Search

Background and purpose: Septic arthritis is a serious orthopedic surgery and delayed management causes irreparable damages. The knee is the most common site involved in septic arthritis. The purpose of this study was to determine mortality rate, adverse joint outcome and prognostic factors in adult patients diagnosed with septic arthritis of the knee who had undergone debridement surgery. Materials and methods: This retrospective cohort study was carried out using the medical records of all adult patients admitted to Sari Imam Khomeini Hospital and Sari BuAliSina Hospital between 2009 and 2019 who were treated with either arthrotomy or arthroscopic irrigation for acute septic arthritis of the knee. Patients with prosthetic joints were excluded. The rate of mortality was determined. Clinical findings, laboratory evidence, knee radiographs, and the Knee injury and Osteoarthritis Outcome Scores (KOOS) were compared through statistical analysis to identify possible prognostic factors. Radiographic severity was classified based on the Kellgren-Lawrence grading. Results: We included 31 patients and there were 41.9% female patients (mean age= 51.1±20.56). The most common underlying diseases were hypertension (29%) and diabetes mellitus (25.8%). Staphylococcus aureus was identified in 16.1% of synovial fluid cultures. The mortality rate was 22.6%. Factors influencing mortality included older age (P=0.003), diabetes mellitus (P=0.031), fever (P=0.038), length of hospital stay (P=0.019), high C-reactive protein levels (P=0.002), low creatinine clearance (P=0.003), and type of pathogenic microorganisms (P=0.028). Age was the only factor significantly associated with higher radiographic severity (P=0.014). Conclusion: Septic arthritis is an infectious orthopedic emergency that is associated with a high mortality rate even after joint surgery and debridement. Therefore, proper management and updating information about this disease and its treatment methods are necessary.

Introduction: Total Hip Arthroplasty (THA) is one of the most frequent major surgical procedures in orthopedics. Aim: To audit the results of THA in Babol, Northern Iran. Materials and Methods: From 2014 to 2015, all patients with indication for THA referred to Shahid Beheshti and Rohani teaching hospitals in Babol were recruited in this prospective study. Patients with severe osteoarthritis of the knee, a psychiatric disorder, history of previous arthroplasty, bilateral osteoarthritis, contraindications to a major surgery, or failure to attend followup were excluded. The Harris Hip Score (HHS) was used to measure physical hip performance, ranging from 0 (poor) to 100 (excellent) points. All patients were followed for six months. Data were collected and analysed using SPSS with t-test analysis. Results: A total of 58 patients were finally assessed, of whom 24 (41.4%) were male and others were female. The mean age was 56.8±16.56 years. The postoperative complications included infection (one case), posterior hip dislocation (two cases) and peroneal nerve paresis (one case). The mean HHS was 49.69±5 before the surgery, but it improved significantly to 88.02±4.04 at sixth months after THA (p

Simultaneous dislocation of shoulder and humeral shaft fracture is a rare injury, and there is no clear protocol for its treatment. Herein we present a case of a 15-year-old boy, who suffered from a job-related accident and sustained fracture of humeral shaft associated with ipsilateral anterior shoulder dislocation and fracture of greater tuberosity 15 years ago. He received closed reduction of both injuries and coaptation plaster splint for four weeks, followed by Sarmiento splint at that time. Fifteen years after the injury, he has no problem related to the previous injury, and does not experience any episode of shoulder instability.