the RFLP method.

Methods: During January 2015 to January 2018, patients who were suspected of having PJI after arthroplasty surgery or were candidates for revision surgery due to loosening of implant entered the study.

Acute Primary Total Knee Arthroplasty for Proximal Tibial Fractures in Elderly.

Background: Proximal tibial fractures in elderly patients with osteoporosis or knee osteoarthritis (OA) are challenging cases. In the current study, we present our experience with uncommon acute primary total knee arthroplasty (PTKA) in this patient population.

Methods: PTKAs were performed following proximal tibial fractures in 30 consecutive patients over 60 years of age with osteoporosis or knee OA between 2005 and 2009.