RESUMO
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
RESUMO
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