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تبديل مفصل الركبة الكامل نتائج قريبة المدى
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ياسر اسكندر( باحث )
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تمت دراسة و متابعة (٨٠) حالة تبديل مفصل ركبة كامل في مشفى المواسـاة خـلال الأعوام ٢٠٠٠ – ٢٠٠١ ، أغلب الحالات كانت بسبب التهاب مفصل تنكسي مجهـول السبب و بعض حالات التهاب مفصل رثياني. تم الحصول على نتائج جيدة في المدى القريب بعد تبديل مفصل الركبة الكامل عنـد النسبة العظمى من المرضى مع التخلص من الألم و عودتهم إلـى النشـاط و الفاعليـة بشكل جيد شرط إتقان التكنيك الجراحي و فهم الآلية الحركية لمفصل الركبة. و تـوفر الظروف المناسبة لإجراء هذه العمليات مع توفر إمكانية التأهيل.
This study includes ٨٠ cases of total knee Arthroplasty, They were treated in Al-Moassat Hospital during the years ٢٠٠٠- ٢٠٠١. Idiopathic primary osteoarthrihis was the main reason for total knee Arthroplasly. Some cases of Rheumatoid arthritis were observed too. The short term chinicaln gools of total arthoplasty include restoration of the normal activity of the limb and pain relief , which can be obtained under the proper surgical condition, and requirements, supported by better understanding of the biomechanics of the knee joint and good rehabilitation there after.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة التي أجراها الدكتور ياسر اسكندر نتائج تبديل مفصل الركبة الكامل على المدى القريب. تم إجراء الدراسة على 80 حالة في مشفى المواساة خلال الأعوام 2000-2001. كانت أغلب الحالات ناتجة عن التهاب مفصل تنكسي مجهول السبب وبعضها عن التهاب مفصل رثياني. أظهرت النتائج تحسنًا كبيرًا في الألم وعودة المرضى إلى النشاط والفاعلية. أكدت الدراسة على أهمية إتقان التكنيك الجراحي وفهم الآلية الحركية لمفصل الركبة، بالإضافة إلى توفر الظروف المناسبة لإجراء العمليات وإمكانية التأهيل بعد الجراحة.
Critical review
دراسة نقدية: قدمت الدراسة نتائج مشجعة حول فعالية تبديل مفصل الركبة الكامل على المدى القريب، إلا أنها لم تتناول النتائج على المدى البعيد والتي تعتبر مهمة لتقييم النجاح الكلي للعملية. كما أن العينة المدروسة كانت محدودة بـ 80 حالة فقط، مما قد يؤثر على تعميم النتائج. بالإضافة إلى ذلك، لم تتطرق الدراسة بشكل كافٍ إلى المضاعفات المحتملة وكيفية التعامل معها. كان من الأفضل أيضًا تضمين مجموعة مقارنة من المرضى الذين لم يخضعوا للجراحة لتقديم تحليل أكثر شمولية.
Questions related to the research
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ما هي الأسباب الرئيسية التي أدت إلى إجراء تبديل مفصل الركبة الكامل في الدراسة؟
كانت الأسباب الرئيسية هي التهاب مفصل تنكسي مجهول السبب وبعض حالات التهاب مفصل رثياني.
-
كم عدد الحالات التي تمت دراستها في هذه البحث؟
تمت دراسة 80 حالة في مشفى المواساة خلال الأعوام 2000-2001.
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ما هي النتائج القصيرة المدى التي تم الحصول عليها بعد الجراحة؟
تم الحصول على نتائج جيدة تشمل التخلص من الألم وعودة المرضى إلى النشاط والفاعلية.
-
ما هي العوامل التي أكدت الدراسة على أهميتها لضمان نجاح الجراحة؟
أكدت الدراسة على أهمية إتقان التكنيك الجراحي وفهم الآلية الحركية لمفصل الركبة، بالإضافة إلى توفر الظروف المناسبة لإجراء العمليات وإمكانية التأهيل بعد الجراحة.
References used
Colizza,W.A.; Insall. J.N.; Scuderi, J.R.; the posterior stabilized total knee prosthesis: assessment of polyethylene damage and osteolysis after a ten –year- minimum follow up.J.Bone Joint Surg,1995
Ewald, F.V.: the knee Society total knee Arthroplasty roentgenographic evelution and scoring system. Clin. Orthop,1989
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THA as a primary management for acute fractures around the hip should
generally be reserved to a very selected few patients where the general
condition, life expectancy, age, bone quality, pathological changes, type of
injury...
Primary THA for a
cute fractures around the hip done with proper
patient selection under the proper condition, and requirements can result
in good clinical results with excellent short-term survival of the
prosthesis.
The rate of venous thromboembolism is unacceptable without prophylaxis.
Venographic studies of patients without prophylaxis show that the deep vein-thrombosis rates range from
40-84% after total knee replacement, and rates of pulmonary embolism ran
ge from 1.5-10%.
Surgeons must balance the need for thromboprophylaxis with the need to avoid bleeding complications.
The purpose of this study is to evaluate the status of thrombo prophylaxis after primary total knee
replacement in ALMouassat university hospital, and to improve our outcome in future, to get better
results and fewer complications.
Background& Objective: The acetabular bone deficiency secondary to acetabular fractures presents a
complex clinical problem and a big challenge to the orthopedic surgeons due to the technical difficulties
related to this deficiency, considering tha
t significant number of patients treated either surgically or
without surgery will require T.H.A in the future.
The purpose of our study was to determine the outcome of T.H.R performed in patients with a history of
acetabular fracture.
Materials & Methods: We performed T.H.R in 21 patients with previous acetabular fractures in Al-Assad
Hospital between2004-2009prespectively, these cases were divided into 3 groups:
-first group formed of 7 patients were treated conservatively. Second group formed of 9 patients did an
open reduction and internal fixation by screws and plates.
-Third group formed of 5 elderly patients with fresh acetabular fractures and were treated primarily by a
total prosthesis with use a reinforcement Muller ring .
For the clinical evaluation of our cases we used the modified Harris Hip Score Scale and for the
radiological evaluation we used the Delee and Charnley scale system .
Results: Our overage Harris Hip Score was 83.(80 for the first group, 86 for the second group, and 83 for
the third group).
-No complications were encountered intraoperative, in the early postoperative period one case developed
superficial wound infection and treated by repeated dressing and antibiotic, there was one case of D.V.T
on the 4th day treated by rest and anticoagulant, and one case developed loosening of acetabular
component 8 months after T.H.A and underwent to revision.
Conclusion: T.H.R in acetabular fractures despite the difficulties faced during the procedure is a safe and
effective way to salvage the hip when secondary osteoarthritis develops, open reduction and internal
fixation of acetabular fractures may have benefits even if it fails to prevent posttraumatic arthritis
.Furthermore the clinical results of T.H.R after surgical treatment of acetabular fractures are better than
it after conservative treatment of these fractures.
Reinforcement ring is an ideal solution when the decision of T.H.R is taken as a primary treatment of
acetabular fractures depending on the indications described by Joly.
Background: Many options are available for the treatment of synovitis or target joint in hemophilia to prevent recurrent bleeding and further joint destruction when conservative therapy fails such as chemical synovectomy. Chemical synovectomy with Ri
fampicin has been used for many years in several clinical trials with good results and without serious complications.
Objective :evaluate the safety and the efficacy of this procedure in the Syrian hemophilic patients.
Conclusion: chemical synovectomy with rifampicin is a good treatment, cheap and safe in hemophilic patients.
The aim of this paper is to study the changes of knee movement during walking for
patella femoral pain using flexible electro-goniometry, This is very important for gait research
and stability of knee, the start and end of the gait cycle were deter
mined by foot sensors, A
program was designed for signal processing of the data by Mat lab, Testes were carried out at
Hamish hospital in Damascus, Subjects were divided into two groups: 46 normal subjects and
21 patients. Results showed that the lesion effect on knee movement which the values of knee
flexion are less than normal, In the stance phase it is noted that the knee cancels its first
flexion, and In swing phase it noted that the decrease in knee flexion. It was also noted that
these values were varied between the patient tested.
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