Amir Vosoughi - Academia.edu (original) (raw)

Papers by Amir Vosoughi

Osteoarthritis is common especially in over 50 years of age patients. There are several nonsurgic... more Osteoarthritis is common especially in over 50 years of age patients. There are several nonsurgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, osteotomy of tibia and arthroscopic débridement. Careful selection of patients in particular, for arthroscopic débridement is a very important point.

Revista Brasileira de Ortopedia (English Edition), 2016

Shiraz E Medical Journal, 2006

Iranian Journal of Orthopaedic Surgery, Jun 15, 2012

Pakistan journal of medical research

Background: The dominant role of percutaneous transluminal coronary angioplasty (PTCA), especiall... more Background: The dominant role of percutaneous transluminal coronary angioplasty (PTCA), especially with drug-eluting stent is obvious in alleviating symptoms and improving life quality of patients with coronary artery disease. Patients and Methods: We analyzed a total 2267 angioplasty cases (906 women, and 1361 men) in six public and private catheterization centers in Shiraz, from January 2006 to January 2007. Results: A) Pure old balloon angioplasties were performed only in 12 cases (0.52 %).B) Drug-eluting stents (53.7 %) were placed more frequently than Bare-metal stents (46.3 %). There was 13% increase in placing drug-eluting stent during 2005. C) Drug-eluting stents were used in 50.0 % and 54.9 % of patients in public and private hospitals, respectively. D) In Shiraz centers, Cypher model was used more often than other models (29.1 %). E) Single-vessel disease PTCAs were done in 65.5 % of patients followed by two (27.0 %), and three-vessel diseases (7.5 %). Conclusion: We recom...

Background: Meniscal injury is a major cause of functional impairment of the knee .Total meniscec... more Background: Meniscal injury is a major cause of functional impairment of the knee .Total meniscectomy was the treatment of choice for many years, but long-term results were not satisfactory. Nowadays, minimal partial meniscectomy performed arthroscopically, or meniscal repair when practical, have become the standard choice. Methods: One hundred and ten patients with stable knee and history of pain, giving way, and locking, which their MRI showed only medial meniscus tear were selected for partial meniscectomy. Evaluation included a patient radiological evaluation by Fairbanks classification for operated and non-operated knee, physical examination and Lysholm score before and 6, 18, 36 months after operation. Results: Only 87 patients (78 men, 9 women) were available for follow-up. Mean age for men was 27.8 years (18-53 years) and for women 36.9 years (22-50 years). Meniscus tear was bucket handle in 54%, flap in 10.4%, radial in 8%, and complex in 27.6% of cases. Mean Lysholm score ...

Revue de Chirurgie Orthopédique et Traumatologique, 2012

ABSTRACT SummaryBackground Prevention of arthrofibrosis by different drugs and surgical technique... more ABSTRACT SummaryBackground Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopedics. Hypothesis Intra-articular injection of bevacizumab can reduce arthrofibrosis on the rabbit's stifle joint model. Materials and methods Arthrofibrosis was induced in the right stifle joint of 30 males New Zealand white rabbits by removing the cortical bone of the medial femoral condyle under general anesthesia. The rabbits were randomly divided into three equal groups. The control group received intra-articular injection of saline; the one-injection group received a single dose of bevacizumab (2.5 mg/kg), and the two-injection group received two intra-articular injections the operation day and 14 days later. Forty-five days after surgery, animals were sacrificed. The severity of fibrosis was assessed based on the range of motion of the joint, a macroscopic adhesion score, and histopathologic variables such as the number of fibroblasts and of inflammatory cells, collagenous matrix deposition, synovial hyperplasia, granulation tissue formation, vascular proliferation, and presence of giant cells. Results Although no statistically significant differences were found between the range of motion (P = 0.222) and the macroscopic evaluation (P = 0.067) of the control group and the one-injection group, all microscopic variables regarding the prevention of arthrofibrosis were significantly superior in the one-injection group except granulation tissue (P = 0.347). Compared to the one-injection group, the two-injection group had better results not only in terms of macroscopic evaluation (P = 0.001 for range of motion and 0.012 for visual adhesion score) but also in most of the histopathologic variables especially the number of fibroblasts (P = 0.002), vascularity (P = 0.028) and collagenous matrix deposition (P = 0.039). Conclusion A single intra-articular injection of bevacizumab was effective for prevention of microscopically detected arthrofibrosis in the rabbit. Compared to single injection, two injections of bevacizumab improved the clinical outcome. Level of evidence Level II.

This report describes a rare intra-articular benign tumor, lipoma arborescens, ofthe knee joint i... more This report describes a rare intra-articular benign tumor, lipoma arborescens, ofthe knee joint in a 21 year-old female. The patient suffered from left knee joint swellingfor five years with occasional pain. Swelling was soft and boggy in the suprapatellararea. Motion of joint was complete. No abnormality was detected in any laboratorytests. MRI showed a large soft tissue density in the suprapatellar area with high signalintensity on T1 and T2 weighted images. Operative arthroscopy revealed a creamybrown hypertrophied synovium with diffuse papillary processes characterized byvillous proliferation of the synovium infiltrated by mature fat tissue, chronicinflammatory cells and vessels as seen in the pathologic slides. Lipoma arborescensor villous lipomatous proliferation of the synovial membrane should be distinguishedfrom other similar lipomatoid conditions such as synovial lipoma and Hoffa disease.Lipoma arborescens should be considered in patients with painless, slowly progressives...

Background: Over the past decade, several studies have revealed the role of high sensitivity C-re... more Background: Over the past decade, several studies have revealed the role of high sensitivity C-reactive protein (hs-CRP), an acute inflammatory marker, as a prognostic factor in the setting of myocardial infarction, predicting futurecardiac outcome of patients suffering from an acute coronary event. This study compares hs-CRP and low densitylipoprotein-cholesterol (LDL-C) in predicting degree of coronary stenosis in patients with chronic stable angina.Methods: One hundred and five patients with chronic stable angina undergoing angiography were evaluatedregarding known cardiovascular risk factors including age, sex, smoking habit, exercise, parental history of prematureCAD, history of diabetes mellitus, hyperlipidemia, and hypertension, total-cholesterol, LDL-C, HDL-C andtriglyceride. hs-CRP was measured by nephlometery and degree of coronary involvement was quantified byusing an angiographic scoring scale.Results: Results showed that hs-CRP was not correlated with angiographic score...

background: Femoroacetabular impingement leads to pain, limited joint motion and eventually osteo... more background: Femoroacetabular impingement leads to pain, limited joint motion and eventually osteoarthritis. The aim was to determine usefulness of different radiographic criteria to diagnose femoroacetabular impingement. Methods: Two hundred and fifty healthy-appeared persons were selected randomly for screening of hip pain and specific impingement tests. They categorized to three groups; group 0 included asymptomatic persons without positive impingement tests, group 1 persons were either asymptomatic with positive impingement tests or symptomatic with negative tests. Patients with painful hip and positive impingement tests belonged to group 2. Radiographic criteria including cross over sign, posterior wall sign, coxa profunda, acetabular protrusion, pistol grip deformity, center edge angle, extrusion index, offset ratio, alpha angle, herniation pits, and osteoarthritic changes were assessed in anteroposterior and cross-table lateral radiographs of all cases. Radiographic criteria w...

Devastating perilunate injuries are rare, compromising of less than 10% of wrist injuries. We rep... more Devastating perilunate injuries are rare, compromising of less than 10% of wrist injuries. We report a 19-year-old worker man who presented with left wrist pain and swelling after falling from a height. Not only the lunate was seen in middle third of forearm, but also proximal part of the scaphoid was in distal forearm. Open reduction and internal fixation was done via volar approach. He came back after two years with limited motion, pain, and weakness because of static scapholunate dissociation and osteonecrosis of lunate and proximal scaphoid. Despite optimal management, the prognosis of this injury is relatively poor especially if the initial trauma was severe.

MUSCULOSKELETAL SURGERY

Researches on the results of surgical treatment of thoracolumbar spine fractures are infrequent. ... more Researches on the results of surgical treatment of thoracolumbar spine fractures are infrequent. The aim of this study was to determine midterm outcomes of surgical treatment of these fractures in a prospective survey. A case series study on pediatric patients with the diagnosis of thoracic and/or lumbar vertebral fractures was conducted over a ten-year period. Surgically treated patients were evaluated in the follow-up period, based on back pain, independent function, neurological status, and radiographic indices. There were 102 pediatric individuals, 61 boys and 41 girls, aged 3-17 years (mean 12 years of age) with thoracic and/or lumbar spinal fractures. Motor vehicle accident was the most common mechanism of injury (45.0 %). L1 was the most frequent level of fractured vertebra (24.4 %), and pelvic fracture was the most common associated orthopedic injury (21.5 %). Totally, 20 patients underwent surgery, but only fifteen (14 boys and one girl) participated in follow-up (mean 49 m...

Journal of Orthopaedics and Traumatology, 2015

The position of immobilization after anterior shoulder dislocation has been a controversial topic... more The position of immobilization after anterior shoulder dislocation has been a controversial topic over the past decade. We compared the effect of post-reduction immobilization, whether external rotation or internal rotation, on coaptation of the torn labrum. Twenty patients aged <40 years with primary anterior shoulder dislocation without associated fractures were randomized to post-reduction external rotation immobilization (nine patients) or internal rotation (11 patients). After 3 weeks, magnetic resonance arthrography was performed. Displacement, separation, and opening angle parameters were assessed and analyzed. Separation (1.16 ± 1.11 vs 2.43 ± 1.17 mm), displacement (1.73 ± 1.64 vs 2.28 ± 1.36 mm), and opening angle (15.00 ± 15.84 vs 27.86 ± 14.74 °) in the externally rotated group were decreased in comparison to the internally rotated group. A statistically significant difference between groups was seen only for separation (p = 0.028); p values of displacement and opening angle were 0.354 and 0.099, respectively. External rotation immobilization after reduction of primary anterior shoulder dislocation could result in a decrease in anterior capsule detachment and labral reduction. Level 2.

Journal of orthopaedic surgery (Hong Kong), 2012

Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-... more Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-old woman who had bilateral subcapital femoral neck fractures during the 6th month of pregnancy. The diagnosis was made 4 days after delivery, because radiography was declined by the patient for fear of radiation. Fixation was not feasible owing to bone resorption, and 2-stage bipolar hemiarthroplasty was therefore performed. Magnetic resonance imaging is the best non-invasive investigative tool for pregnant women with hip pain. Early detection can prevent complications and resorting to major surgeries.

MUSCULOSKELETAL SURGERY, 2011

Operative procedures are the usual treatment for patients with anterior traumatic shoulder instab... more Operative procedures are the usual treatment for patients with anterior traumatic shoulder instabilities. Soft tissue procedures, Bankart repair, cannot be performed in some patients. They need Bristow-Latarjet one. We decided to determine midterm results of this procedure in almost all types of anterior shoulder instability, even shoulders with Bankart lesion in non-athletic cases. Thirty patients after Bristow-Latarjet procedure from 1997 to 2007 were followed 2-8 years. Clinical outcomes, consisted of muscle strength, range of motion (mean 8.66 degrees decreased in external rotation with arm in neutral position and 18.33 with arm in 90 degrees of abduction), recurrent instability (no relapse), and Rowe score (mean 77.66) showed good to excellent results. We had no screw-related or neurovascular complications. Thirty percent of cases had signs of mild arthropathy. Although Bankart procedure is the preferred method in patients with isolated Bankart lesion, but we can perform Bristow-Latarjet for all types of anterior traumatic shoulder instability in non-athletics cases with acceptable results.

Osteoarthritis is common especially in over 50 years of age patients. There are several nonsurgic... more Osteoarthritis is common especially in over 50 years of age patients. There are several nonsurgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, osteotomy of tibia and arthroscopic débridement. Careful selection of patients in particular, for arthroscopic débridement is a very important point.

Revista Brasileira de Ortopedia (English Edition), 2016

Shiraz E Medical Journal, 2006

Iranian Journal of Orthopaedic Surgery, Jun 15, 2012

Pakistan journal of medical research

Background: The dominant role of percutaneous transluminal coronary angioplasty (PTCA), especiall... more Background: The dominant role of percutaneous transluminal coronary angioplasty (PTCA), especially with drug-eluting stent is obvious in alleviating symptoms and improving life quality of patients with coronary artery disease. Patients and Methods: We analyzed a total 2267 angioplasty cases (906 women, and 1361 men) in six public and private catheterization centers in Shiraz, from January 2006 to January 2007. Results: A) Pure old balloon angioplasties were performed only in 12 cases (0.52 %).B) Drug-eluting stents (53.7 %) were placed more frequently than Bare-metal stents (46.3 %). There was 13% increase in placing drug-eluting stent during 2005. C) Drug-eluting stents were used in 50.0 % and 54.9 % of patients in public and private hospitals, respectively. D) In Shiraz centers, Cypher model was used more often than other models (29.1 %). E) Single-vessel disease PTCAs were done in 65.5 % of patients followed by two (27.0 %), and three-vessel diseases (7.5 %). Conclusion: We recom...

Background: Meniscal injury is a major cause of functional impairment of the knee .Total meniscec... more Background: Meniscal injury is a major cause of functional impairment of the knee .Total meniscectomy was the treatment of choice for many years, but long-term results were not satisfactory. Nowadays, minimal partial meniscectomy performed arthroscopically, or meniscal repair when practical, have become the standard choice. Methods: One hundred and ten patients with stable knee and history of pain, giving way, and locking, which their MRI showed only medial meniscus tear were selected for partial meniscectomy. Evaluation included a patient radiological evaluation by Fairbanks classification for operated and non-operated knee, physical examination and Lysholm score before and 6, 18, 36 months after operation. Results: Only 87 patients (78 men, 9 women) were available for follow-up. Mean age for men was 27.8 years (18-53 years) and for women 36.9 years (22-50 years). Meniscus tear was bucket handle in 54%, flap in 10.4%, radial in 8%, and complex in 27.6% of cases. Mean Lysholm score ...

Revue de Chirurgie Orthopédique et Traumatologique, 2012

ABSTRACT SummaryBackground Prevention of arthrofibrosis by different drugs and surgical technique... more ABSTRACT SummaryBackground Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopedics. Hypothesis Intra-articular injection of bevacizumab can reduce arthrofibrosis on the rabbit's stifle joint model. Materials and methods Arthrofibrosis was induced in the right stifle joint of 30 males New Zealand white rabbits by removing the cortical bone of the medial femoral condyle under general anesthesia. The rabbits were randomly divided into three equal groups. The control group received intra-articular injection of saline; the one-injection group received a single dose of bevacizumab (2.5 mg/kg), and the two-injection group received two intra-articular injections the operation day and 14 days later. Forty-five days after surgery, animals were sacrificed. The severity of fibrosis was assessed based on the range of motion of the joint, a macroscopic adhesion score, and histopathologic variables such as the number of fibroblasts and of inflammatory cells, collagenous matrix deposition, synovial hyperplasia, granulation tissue formation, vascular proliferation, and presence of giant cells. Results Although no statistically significant differences were found between the range of motion (P = 0.222) and the macroscopic evaluation (P = 0.067) of the control group and the one-injection group, all microscopic variables regarding the prevention of arthrofibrosis were significantly superior in the one-injection group except granulation tissue (P = 0.347). Compared to the one-injection group, the two-injection group had better results not only in terms of macroscopic evaluation (P = 0.001 for range of motion and 0.012 for visual adhesion score) but also in most of the histopathologic variables especially the number of fibroblasts (P = 0.002), vascularity (P = 0.028) and collagenous matrix deposition (P = 0.039). Conclusion A single intra-articular injection of bevacizumab was effective for prevention of microscopically detected arthrofibrosis in the rabbit. Compared to single injection, two injections of bevacizumab improved the clinical outcome. Level of evidence Level II.

This report describes a rare intra-articular benign tumor, lipoma arborescens, ofthe knee joint i... more This report describes a rare intra-articular benign tumor, lipoma arborescens, ofthe knee joint in a 21 year-old female. The patient suffered from left knee joint swellingfor five years with occasional pain. Swelling was soft and boggy in the suprapatellararea. Motion of joint was complete. No abnormality was detected in any laboratorytests. MRI showed a large soft tissue density in the suprapatellar area with high signalintensity on T1 and T2 weighted images. Operative arthroscopy revealed a creamybrown hypertrophied synovium with diffuse papillary processes characterized byvillous proliferation of the synovium infiltrated by mature fat tissue, chronicinflammatory cells and vessels as seen in the pathologic slides. Lipoma arborescensor villous lipomatous proliferation of the synovial membrane should be distinguishedfrom other similar lipomatoid conditions such as synovial lipoma and Hoffa disease.Lipoma arborescens should be considered in patients with painless, slowly progressives...

Background: Over the past decade, several studies have revealed the role of high sensitivity C-re... more Background: Over the past decade, several studies have revealed the role of high sensitivity C-reactive protein (hs-CRP), an acute inflammatory marker, as a prognostic factor in the setting of myocardial infarction, predicting futurecardiac outcome of patients suffering from an acute coronary event. This study compares hs-CRP and low densitylipoprotein-cholesterol (LDL-C) in predicting degree of coronary stenosis in patients with chronic stable angina.Methods: One hundred and five patients with chronic stable angina undergoing angiography were evaluatedregarding known cardiovascular risk factors including age, sex, smoking habit, exercise, parental history of prematureCAD, history of diabetes mellitus, hyperlipidemia, and hypertension, total-cholesterol, LDL-C, HDL-C andtriglyceride. hs-CRP was measured by nephlometery and degree of coronary involvement was quantified byusing an angiographic scoring scale.Results: Results showed that hs-CRP was not correlated with angiographic score...

background: Femoroacetabular impingement leads to pain, limited joint motion and eventually osteo... more background: Femoroacetabular impingement leads to pain, limited joint motion and eventually osteoarthritis. The aim was to determine usefulness of different radiographic criteria to diagnose femoroacetabular impingement. Methods: Two hundred and fifty healthy-appeared persons were selected randomly for screening of hip pain and specific impingement tests. They categorized to three groups; group 0 included asymptomatic persons without positive impingement tests, group 1 persons were either asymptomatic with positive impingement tests or symptomatic with negative tests. Patients with painful hip and positive impingement tests belonged to group 2. Radiographic criteria including cross over sign, posterior wall sign, coxa profunda, acetabular protrusion, pistol grip deformity, center edge angle, extrusion index, offset ratio, alpha angle, herniation pits, and osteoarthritic changes were assessed in anteroposterior and cross-table lateral radiographs of all cases. Radiographic criteria w...

Devastating perilunate injuries are rare, compromising of less than 10% of wrist injuries. We rep... more Devastating perilunate injuries are rare, compromising of less than 10% of wrist injuries. We report a 19-year-old worker man who presented with left wrist pain and swelling after falling from a height. Not only the lunate was seen in middle third of forearm, but also proximal part of the scaphoid was in distal forearm. Open reduction and internal fixation was done via volar approach. He came back after two years with limited motion, pain, and weakness because of static scapholunate dissociation and osteonecrosis of lunate and proximal scaphoid. Despite optimal management, the prognosis of this injury is relatively poor especially if the initial trauma was severe.

MUSCULOSKELETAL SURGERY

Researches on the results of surgical treatment of thoracolumbar spine fractures are infrequent. ... more Researches on the results of surgical treatment of thoracolumbar spine fractures are infrequent. The aim of this study was to determine midterm outcomes of surgical treatment of these fractures in a prospective survey. A case series study on pediatric patients with the diagnosis of thoracic and/or lumbar vertebral fractures was conducted over a ten-year period. Surgically treated patients were evaluated in the follow-up period, based on back pain, independent function, neurological status, and radiographic indices. There were 102 pediatric individuals, 61 boys and 41 girls, aged 3-17 years (mean 12 years of age) with thoracic and/or lumbar spinal fractures. Motor vehicle accident was the most common mechanism of injury (45.0 %). L1 was the most frequent level of fractured vertebra (24.4 %), and pelvic fracture was the most common associated orthopedic injury (21.5 %). Totally, 20 patients underwent surgery, but only fifteen (14 boys and one girl) participated in follow-up (mean 49 m...

Journal of Orthopaedics and Traumatology, 2015

The position of immobilization after anterior shoulder dislocation has been a controversial topic... more The position of immobilization after anterior shoulder dislocation has been a controversial topic over the past decade. We compared the effect of post-reduction immobilization, whether external rotation or internal rotation, on coaptation of the torn labrum. Twenty patients aged <40 years with primary anterior shoulder dislocation without associated fractures were randomized to post-reduction external rotation immobilization (nine patients) or internal rotation (11 patients). After 3 weeks, magnetic resonance arthrography was performed. Displacement, separation, and opening angle parameters were assessed and analyzed. Separation (1.16 ± 1.11 vs 2.43 ± 1.17 mm), displacement (1.73 ± 1.64 vs 2.28 ± 1.36 mm), and opening angle (15.00 ± 15.84 vs 27.86 ± 14.74 °) in the externally rotated group were decreased in comparison to the internally rotated group. A statistically significant difference between groups was seen only for separation (p = 0.028); p values of displacement and opening angle were 0.354 and 0.099, respectively. External rotation immobilization after reduction of primary anterior shoulder dislocation could result in a decrease in anterior capsule detachment and labral reduction. Level 2.

Journal of orthopaedic surgery (Hong Kong), 2012

Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-... more Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-old woman who had bilateral subcapital femoral neck fractures during the 6th month of pregnancy. The diagnosis was made 4 days after delivery, because radiography was declined by the patient for fear of radiation. Fixation was not feasible owing to bone resorption, and 2-stage bipolar hemiarthroplasty was therefore performed. Magnetic resonance imaging is the best non-invasive investigative tool for pregnant women with hip pain. Early detection can prevent complications and resorting to major surgeries.

MUSCULOSKELETAL SURGERY, 2011

Operative procedures are the usual treatment for patients with anterior traumatic shoulder instab... more Operative procedures are the usual treatment for patients with anterior traumatic shoulder instabilities. Soft tissue procedures, Bankart repair, cannot be performed in some patients. They need Bristow-Latarjet one. We decided to determine midterm results of this procedure in almost all types of anterior shoulder instability, even shoulders with Bankart lesion in non-athletic cases. Thirty patients after Bristow-Latarjet procedure from 1997 to 2007 were followed 2-8 years. Clinical outcomes, consisted of muscle strength, range of motion (mean 8.66 degrees decreased in external rotation with arm in neutral position and 18.33 with arm in 90 degrees of abduction), recurrent instability (no relapse), and Rowe score (mean 77.66) showed good to excellent results. We had no screw-related or neurovascular complications. Thirty percent of cases had signs of mild arthropathy. Although Bankart procedure is the preferred method in patients with isolated Bankart lesion, but we can perform Bristow-Latarjet for all types of anterior traumatic shoulder instability in non-athletics cases with acceptable results.