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Background Osteoarthritis (OA) is a degenerative disease commonly affecting the knee joints. It affects patients socially, psychologically and economically and rates of the disease have been increasing due to obesity and old age. Regardless of choosing a medically conservative approach, it is a challenge in the long term to provide OA patients efficient treatment with minimal side effects and long-term efficiency. Platelet-rich plasma (PRP) is a convenient, low-cost and affordable treatment technique used in treating knee OA with encouraging efficient and safe outcomes. In this study we will investigate the effect of PRP on knee OA. Methods This is a prospective cohort study involving 252 patients with different OA grades. The Kellgren and Lawrence (K&L) system was used in classifying the affected knee by degenerative cartilage lesions as well as early and severe OA. All patients with a diagnosis of knee OA were screened in every visit before the injection, the pain was assessed by the 0-10 Numeric Rating Scale (NRS), and knee range of motion including flexion and extension was assessed by goniometer. Follow-up appointments were done on three-month intervals for a total of three visits for evaluation. Injection of PRP was given to all the patients with a maximum of four injections. The results were evaluated statistically according to the total number of follow-up visits. Results In grade II patients, the pain improved with the visits and the maximum improvement in flexion degree was noticed in patients who came for a total of three follow-up visits. In grade III patients, the most improvement in pain was in patients who came for three follow-up visits, while the most improvement in flexion degree was in patients who came for a total of two follow-up visits. Patients with grade IV who came for three follow-up visits showed the most improvement in pain and degree of flexion. Conclusions Intra-articular injections gave significant pain and flexion improvement in grades II, III and IV in OA patients, especially with multiple injection in the short-term follow-up. As a result, recommendation of repeated multiple injections up to four times is efficient in providing long time relief in knee OA.
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Gout is one of the most common diseases affecting men globally due to the spread of unhealthy dietary habits, kidney disease, and the use of diuretics. It is characterized as having monosodium crystals depositions in the synovial fluid, which causes an inflammatory response and painful joints. Most of the time, it can be found affecting the first metatarsophalangeal joint or other large joints in concurrence with other disorders. Non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, and steroids have been known to suppress such events in most cases without the need for any surgical intervention. We present a case of a 44-years-old medically free healthy male who presented with a case of gouty arthritis in the second distal interphalangeal joint. Initially, colchicine treatment was given along with NSAIDs, but symptoms failed to subside. After a persistent increase of swelling and pain, the surgical evacuation was sought to reduce the pain and exclude any other causes of arthritis. Histopathology report confirmed the presence of monosodium urate crystals without any signs of infection. In conclusion, surgical intervention of gouty arthritis can be beneficial in cases of persistent pain and increasing rate of swelling despite the medicinal trial, especially in unusual cases of gouty arthritis such as gout of the second metatarsophalangeal joint.
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Purpose The purpose of this study was to study the association of anterior cruciate ligament (ACL) injury with meniscal, collateral ligament, and bone injuries using magnetic resonance imaging (MRI) for clinical correlation during ACL repair. Methods This was a retrospective cohort study conducted on 136 patients diagnosed with ACL injury by MRI at King Abdulaziz University Hospital (KAUH) between September 2010 and September 2018. Results The medial meniscus was injured in approximately half (49.3%) of patients, while the lateral meniscus was injured in 16.2%. Regarding collateral ligament injuries, the medial collateral ligament was injured in six patients (4.4%), the lateral collateral ligament in four patients (2.9%), and both collateral ligaments in three patients (2.2%). There was a significant relationship between the age group and the side of ACL injury (P<0.05) but not between the age group and the presence of an associated injury. Conclusion There was no significant relationship between ACL injury and menisci, collateral ligament, or bone injury.
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Objectives We investigated the relationship between acromial shape, classified as Type I-IV by magnetic resonance imaging, and the occurrence and characteristics of rotator cuff tears (RCTs). Methods This retrospective cohort study included 89 patients aged 25 - 60 years who underwent RCT surgeries in the Orthopedic Department at King Abdulaziz University Hospital (KAUH) from January 2014 to April 2019. We collected imaging findings from the KAUH record system, which were then entered into a Google form (Google, Inc., Mountain View, CA) and exported to Microsoft Excel 2016 (Microsoft® Corp., Redmond, WA). Correlations between variables were assessed using Chi-squared tests. Results The supraspinatus muscle in both men and women was most commonly affected by RCTs, accounting for 73.6% of all tears. Subscapularis was the next most commonly injured muscle of the rotator cuff (15.1%), followed by the infraspinatus muscle (11.3%). The majority of supraspinatus, infraspinatus, and subscapularis tears (69.2%, 66.7%, and 56.3%, respectively) were associated with flat acromia. In all cases, tears in association with flat acromia were more prevalent among women (supraspinatus: 51.3% in women, 17.9% in men, p = 0.030; infraspinatus: 50% in women, 16.7% in men, p = 0.292; subscapularis: 43.8% in women, 12.5% in men, p = 0.054). Conclusions No correlation exists between acromial shape and sex, regardless of the specific muscle injured. However, supraspinatus injury, acromial shape, and sex are significantly related; right-side partial tear injuries occur more frequently among women aged ≥ 50 years with flat acromia than other RCTs.
