ABSTRACT
Hip ankylosis includes the limitation of hip motion and hip arthroplasty is the recommended treatment. This study aimed to evaluate the clinical and radiographic outcomes in the treatment of ankylosis hip joint by the Harris Hip Score [HHS]. This interventional study was performed on patients with ankylosis in one or both hip joints, who were referred to Sina Hospital, Tehran, Iran from 2011-13. Electromyogram and nerve conduction studies were taken from the hip abductor muscles before surgery and HHS was calculated. Type of surgery and prosthesis, osteotomy required for the neck and trochanteric region of the femur, periprosthetic fracture and the need to restore acetabular were studied in the patients. Postoperative complications such as infection and dislocation at 3, 6 and 12 months after surgery were examined and then the HHS was calculated. Seventy-seven patients [42 m/35 f] with a mean age of 36.71 +/- 11.78 years underwent total hip arthroplasty. Most causes of hip joint ankylosis in the patients were elderly osteoarthritis [20 cases] and avascular necrosis [13 cases]. Electromyogram and nerve conduction studies showed high and low velocity conduction in 12 and 65 patients, respectively. We used the posterior approach in 55 patients [71.4%] and lateral approach in 22 patients [28.6%]. Periprosthetic fracture occurred in two patients and 12 patients needed acetabular reconstruction. Standard prosthesis was used in 83.1% of patients. Six patients in month 6 and two patients in month 12 were excluded from the study due to surgery complications. The HHS mean of patients before surgery was 48.53 +/- 6.28 and it progressed to 88.22 +/- 3.78 in the month 12 [P<0.001]. Total hip arthroplasty for patients with ankylosed hip can improve the range of joint motion, especially in the long-term follow-up. However, good results should be considered in the absence of pre- and post-operative complications
ABSTRACT
Severe spondylolisthesis is related to high degenerative changes in vertebral spine. Degenerative spondylolisthesis often is seen with high-sacral slope. This study was conducted to investigate the relationship between high degenerative spondylolisthesis and sacral slope. A cross-sectional prospective study was done in patients with low back pain in Shafa Yahyaian and Sina University Hospitals in Tehran, in 18 months [April 2010-October 2011]. Intermittent or continuous low back pain for three months and history of two disable low back pain attacks since one year ago were inclusion criteria. Pregnant patients were excluded. Lumbar vertebra displacement to vertebra body size ratio was calculated in dynamic mode. The ratio higher than 8% was considered as a lumbar instability. Rotation angle more than 11 Degree was considered abnormal. In this study, 52 patients [30 men, 22 women] with 38.35 +/- 9.49 years old were enrolled. Mean body mass index was 23.01 +/- 4.59 kg/m[2]. Thirty cases had abnormal vertebral displacement. Angulation of the disc space more than 11 degrees was seen in 20 patients. No statistically significant difference in pelvic index between normal and abnormal lumbar vertebra displacement [P=0.443]. The mean pelvic index in normal and abnormal angulation groups were 55.97 Degree and 53.58 Degree, respectively; the difference was not statistically significant [P=0.556]. The results of the study showed disc degeneration had no association with sacral slope. High sacral slope can intensify spondylolisthesis but does not affect the incidence of degenerative spondylolisthesis. Additional research is required to find the other causes of degenerative spondylolisthesis
ABSTRACT
To compare the effectiveness of 5 different modalities, and determine the usefulness of recently proposed extensor grip test [EGT] in predicting the response to treatment. In a randomized controlled clinical trial, 92 of 98 tennis elbow patients in Sina Hospital Tehran, Iran between 2006 and 2007 fulfilled the trial entry criteria. Among these patients 56 [60.9%] had positive EGT result. The stratified EGT result, were randomly allocated to 5 treatment groups: brace, physiotherapy, brace plus physiotherapy, injection, and injection plus physiotherapy. Patients with a positive EGT result had better response to treatments. Among them, injection plus physiotherapy was the most successful, then brace plus physiotherapy, physiotherapy, and brace injection was the worst treatment modality. Response to treatment was comparable in all groups between EGT positive and negative patients except bracing, in which positive EGT was correlated with a dramatic response to treatment. In all patients, injection plus physiotherapy and then brace plus physiotherapy is recommended, but in EGT negatives, bracing seems to be of no use. Injection alone is not recommended in either group