مجله جراحی استخوان و مفاصل ایران
سال پانزدهم شماره 2 (پیاپی 57، بهار 1396)

Aim: Closed treatment using Ponseti casting technique is the standard management for clubfoot deformity. This study is investigating the efficacy of repeat use of Ponseti technique in late cases that had not achieved correction following previous attempts.
A prospective study was conducted on clubfeet cases of over 3 months of age who had not achieved correction with previous casting and were referred for surgery to our clinics. The Baseline and final Pirani scores were compared in a 4 .5- year average follow-up. The functional scores, recurrence rates and additional procedures required for correction were also documented.
79 feet in 53 patients of 3 months to 9 years of age were studied. They had mean Pirani scores of 4.4 and had previously received 7.8 ± 2.5 castings and 9 Achilles tenotomies. An average of 4.3 ± 1.7(2–8) castings and 32 Achilles tendon lengthening were needed to achieve complete correction in 77 feet (98%). Relapse of deformity was seen in 42 (53%) feet, which dropped the correction rate in the final follow-up to 89%. However, the functional score at the end , was good or excellent in 93% of the cases.
Accurate re-use of Ponseti technique in cases of previously- failed clubfoot casting has high success rate, even in late referrals.

Osteoarthritis (OA) recognized, as degenerative arthritis. Synthetic drugs available to treat the OA have, the dangerous side effects and low efficacy. Therefore, using of herbal medicines is an important component of alternative and complementary medicine, Mesenchymal stem cells have a special site in the treatment of diseases. drugs.Psidium guajava Leaves used as antioxidant, anti-inflammatory antinociceptive and analgesic. The goals of scientific research of this study were to the evaluate the regeneration articular cartilage effect of injection of the hydroalcoholic extract of leave of Psidium Guajava with Stem Cell into the knee joints of rats.
Firstly, ninety male rats were choosen, and collagenase type II was prepared for an intra-articular knee injection, for them to induce OA in the animal models. Then, they were divided into nine treatment groups. (N = 10): (a) Sham, (b) Control, (c) injection of hyaluronic Acid intra-articular, (d) Injections of Stem Cell intra-articular, (e) Injections of PRP, (f): Injections of the extract Psidium guajava leaves (g) Injections of the extract Psidium guajava leave with PRP, (h) Injections of the extract Psidium guajava leaves with Stem Cell (i) Injections of the extract Psidium guajava leaves with Stem Cell and PRP. After 5 months, the results were assessments by a Radiologist and Histopathologist.
Radiological and histopathological findings were in which the improvement of the articular cartilage was better in the leaves with Stem Cell and PRP compared with the control group(P It seems that Psidium guajava leaves can be suggested as an effective complementary and alternative treatment for OA of the knee. Because it has a lot of polyphenol compounds.

Clavicle fractures have various complications following open reduction and internal fixation. The main objective of this study was to investigate the prevalence of complications of Clavicle fractures following operative treatment. Also, the prevalence of infection, local dissatisfaction, non:::::union::::: and mal:::::union::::: in the Clavicle fracture after internal fixation was investigated.
Material and The study was cross-sectional. A sample of 52 patients was treated with clavicle fractures, which were treated with open resection and internal fixation. In order to determine the range of motion, strength and shoulder pain, patients were selected from Constant Shoulder Score. Radiography used to detect :::::union:::::.
12 were female and 40 were male of 52 patients. The mean score of the shoulder was 84 ± 2 (95% CI 83-84). One third of the patients used Hook. Patients complained more dysmorphic scar (96%), skin numbness (80%) and pain (73.1%). The rate of infection in patients was very low.
The most common complication is pain, dysmorphic scar and skin numbness that can be said to be relatively normal and can be seen in most patients. Of course, it should also be taken into account that the differences in surgical techniques, surgeries, cultural issues, gender, and age of the patients can be affected.

Weaver-Dunn technique is one the prevalent methods for treating acute acromioclavicular joint (ACJ) dislocation. Until now, several modifications of this technique have been introduced. Regarding the drawbacks of the previous modifications and the importance of presence of an intact coracoacromial ligament (CAL), we introduced a new modification of Weaver-Dunn technique and investigated the preliminary results.
There were 15 patients with acute ACJ enrolled in current study. In the modified surgical technique, the medial half of the CAL is dissected from the bone and passed through a hole made in the clavicle bone and tied on itself. Before the operation and at the last visit, CC distance was measured on both sides. At the last visit, Constant score and UCLA score were completed. The pain intensity was measured using visual analogue scale (VAS). The patients were followed for 4.2±2.6 years.
Preoperatively, CC distance of injured side was significantly greater than the other side (19.5±1.6 mm Vs 7.1±0.5 mm; p Treatment of acute ACJ dislocations using the modified technique was associated with favorable outcomes. Utilizing this method, the joint stability and function are preserved.

Nowadays, bone grafting is used in both human and veterinary orthopedics to stimulate fracture healing, accelerate joint ::::union::::, and to restore bone defects. In such procedures, orthopedic surgeons are searching to favorable substitute for autograft bone. The purpose of this study is evaluation of theranekron and hydroxyapatite effects on bone healing in rabbit model.
First, 20 rabbits were prepared and they were divided into four groups of five. In the group of theranecron, theranecrone was injected to the bone defected site on days 3, 7, and 10 after surgery and one of the group was left empty as control group and in the third group combination of the theranekron and hydroxyapatite was filled in the defected site and in the final group hydroxyapatite was implanted alone. Radiographs from rabbit's hand after surgery were taken on days 14, 28, 42, 56 in lateral view. At the end of the study, histopathological samples were taken from injured area of radius.
In radiographical and histopathological evaluations the group of theranekron-hydroxyapatite had the best performance in healing criteria and the control group was the weakest group.
theranekron group and theranekron –hydroxyapatite groups were better than two other groups in bone healing criteria by radiological and histopathological evaluation.

total Knee arthroplasty is an effective and cost-reducing therapeutic approach, which is very useful in relieving pain and improving the performance of patients with advanced knee arthritis, but there are some factors that may lead to the failure of this surgery. From that which patients need for re-surgical repair, the most common causes of knee replacement are included as infection, poor mechanized joint replacement, implant failure, or frailty of implant. Infection is the most common cause of the main cause Knee replacement surgery. The main goal in this study is to explore new procedures to reduce implant-induced defects and also increase the implants life in knee arthroplasty surgery.
search was carried out in PubMed, science direct and magazine of materials for identification of published articles and studies on infections caused by bone implants. 76 articles were reviewed from 2003 to 2016 and 50 articles of them were cited in the text.
From the 50 papers cited in this study, 41 articles examined the effects of non-antibiotics on infections of bone implants. 5 papers have been reviewed carefully for non-antibiotic treatments and their effects on bone tissue in vitro and 4 are related to combination of these agents with antibiotics and subsequent increase in their efficacy after surgery.
Using of non-antibiotic agents to preventing cause infections after knee surgery intended to preventing biofilm formation in this area is one of the methods suggested to prevent antibiotic resistance against antibiotics.
Today, in these surgeries, polyethylmetacrylate cements are commonly used filled with antibiotics such as vancomycin and gentamicin, which unaccustomedly may be exposed by bacteria and biofilms, and ultimately lead to acute infections. Our overview is exploring the technologies that can improve the performance of orthopedic implants, which may reduce the severity of knee joint infections. The results of these reports also have revealed that the combination of technology and different types of infections at the same time, can promote microbial infection Cause.