Showing 16 results for Joint
A A. khoshbaten, Wr Ferrell,
Volume 12, Issue 2 (8-1998)
Abstract
Previous in vitro work on rabbit knee joint vessels showed that vasoconstrictor
effects of nerve stimulation and administration of α-adrenoceptor agonists were
mediated predominantly by α1-adrenoceptors5,9 The present experiments were
performed to assess the nature of α-adrenoceptor subtypes within these blood
vessels in vivo. Dose/response relationships for adrenaline and noradrenaline
produced a similar pattern of increasing constriction of articular vessels with
increasing doses of drug. The u} agonist phenylephrine also produced dosedependent
constrictor responses which were diminished by prazosin. Using the α2
agonists clonidine and UK -14304,responses in vivo differed from those previously
observed in vitro. There was virtually no response to clonidine in vitro while
responses were obvious in vivo. Although UK-14304 was found to have small
effects in vitro, but only at high doses, this agent exerted more potent effects in
vivo, significantly greater than those obtained with phenylephrine. Responses to
the α2 agonists were not altered significantly by prazosin but were reduced by
rauwolscine. Following injection of UK -14304, the constrictor response to nerve
stimulation was reduced.
The results suggest that both α1 and α2 adrenoceptors are present
postjunctionally within articular blood vessels, and also that prejunctional α2
receptors are present which presumably regulate neurotransmitter release from
sympathetic nerve endings in the joint capsule.
A A. khoshbaten, Wr Ferrell, Wj Angerson, H Najafipour,
Volume 13, Issue 1 (5-1999)
Abstract
Experiments were carried out on anesthetized adult New Zealand rabbits. Acute joint inflammation was achieved by intra-articular injection of 2% carrageenan. Radiolabelled microspheres were used to measure the effect of acute inflammation on blood flow in the knee joint and establish whether neural influences on blood vessel caliber were affected. Surgical exposure of the posterior joint "capsule" increased blood flow in the control knee, but subsequent section of the posterior articular nerve (PAN) supplying the knee produced no further increase. In the inflamed knee, blood flow declined progressively with ea<.:h procedure. Electrical stimulation of PAN reduced blood flow in the posterior region of both knees, with somewhat less effects in the inflamed knee.
H Farahini, Gr Shah Husseini, Mj Shaterzadeh, I Ebrahimi Takamjani, Ms Ghasemi,
Volume 19, Issue 4 (2-2006)
Abstract
Background: The purpose of this study was to investigate the ratio of Electromyography
(EM G) activities of the vastus medialis obliqus (VMO) and vastus lateralis
(VL) within seven angles of knee joint range of motion using isometric contraction in
open kinetic chain (OK C) and closed kinetic chain (CKC).
Methods: The dominant knees of 44 healthy female subjects (mean age: 24.84
with range: 20-30 years old) were analyzed. Surface electrode pairs were attached
over the VMO and VL by using Basmajian methods. The EMG biofeedback data was
collected while the subject performed isometric contraction on isometric and squat
exercise within 7 degrees (0° to 90°) with 15° intervals of knee flexion angle.
Results: Paired T-test andANOVA were performed between variables. Results
demonstrated that in this study there are significant differences: I) between OKC and
CKC exercise in 0°, 15°, and 30° ofknee flexion, II) between all angles in CKC
except: 0-15°,0-30°, 0-45°, 15-30°, 60-75°, and 75-90°, and III) between 15-60°,
30-60°, 45-60°, and 60-90° in OKC (p
Ali Khorsandi,
Volume 21, Issue 2 (8-2007)
Abstract
Abstract
Two cases (20 and 15 years old) of shoulder joint synovial chondromatosis were initially treated with arthroscopic debridement. One was further treated with a second arthroscopy and partial synovectomy (case 1) the second was fully treated by arthroscopic surgery (case 2). The postoperative control X- ray revealed no loose body and the joint was normal. One of the cases (case 1) was affected by Degenerative Joint Disorders (DJD) according to X-ray and arthroscopic findings after treatment physiotherapy was started as soon as possible. The use of arthroscopic surgery allowed the patients to return to normal activity much sooner than a formal open synovectomy. Additionally, the morbidity associated with arthroscopic techniques is much lower than that of an open procedure. Synovial chondromatosis is a condition resulting from intrasynovial formation of multiple metaplastic cartilaginous foci. When these foci are enlarged, they become pedunculated and are extruded into the joint as loose bodies. Subsequently, these loose bodies calcify and ossify and continue to grow because they are nourished by the synovial fluid that surrounds them. Although synovial chondromatosis can affect most joints, it very rarely affects the shoulder joint.
Seyed Pezhman Madani, Mohammad Dadian, Keykavous Firouznia, Salah Alalawi, Ali Akbar Jafarian,
Volume 23, Issue 1 (5-2009)
Abstract
Abstract
Background: Sacroiliac joint (SIJ) dysfunction is a widely known but poorly defined
cause of low back pain. To our knowledge, few published studies have been
conducted to evaluate systematically the prevalence and significance of concomitant
sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant
SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive
interventions such as manipulation, improved understanding of the relationship
between these two diagnoses would improve clinical decision making and research.
Methods: This study was designated to estimate the prevalence of concomitant
sacroiliac joint dysfunction in sub acute low back pain patients with image proven
discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of
pain and functional disability in discopathy. A total of 202 patients with sub acute
radicular back pain and MRI proven herniated lumbar discs underwent standardized
physiatrist history and physical examination, specified for detection of concomitant
sacroiliac joint dysfunction.
Results: Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated
patients. There was significantly higher SIJ dysfunction prevalence in female
patients (p <0.001), patients with recurrent pain (p <0.005) and in patients with positive
straight leg raising provocative test (p <0.0001).
Conclusion: SIJ dysfunction is a significant pathogenic factor with high
possibility of occurrence in low back pain. Thus, in the presence of
radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of
intervertebral disc pathology, must be considered in clinical decision
making.
Hooman Shariatzadeh, Dawood Jafari, Hamid Taheri, Alireza Pahlevansabagh, Farid Najd-Mazhar, Ahmad Shakib Ghanizadeh,
Volume 23, Issue 1 (5-2009)
Abstract
Abstract
Background: The goal of this report is to show our results with extension block technique for treatment of mallet fracture. The indications for this technique were the presence of a large bone fragment, and palmar subluxation.
Methods: We retrospectively assessed the results of treatment in 14 mallet fractures
which have been treated by extension block technique to determine the range of motion in distal interphalangeal joint and associated complications.
Results: According to the Crawford criteria there were 6 excellent, 4 good and 4 fair
results. At an average follow-up period of 19 months, the average extension lag and the
average final active flexion of distal interphalangeal joint were 6° and 54° respectively.
Conclusion: We have found that this technique effective and minimally invasive and it
does not disrupt the remaining extensor mechanism. This technique requires percutaneous transarticular pin, which does not allow early joint mobilization and requires meticulous pin care with regular dressings. In our opinion, joint transfixation is probably the commonest reason for incomplete restoration of the joint range of motion.
Mahmoud Jabalameli, Mohammad Rahbar, Mehdi Ramezan Shirazi,
Volume 23, Issue 4 (2-2010)
Abstract
Abstract
Background: Different methods of surgical treatment for acromioclavicular(AC)
joint injury were considered in the literature. The purpose of the study was to compare intra- articular AC repair technique with the extra-articular coracoclavicular repair technique for the patients with Rockwood type III and VAC joint injury when indicated.
Methods: Nineteen consecutive patients with Rockwood type III and VAC joint injury
were treated with intra-articular (Group I - 12 cases) and extra-articular (Group II - 7
cases) repair technique between 1380 - 1386, and the results reviewed. When the diagnosis was established, the mean age of the patients was 32.5 years (Range, 18 - 60) group I and II 31.8 years (Range, 18 - 60) and 34 years (Range, 22 - 58) respectively. The mean duration of postoperative follow - up was 24 months. The Constant shoulder scoring system was applied to obtain clinical results.
Results: Only in group I, the post-surgical complication was associated with fiber allergy, wound infection and pin site infection in two patients respectively. No pain was detected in fourteen cases. Four patients in group I had occasional mild pain during sport activity, while one case in this group reported severe pain during resting which prevented the patient from activity. Also, there was an ossification in thirteen patients particularly in group I. Clinical results showed the mean constant shoulder score was 93.4 in group I and 97.1 in group II.
Conclusion: At the time of the follow - up, there was a clear difference between both
groups regarding to postoperative pain and discomfort. Therefore, it seemed that potential cause of pain was due to postoperative complications. An interesting postoperative complication without interfere in the functional outcome was coracoclavicular space ossification in most cases. This was probably because of soft tissue injury during the operation. It seemed that surgical treatment of Rockwood type III and VAC joint injuries when indicated had acceptable clinical results particularly if the extra-articular AC repair technique (screw fixation) was chosen. The new arthroscopic surgical technique with endobutton may decrease the rate of complications such as fracture site ossification and morbidity although more study in this field is required.
Afsun Nodehi Moghadam, Maryam Moghadam Salimee,
Volume 26, Issue 3 (8-2012)
Abstract
Background: Generalized joint hyper mobility predisposes some individuals to a wide variety of musculoskeletal complaints. Given the critical role of scapular position in function of shoulder, the aim of this study was to compare scapular position between persons with and without general joint hyper mobility. Methods: By nonprobability sampling 30 hyper mobile persons at average of 22.86 ±2.77 years of age and 30 non hyper mobile persons (age 23.6 ± 2.73years) through a case-control design participated in the study. Scapular position was assessed according to the lateral scapular slide test. Independent t test and repeated measures ANOVA were used to statistically analyze scapular position differences between groups.
Results: Compared to non hyper mobile persons, those with General joint hyper mobility demonstrated a significantly higher superior scapula slide in dependent arm position (p=0.03). However, no significant difference was found between another scores between two groups (p>0.05). Conclusion: The results suggest that altered scapular position may be an important aspect of General joint hyper mobility.
Mahmoud Jabalameli, Khodamorad Jamshidi, Mehran Radi, Hosseinali Hadi, Abolfazl Bagherifard,
Volume 28, Issue 1 (1-2014)
Abstract
Background :Pigmented villonodularsynovitis (PVNS) is characterized by the presence of inflammation and hemosiderin deposition in the synovium. Two forms of PVNS distinguished in the literature are diffused and localized involvements. There are controversies in the literature about the surgical management of PVNS. We report our experience in the management of knee PVNS at a mean follow-up of 4 years. We also introduce our preferred method of treatment for these patients.
Methods : A number of 26 patients (26 knees) with histologically proven PVNS of the knee in the pathology department at ShafaYahyaeyan hospital were identified between January 1996 and February 2012. Annual clinical follow-up was conducted in all patients and a follow-up MRI scans was ordered for symptomatic cases. All patients were examined according to the Knee Society Score (KSS) in which the knees were graded from excellent to poor.
Results : Mean age of the patients was 28.08±12.5. A number of 15 patients (58%) had diffused involvement of the knee joint and 11 (42%) had a localized form of involvement. Mean follow up was 4 years. The mean duration of symptoms prior to presentation was 44.40±38.69 months. In five cases (23%) subtotal synovectomy and in 21 cases (77%) total synovectomy was performed. Two cases (7.7%) had recurrence. In a comparison between new methods vs. routine methods, after adjusting the pre-operation KSS scores, there was a significant difference between both methods in their post-op results. There were no complications in the form of knee instability, infection or neurovascular injury.
Conclusion : The PVNS of knee joint especially the diffused form should be carefully observed and managed using appropriate investigations. Staged open total synovectomy with a posterior and then an anterior approach seems to be a superior method for surgical treatment of diffused forms.
Mehdi Adavi, Masoud Salehi, Masoud Roudbari,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Diabetes and hypertension are important non-communicable diseases and their prevalence is important for health authorities. The aim of this study was to determine the predictive precision of the bivariate Logistic Regression (LR) and Artificial Neutral Network (ANN) in concurrent diagnosis of diabetes and hypertension.
Methods: This cross-sectional study was performed with 12000 Iranian people in 2013 using stratified-cluster sampling. The research questionnaire included information on hypertension and diabetes and their risk factors. A perceptron ANN with two hidden layers was applied to data. To build a joint LR model and ANN, SAS 9.2 and Matlab software were used. The AUC was used to find the higher accurate model for predicting diabetes and hypertension.
Results: The variables of gender, type of cooking oil, physical activity, family history, age, passive smokers and obesity entered to the LR model and ANN. The odds ratios of affliction to both diabetes and hypertension is high in females, users of solid oil, with no physical activity, with positive family history, age of equal or higher than 55, passive smokers and those with obesity. The AUC for LR model and ANN were 0.78 (p=0.039) and 0.86 (p=0.046), respectively.
Conclusion: The best model for concurrent affliction to hypertension and diabetes is ANN which has higher accuracy than the bivariate LR model.
Ali Kazemi Karyani, Arash Rashidian, Ali Akbari Sari, Sara Emamgholipour Sefiddashti,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Nonmarket stated preferences valuation, especially discrete choice experiments (DCEs), is one of the commonly used techniques in the health sector. The primary purpose of this approach is to help select attributes and attributes-levels that are able to properly describe health care products or services. This study aimed at developing attributes and attributes-levels for basic health insurance system in Iran.
Methods: This study was conducted in 3 phases. First, narrative review was performed to identify related attributes. Also, 9 experts were interviewed to identify relevant attributes of health insurance in context. Other 36 experts rated the attributes and levels. Then, the research team decided on the inclusion of attributes and levels in the final design. The design was constructed using generic and D-efficient method with SAS 9.1. The design was divided into 3 blocks, each having 8 choice sets. Finally, the choice set was piloted with 45 participants.
Results: Public hospitals, and private hospitals benefits, dental insurance coverage, inpatient benefits, rehabilitation therapy, and paraclinical benefits, long-term care, medical devices benefits (Ortez, Protez, etc.), and monthly premium were identified and included in the final attribute design (D-efficiency = 98.16). The pilot study revealed that participants could easily understand and answer all the choice sets.
Conclusion: The results of our study indicated that health insurance service benefit packages and premium were among the most important attributes that need to be included in the final attribute design for Iranians. The policymakers and health insurance organizations should emphasize these attributes in the benefit packages to make improvements. The emphasis on these attributes can help elicit people’s preferences and willingness to pay for attributes.
Farid Najd Mazhar, Mohammad Reza Bahaeddini, Davod Jafari, Alireza Mirzaei,
Volume 33, Issue 1 (2-2019)
Abstract
Background: Hemi-hamate arthroplasty, a new attractive method for treatment of unstable Proximal Interphalangeal (PIP) joint fracture-dislocations, offers several advantages over the previous methods. This study was designed to evaluate the clinical and radiological outcome of this procedure.
Methods: In this study, 14 patients and 15 fingers with PIP joint fracture-dislocations were evaluated, including 8 acute and 7 chronic injuries. The mean age and follow-up of the patients were 35.3 years and 29.7 months, respectively. The mean PIP joint involvement was 56.6%. Objective assessment of the outcome was performed by joint alignment, motion, stability, and grip and pinch strength. Subjective evaluation of the outcome was performed using the Visual Analogue Scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Statistical analysis was performed using SPSS for Windows (version 16). Independent sample t test or Mann-Whitney U test were used for statistical comparison of the mean values. A p value of < 0.05 was considered significant.
Results: At the final follow-up, 14 out of 15 PIP joints were clinically stable. Grip and pinch strength of the injured hand averaged 87.6% and 88% of contralateral hand, respectively. The mean PIP joint flexion, arch of motion, and flexion contracture were 82.6, 63.6, and 19 degrees, respectively. The mean DASH score was 20.33±21.87 in acute and 7.25±11.71 in the chronic group (p=0.181). The mean VAS was 2.87±2.29 in acute versus 0.42±0.78 in chronic patients (p=0.022). The degenerative joint disease was observed in 5 cases.
Conclusion: Although hemi-hamate arthroplasty is a promising method for the reconstruction of severe PIP joint fracture-dislocations, it is associated with minimal functional limitation and high rate of osteoarthritis.
Khaled Rezaie, Ali Amiri, Esmaeil Ebrahimi Takamjani, Gholamreza Shirani, Saman Salehi, Leila Alizadeh,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Temporomandibular joint disorders (TMJDs) are the main musculoskeletal cause of orofacial pain. This study aimed to assess the efficacy of manual therapy and routine treatment compared with routine treatment on pain, maximum mouth opening (MMO), and cervical range of motion (ROM) in patients with the temporomandibular joint disorder (TMJD).
Methods: This study was performed at the biomechanics laboratory of the physiotherapy department of Iran University of Medical Sciences, Tehran, Iran. A total of 30 patients with TMJD were randomized into 2 groups: an intervention group (manual therapy plus routine treatment) and a control group (conventional treatment). Treatment included 10 sessions. The primary outcome was pain intensity and the secondary outcomes were MMO, and range of cervical flexion and extension. The outcomes were measured at the baseline, at the end of the treatment, and after a 4-week follow-up period. The repeated measures analysis of variance was used to assess group × time interaction, and the Bonferroni adjustment was used for between-group comparisons. The effects size of Cohen's d was used to determine the magnitude of between-group differences.
Results: The results showed that there were significant group × time interactions for pain, MMO, and the cervical flexion ROM (P<0.001). In comparion with the baseline, the intervention group showed significant improvements in jaw pain, MMO, and cervical flexion ROM (P<0.001), while in the control group, compared with the baseline, only pain and MMO significantly improved (P<0.05). Results of between-group comparisons revealed that there were significant and clinical differences between the 2 groups after treatment, and the intervention group had lower jaw pain, more MMO, and cervical flexion than the control group (P<0.001). In addition, the efficacy of manual therapy based on the Cohen's d was large for the outcomes of pain, MMO, and cervical flexion.
Conclusion: The findings showed that adding manual therapy of the upper cervical spine and TMJ to the routine treatment could be an effective intervention for patients with TMD.
Alireza Ghaznavi, Seyed Mani Mahdavi, Mehdi Moghtadaei, Nima Taheri, Ali Yeganeh, Amer Karimpour, Mohammad Soleimani,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Flatfoot is a relatively frequent deformity seen in almost 5% of children. It is classified into flexible and rigid flatfoot. Symptomatic flexible flatfoot (FFF) can be managed using several procedures, and calcaneostop is one of the procedures that has gained popularity recently. This study aimed to evaluate the outcome of the calcaneostop procedure using screws.
Methods: We retrospectively evaluated 57 feet in 44 consecutive patients with FFF undergoing calcaneostop surgery. The same pediatric orthopedic surgeon performed all surgeries. Following a 10-mm incision on the sinus tarsi, a partial thread 6.5 cancellous screw size 40 was inserted. Achilles tendon lengthening was performed on all patients, and a short leg cast was applied. Pain relief, complications, and the change in the talocalcaneal (Kite), talometatarsal (Meary’s), and calcaneal inclination (Pitch) angles were evaluated on plain radiographs using a paired t test.
Results: Pain relief was achieved in 55 (96.5%) cases, and 2 (3.5%) patients experienced pain after surgery. Other complications, including nerve damage, infection, screw loosening, fracture, or position loss, were not observed. The mean preoperative and postoperative Meary’s, Kite, and Pitch angles were 15.74 ± 2.02 (12.30-21.60), 8.72 ± 1.03 (7.20-10.60), 31.23 ± 1.97 (27.80-37.30), 21.30 ± 1.98 (18.50-24.60), 12.40 ± 1.64 (8.50-16.60), and 18.52 ± 1.97 (15.90-22.60), respectively. A significant improvement was observed in each angle following surgery (p<0.001).
Conclusion: Calcaneostop is an inexpensive and simple procedure that avoids the involvement of several joints and uses a simple incision leaving a small scar. This procedure is remarkably successful and can be quite convenient.
Ergali Nabiyev, Arnat Baizakov, Khadisha Kashikova, Ramazan Askerov, Zhassulan Argynbayev, Bauyrzhan Bissaliyev,
Volume 37, Issue 1 (2-2023)
Abstract
Background: This article presents a mathematical justification for a new approach to arthroscopic stitching of the knee joint meniscus, based on a 3D computer model of the meniscus developed using the COMPASS-3D (APMFEM) program and AutodeskInventorPRO. The research with the patent RK No. 35413 dated 10.12.2021, titled "Method of arthroscopic stitching of the meniscus of the knee joint" builds upon the work of Yu.V. Labunsky.
Methods: Mathematical analysis was performed to compare two methods of stitching the meniscus: the new oblique-vertical stitch and the classical vertical stitch. The contact area of the meniscus tissues in the area of the rupture was measured for both stitching methods.
Results: The findings demonstrate that the new oblique-vertical stitch offers a 1.5 times larger contact area of the meniscus tissues in the area of the rupture, compared to the classical vertical stitch. Additionally, the new method provides a more significant grip on the radial and circular fibers of the meniscus, surpassing the capabilities of the classic seam.
Conclusion: The results of this study can be utilized to develop practical recommendations for traumatologists regarding arthroscopic stitching of the meniscus in the knee joint. The new approach, supported by mathematical analysis and a 3D computer model, offers improved outcomes in terms of contact area and grip on the meniscus fibers, potentially leading to enhanced surgical techniques and patient outcomes.
Ergali Nabiyev, Arnat Baizakov, Khadisha Kashikova, Ramazan Askerov, Zhenisbek Baubekov, Zhassulan Argynbayev, Kuanysh Baikubesov,
Volume 37, Issue 1 (2-2023)
Abstract
Background: Meniscal injury is a common problem that can lead to knee pain and dysfunction. Meniscal repair and meniscectomy are two treatment approaches for meniscal injury, but the latter may increase the risk of osteoarthritis. We aimed to compare the 3-year outcomes of a new method of meniscal suturing with meniscectomy among patients with meniscal injury.
Methods: This retrospective cohort study compared meniscal repair (treatment group) and meniscectomy (control group) in patients with meniscal injury. We evaluated the outcomes of 134 patients. under treatment with these approaches based on the Lysholm scale, which measures knee function and symptoms. The study used the chi-square test and the Mann-Whitney U test to compare the proportion of patients with different outcomes and the Lysholm scale scores between the treatment and control groups. The study also conducted subgroup analyses based on gender and age using the Mann-Whitney U test. The level of significance was set at P < 0.05 for all statistical tests.
Results: The treatment group had a higher proportion of patients with excellent results, although the difference was not statistically significant (17.2% in the treatment group vs. 10.0% in the control group, P = 0.223). However, a comparative analysis of the proportion of patients with good results revealed statistically significant differences, with 67.2% of patients in the treatment group achieving good outcomes compared to 45.7% in the control group (χ2 = 6,256, df = 1 P = 0.012, HR 1,470 95%CI 1,081-1,999). The average score on the Lysholm scale was significantly higher in the treatment group (87.48, 95% CI 85.1-89.7, SD = 9.2) compared to the control group (81.73, 95% CI 78.4-84.9, SD = 13.7) (U = 1609, Z = -2.813, P = 0.005). Subgroup analyses based on gender and age also showed significant differences in the Lysholm scale scores.
Conclusion: The study demonstrates that meniscal repair is more effective than meniscectomy in improving patient outcomes, with a higher proportion of patients achieving excellent and good results and higher scores on the Lysholm scale. These findings support the use of meniscal repair as a preferred treatment approach for patients with meniscal injuries.
