Mehran Radi - Academia.edu (original) (raw)

Papers by Mehran Radi

Shafa Orthopedic Journal, May 10, 2014

Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament... more Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament reconstruction, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. From a consecutive case series of 1,283 patients who underwent arthroscopic anterior cruciate ligament reconstruction between January 1997 and May 2008, we report on 3 patients (0.23%) with post-operative septic arthritis. All patients had acute infection (ʺ 2 weeks), bacterial cultures showed Staphylococcus species in 2 patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side differences averaged 13 mm. Their performance in the single-legged hop test gave excellent results. The goals of treatment for septic arthritis after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.

European Journal of Orthopaedic Surgery and Traumatology, Mar 29, 2023

Tehran University Medical Journal TUMS Publications, 2013

High tibial open wedg osteotomy is one of the most important modality for treatment of varus defo... more High tibial open wedg osteotomy is one of the most important modality for treatment of varus deformity in order to correct deformity and improving signs and symptoms of patients with primary degenerative osteoarthritis. The aim of this study was to investigate the results of high tibial open wedge osteotomy in patients with varus deformities. Methods: This retrospective study conducted on twenty nine patients (36 knees) undergone proximal tibial osteotomy operation in Shafa Yahyaian University Hospital from 2004 to 2010. Inclusion criteria were: age less than 60 years, high physical activity, varus deformity and involvement of medical compartment of knee. Patients with obesity, smoking, patelofemoral pain, lateral compartment lesion, deformity degree more than 20 degree, extension limitation and range of motion less than 90 degree were excluded. The clinical and radiologic characteristics were measured before and after operation. Results: Fourteen patients were females. All of them were younger than 50 years, with mean (±SD) 27.64 (±10.88). The mean (±SD) of follow up time was 4.33 (±1.7). All the patients were satisfied with the results of operation. Tenderness and pain decreased in all of them. In all patients autologus bone graft were used, in 15 cases (42.5%) casting and in the rest T.Buttress plate were used for fixation of fractures. In both groups of primary and double varus the International knee documentation committee (IKDC) and modified Larson indices were improved after operation, but there was no significant difference between two groups. Conclusion: High tibial open wedge osteotomy can have satisfying results in clinical signs and symptoms of patients with primary medial joint degenerative osteoarthritis. This procedure also may correct the deformity and improves the radiologic parameters of the patients.

$Research paper thumbnail of Cortical 3.5-mm screws in tibial plateau fracture surgery$

Minerva Ortopedica e Traumatologica

AIM: The aim of this study was to assess functional and radiologic results of tibial plateau frac... more AIM: The aim of this study was to assess functional and radiologic results of tibial plateau fracture ORIF with subchondral cortical 3.5-mm raft screws compared with cancellous 6.5-mm screws. METHODS: Between 2007 to 2011 we have retrospectively reviewed functional and radiological outcomes of 48 treated tibial plateau fractures with ORIF in Shafa-Yahyaian Hospital. All fractures were classified according to Schatzker classification. There were two Schatzker type I, 25 type II, one type III, 10 type IV, 8 type V and two type VI. Complication rate including infection, deep vein thrombosis and skin breakdown was low. In 42 cases, in which subchondral rafting screws were used, two groups were identified: 25 cases of cancellous 6.5-mm and 17 cases of cortical 3.5-mm screws. Patients were followed for a mean of 24 months. RESULTS: Functional outcomes based on WOMAC Score, showed no difference between the two groups. At two-year follow-up, Ahlback Score was statistically different in the ...

Journal of the American Academy of Orthopaedic Surgeons, 2022

Stems are required during revision total knee arthroplasty to bypass damaged periarticular bone a... more Stems are required during revision total knee arthroplasty to bypass damaged periarticular bone and transfer stress to healthier diaphyseal bone. The mode of stem fixation, whether fully cemented or hybrid, remains controversial. Improvements in surgical technique and implant and instrument technology have improved our ability to deal with many of the challenges of revision total knee arthroplasty. Recent publications that reflect contemporary practice has prompted this review of literature covering the past 20 years to determine whether superiority of one fixation mode over the other can be demonstrated. We reviewed single studies of each type of fixation, studies directly comparing both types of fixation, systematic reviews, international registry data, and studies highlighting the pros and cons of each mode of stem fixation. Based on the available literature, we conclude that using both methods of fixation carries comparable outcomes with marginal superiority of the hybrid fixation method, which is of nonstatistical significance, although on an individual case basis, all fixation methods should be kept in mind and the appropriate method implemented when suitable.

Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a me... more Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: in-troducing a novel technique

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 1998

Medical Journal of The Islamic Republic of Iran, Oct 29, 2014

Pigmented villonodular synovitis (PVNS) is characterized by the presence of inflammation and hemo... more Pigmented villonodular synovitis (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. A number of 26 patients (26 knees) with histologically proven PVNS of the knee in the pathology department at Shafa Yahyaeyan 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. Mean age of the patients was 28.08±12.5. A number of 15 patients (58%) had diffused involvement of t...

Shafa Orthopedic Journal, 2013

Rotational positioning of femoral component is a critical aspect of total knee arthroplasty and e... more Rotational positioning of femoral component is a critical aspect of total knee arthroplasty and evaluation of the landmarks for rotation of distal femur is a challenge. Most orthopedic surgeons prefer to use more available posterior femoral condyle axis, but other landmarks especially surgical transepicondylar axis may be more valid. Preoperative CT scan can help to evaluate these landmarks more accurately. The purpose of our study was to ascertain the relationships among the described axes guiding distal femur rotational alignment in CT scan of Iranian healthy population and the effects of age and gender on these relationships. Methods: Ninety cases aged between 16 and 75 years presenting with acute tibial plateau or patella fracture were included in this study. The rotation of distal femur was evaluated using the single axial CT image through the femoral epicondyles. Four lines were drawn digitally in this view: anatomical & surgical transepicondylar axes, posterior condylar axis ...

High tibial osteotomy (HTO) is a well-established treatment option for uni-compartmental osteoart... more High tibial osteotomy (HTO) is a well-established treatment option for uni-compartmental osteoarthritis. Recently, medial opening wedge HTO has become the primary surgical technique. It is very important in a high tibial open wedge osteotomy to keep the slope unchanged in the sagittal plane. The purpose of this study is to introduce a quantitative method of open wedge HTO to preserve the tibial slope without considering the osteotomy line. At first, mathematical calculations were concentrated, and the relations, formulas and tables were extracted. The results of formulas and tables were examined using software on reconstruction CT scanning of two intact tibiae (Level of Evidence: V). Then the results of the calculations were tested on five real cadavers. Software results showed that the changes in slope angle using the simplified formulas and tables are less than 0.5° in both subjects. Based on the p-value, the simplified formula or the tables can be used to correct the varus with m...

Background: Total knee arthroplasty in patients with rheumatoid arthritis is associated with some... more Background: Total knee arthroplasty in patients with rheumatoid arthritis is associated with some problems, and yet is an effective method for management of knee ailments in these patients. The aim of this cross-sectional study was to evaluate the results of this procedure in a series of patients with rheumatoid arthritis. Methods: Fourteen patients (23 knees) with rheumatoid arthritis who underwent knee arthroplasty were recruited. Clinical and radiographic results including knee score and functional score, radiographic score, the amount of deformity correction, the length of recovery time and complications were evaluated. Results: All patients were female, with mean age of 64.8 years and were followed for an average of 50.3 months. Average knee range of motion had increased from 87 degrees to 108 degrees postoperatively (p=0.002). The mean knee and functional score were 93 (4.49 SD) and 73 (27.99 SD), respectively. None of the patients had radiographic signs of loosening. Conclusi...

Journal of Research in Rehabilitation Sciences, 2019

Introduction: We aimed to design a triple-blinded randomized clinical trial study to asssess the ... more Introduction: We aimed to design a triple-blinded randomized clinical trial study to asssess the effect of low-level laser (LLL) on pain and function in patients with patellofemoral pain syndrome (PFPS). Materials and Methods: This designed study will involve 60 patientswith PFP syndrome. Eligible subjects will be divided randomly into control (physical therapy), physical therapy plus active LLL, and physical therapy plus placebo laser. The physical therapy program will be exactly the same for all groups including exercise and education for ten sessions, every other day. The LLL group will receive 808 nm, 200 mW, 4 J Ga-Al-As laser over 5 points for 20 seconds per point. The laser will be deactivated in placebo group, and for the control group, the laser will not be used. The outcomes include pain and function, which will be measured using visual analogue scale (VAS), the Persian version of the Kujala patellofemoral questionnaire, and the step down test. Following Shapiro-Wilk test,...

Medical Journal of the Islamic Republic of Iran, 2014

Background: Pigmented villonodular synovitis (PVNS) is characterized by the presence of inflammat... more Background: Pigmented villonodular synovitis (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 Shafa Yahyaeyan 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%)...

The Journal of Arthroplasty

The Bone & Joint Journal

Aims Improvements in functional results and long-term survival are variable following conversion ... more Aims Improvements in functional results and long-term survival are variable following conversion of hip fusion to total hip arthroplasty (THA) and complications are high. The aim of the study was to analyze the clinical and functional results in patients who underwent conversion of hip fusion to THA using a consistent technique and uncemented implants. Methods A total of 39 hip fusion conversions to THA were undertaken in 38 patients by a single surgeon employing a consistent surgical technique and uncemented implants. Parameters assessed included Harris Hip Score (HHS) for function, range of motion (ROM), leg length discrepancy (LLD), satisfaction, and use of walking aid. Radiographs were reviewed for loosening, subsidence, and heterotopic ossification (HO). Postoperative complications and implant survival were assessed. Results At mean 12.2 years (2 to 24) follow-up, HHS improved from mean 34.2 (20.8 to 60.5) to 75 (53.6 to 94.0; p < 0.001). Mean postoperative ROM was flexion 7...

Shafa Orthopedic Journal

Traumatic bilateral patellar tendon rupture (BPTR) is a rare injury with low levels of clinical s... more Traumatic bilateral patellar tendon rupture (BPTR) is a rare injury with low levels of clinical suspicion, especially in young adults. Since early diagnosis of the BPTR is the cornerstone of a successful management, BPTR reports are valuable as they raise awareness of the careful clinical and radiologic workout in similar cases. Here, we present a case of BPTR in a 34-year-old male following a motorcycle accident. At the emergency department, the necessary examinations including clinical, physical, and radiologic tests were performed and BPTR was diagnosed accordingly. The patient underwent reconstruction surgery the day after the injury. At the last follow-up, the patient was able to perform active straight leg raise with 130°flexion and no extension lag. The superior results of BPTR reconstruction in this report further emphasize the importance of early diagnosis and repair of BPTR. Active straight leg raise test is necessary to perform for all patients with a history of an eccentric load of the knee extensor mechanism, and if positive, extensor mechanism rupture should be strongly suspected.