siti tahir - Academia.edu (original) (raw)

Papers by siti tahir

Clinical Orthopaedics & Related Research, 2009

Surgery Journal, 2018

Please read proofs carefully for typographical and factual errors only; mark corrections in the m... more Please read proofs carefully for typographical and factual errors only; mark corrections in the margins of the proofs in blue or black pen, or use Adobe Acrobat tools to mark the changes in the PDF file directly. Please be sure to write as clearly as possible so no errors are introduced into your article. Answer (on the proofs) all author queries marked in the margins of the proofs. Check references for accuracy. Please check on the 1st page of your article that your titles and affiliations are correct. Avoid elective changes, because these are costly and time consuming and will be made at the publisher's discretion. 2) Please pay particular attention to the proper placement of figures, tables, and legends. Please provide copies of any formal letters of permission that you have obtained. 3) As a contributor to this journal you will receive a complimentary PDF file of the article after publication.

International journal of science and research, 2021

Arthroscopic ACL avulsion fracture fixation has gained popularity in recent years, but there is n... more Arthroscopic ACL avulsion fracture fixation has gained popularity in recent years, but there is no consensus on which method of fixation works best. The aim of this study is to evaluate the clinical outcome of the arthroscopic reduction and pull-out suture technique in displaced ACL avulsion fractures. This was a cross-sectional study conducted in two institutions from March 2015 to January 2019. A total number of 13 patients who met the inclusion criteria were enrolled in the study. From our study, all patients achieved overall good postoperative functional outcomes. Hence, ACL avulsion fractures can be effectively treated with arthroscopic pull-out suture fixation.

International journal of science and research, 2020

Acromioclavicular joint injuries are common cause for shoulder pain among young adults and athlet... more Acromioclavicular joint injuries are common cause for shoulder pain among young adults and athletes. There are shift of interest towards anatomical ACJ reconstruction recently owing to perceived biomechanical and clinical advantages. Yet, double tunnels in coracoid process resulting in more complications especially iatrogenic fracture. Arthroscopic and radiographic measurements of base of coracoid process in 42 patients who underwent arthroscopic ACJ reconstruction was obtained. The mean length was then compared to each other and with patient's demographic data (age, gender, ethnicity and BMI). The data were also compared to previously published studies. The mean arthroscopic measurement of coracoid base width was 19.21±1.38mm. There was significant difference between arthroscopic and radiographic measurement, with the latter having wider length, 22.30±1.48mm. Male subjects were found to have wider coracoid base width as compared to female subjects. There was no significant difference observed in between ethnicity groups and no association found in between age and BMI with regards to coracoid base width. The mean coracoid base width in Malaysian population is smaller as compared to previous studies performed on Caucasian populations. Given the potentially narrower coracoid base width of the Malaysian population, extra precautions are required to minimize the risk of iatrogenic coracoid fractures.

Clinical Orthopaedic and Related Research, 2009

Biomechanical studies suggest a suture bridge technique enhances rotator cuff tendon footprint co... more Biomechanical studies suggest a suture bridge technique enhances rotator cuff tendon footprint contact area, holding strength, and mean contact pressure. Based on these studies, we asked whether (1) the suture bridge technique would provide a high rate of cuff integrity after surgery, (2) the status of the repaired cuff would change with time, (3) preoperative factors could predict postoperative cuff integrity, and (4) patients with retears had less favorable pain, functional scores, range of motion (ROM), and muscle strength compared with those with intact repairs. We prospectively followed 78 patients with arthroscopic repairs in whom we used the suture bridge technique. The integrity of the rotator cuff repair was determined using ultrasonographic evaluation at 4.5 and 12 months after surgery. Ultrasonography revealed intact cuffs in 91% at 4.5 months postoperatively, all of which were maintained at the 12-month followup. Failure rates were 17.6% (three of 17) for massive tears, 11.1% (two of 18) for large tears, 6.3% (two of 32) for medium tears, and no failures for small tears. Preoperative fatty degeneration of the supraspinatus muscle was a strong predictor of cuff integrity. We found no correlation between the integrity and clinical outcomes except for a temporary decrease of abduction strength at 6 months. Arthroscopic repair using suture bridge technique can achieve a low retear rate in shoulders treated for rotator cuff tears, but the occurrence of retear did not influence the outcome. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Journal of Shoulder and Elbow Surgery, 2010

Purpose: Our aim was to verify the association of fullness over the skin distal to anterior acrom... more Purpose: Our aim was to verify the association of fullness over the skin distal to anterior acromion termed ''ballooning'' in relation to accuracy of subacromial injection and determine its accuracy in terms of sensitivity, specificity, and predictive value. We hypothesized that a positive ballooning was a sign of an accurately placed injection into the subacromial bursa. Methods: Data of 136 shoulders with impingement, which received subacromial steroid injections, were evaluated for presence of ballooning signs, pain, motion, and muscle strength. Injections were performed via anterolateral approach, followed by radiographs to locate the contrast. Data were compared between pre-and post-injections as well as between accurate and inaccurate groups to evaluate the correlations between targeting accuracy and immediate outcomes. Results: Ballooning signs were positive in 104 shoulders (76.5%), of which majority were inaccurate (58.7%). The accuracy rate was 49.3% with sensitivity of 64.2%, specificity 11.6% and positive as well as negative predictive values of 41.3% and 25% consecutively. Dispersal rate to the surrounding structures was 86.6% with majority infiltrated the deltoid (29.4%). Significant improvement was noted between pre-and postinjections in all parameters except muscle strength, indicating equal pain relief regardless of locations. Conclusion: The ballooning sign is not a reliable indicator for or against subacromial injection. Blind subacromial injections are frequently inaccurate using the anterolateral approach. Nevertheless, immediate improvement of pain, motion, and muscle strength can be expected regardless of location.

La Clinica terapeutica, 2014

To evaluate the functional outcomes of a delayed (>6 months post-injury) and combined reconstr... more To evaluate the functional outcomes of a delayed (>6 months post-injury) and combined reconstruction of grade III posterior cruciate ligament (PCL) and grade III posterolateral corner (PLC) deficiencies. Between March 2006 and October 2009, a delayed surgery consisting of arthroscopically-assisted PCL reconstruction and open reconstruction of the PLC was performed on 19 men and 2 women (average age, 29 years). The mean time-to-surgery was 18 months (range, 7-51 months) and duration of follow-up was 22 months (range, 12-48 months). Postoperatively, patients were evaluated using Lysholm score, Tegner activity score, and International Knee Documentation Committee (IKDC) subjective and objective scores. At the final follow-up, majority of the knees (61.9%) achieved either normal or nearly normal rating objective IKDC score. The means of IKDC subjective score, Lysholm score and Tegner activity level were 62.09, 74.35 and 5.14 respectively. One patient was able to participate in compet...

$Research paper thumbnail of Midterm Clinical Outcome of Single-Stage Knee Articular Cartilage Repair Using Hyaluronic Acid-Based Scaffold Embedded with Bone Marrow Aspirate Concentrate (HA-BMAC) Combined with Microfracture$

Acta Scientific Orthopaedics, Aug 1, 2022

Introduction: Single-stage knee articular cartilage repair using Hyaluronic Acid-based scaffold e... more Introduction: Single-stage knee articular cartilage repair using Hyaluronic Acid-based scaffold embedded with bone marrow aspirate concentrate combined with microfracture (HA-BMAC-microfracture) is a significant advancement in the treatment of chondral injury. Objectives: To investigate the midterm clinical outcome of knee cartilage repair treated with HA-BMAC-microfracture. Methods: Clinical outcomes were assessed via patient-reported scoring tools, namely the International Knee Documentation Committee (IKDC), subjective function score (Lysholm score), ability to return to sports and performing daily prayers in a normal manner. They were assessed preoperative, at short-term follow-up (1 year and 2 years postoperative), and at mid-term follow-up (4 years postoperative). Results: Twenty-four patients fulfilled the criteria, mean age 36.7 years. Mean IKDC score showed statistically significant (P value < 0.001) increase from preoperative to 1year postoperative (65.2), from preoperative to 2 years postoperative (62.6) and from preoperative to 4years postoperative (58.2). Lysholm score also showed statistically significant (P value < 0.001

Acromioclavicular joint (ACJ) injuries are relatively common, encompassing 3.2% of all shoulder g... more Acromioclavicular joint (ACJ) injuries are relatively common, encompassing 3.2% of all shoulder girdle injuries. High grade (Type IV-VI) dislocation of the ACJ requires tear of both the coracoclavicular ligaments and acromioclavicular ligaments plus ACJ capsule and deltotrapezial fascia simultaneously. Surgery is the mainstay of treatment for high grade ACJ disruptions. High grade injuries are stabilized surgically via an open approach, arthroscopically, or a combination of both. The incidence of associated intraarticular lesions encountered during arthroscopic assisted ACJ stabilization has been reported to range from 43% to 53% in recent literature. In our study, more than half (65.9%) of our patients had an associated intraarticular injury. Of these, 74% required additional debridement or reconstructive surgery. We highly recommend the use of arthroscopic assisted ACJ stabilization to accurately diagnose and treat associated intraarticular lesions.

The Surgery Journal, 2019

The anterior horn of lateral meniscus tear is usually repaired using outside-in technique. Althou... more The anterior horn of lateral meniscus tear is usually repaired using outside-in technique. Although easy to perform, it was associated with several complications which may alter the outcome of the surgery. Here, we present a case of an adolescent girl presented with incomplete discoid lateral meniscus accompanied by tear of anterior horn. The tear was repaired using all-inside technique without any implants. We described the surgical technique and discussed the rationale.

Introduction : Rotator cuff tear is a common cause of pain affecting the shoulder. In massive rot... more Introduction : Rotator cuff tear is a common cause of pain affecting the shoulder. In massive rotator cuff tear the humeral head displaces superiorly, therefore causing narrowing of the subacromial space quantified as acromiohumeral distance which be measured from radiographic imaging of the shoulder plain x - ray and MRI. Objective : To determine the mean acromiohumeral distance measurement of rotator cuff tear in local population and to evaluate the correlation between acromiohumeral distance measure from plain x - ray and MRI. Methodology : This is a retrospective study conducted in a single center by reviewing the records of patients with confirmed rotator cuff tear from 2014 - 2018 with ethics approved and consented by patients. Mean value of measured acromiohumeral distance from plain x-ray (anteroposterior and Y scapula view) and MRI were calculated. The presence of rotator cuff tear, muscle atrophy and fatty degeneration were analyzed. Result : 100 patients’ plain X-Ray were recruited with mean age of 52 (±11.4). 59% of them were male. Half of the patient presented with complete tear of supraspinatus tendon, and 42% with partial tear, and another 8% with other type of rotator cuff tear. The mean acromiohumeral distance for complete tear based on x-ray measurement was 6.30mm(±0.96), while the MRI was 6.00mm(±0.88). For partial tear mean measurement for x-ray was 7.20mm(±0.51) and MRI 6.80mm(±0.54). There was positive correlation between the two factors(p=<0.001). Out of 100 patients only 26% associated with muscle atrophy and 7% with fatty degeneration.The acromiohumeral distance does not correlate with muscle atrophy and fatty degeneration (P value 0.100 and 0.317). Conclusion : X-ray and MRI both give significant reading correlation, usage of MRI over x-ray is more superior because it can detect soft tissue injury with lesser radiation. However, in Malaysian setting, x-ray is easily accessible with cheaper cost, hence, makes it a widely used predictive tool in this case. Western study showed that from plain x-ray, distance below 7mm associated with complete tendon tear and 7 to 10mm associated with partial tendon tear. From this study the mean acromiohumeral distance in Malaysian population for complete tear is lower, mainly because our glenohumeral joint is smaller compared to westerner, and the distance has no correlation with muscle atrophy and fatty degeneration