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Evaluation Of Patellar Tracking During Knee Range Of Motion In Patients With Patellar Lateralization And Normal Subjects
Goharpei Sh, Jabal Amoli M, Karimi H, Hadizadeh Kharrazi H, Ebrahimi Takamjani E,
Volume 62, Issue 3 (11 2004)
Abstract

Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle.

Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees) in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years.

Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.


Assessing the role of enema in improving outcomes and complications of benign gynecological laparoscopy: a randomized clinical trial
Zahra Asgari, Azam Barkhordarinasab, Reihaneh Hosseini , Alireza Hadizadeh, Venus Chegini, Sara Farzadi,
Volume 79, Issue 11 (February 2022)
Abstract
Background: mechanical bowel preparation (MBP) is a common practice before laparoscopic gynecologic surgeries but the role and efficacy of preparation have been questioned. this study assesses visualization and bowel handling in a group of patients who receive MBP and the control group and thereafter; compares the results.
Methods: We designed and conducted this randomized, single-blinded and controlled trial on patients who underwent advanced gynecologic laparoscopic surgeries. This clinical trial was carried out between July 2020 and January 2021. The patients were enrolled from l the laparoscopic office. 120 women aged 18-65 years undergoing level 2 and 3 benign gynecologic laparoscopic surgeries were randomized to bowel preparation with a normal saline enema (n=60) or non-bowel preparation (n=60) groups. Our patients underwent level 2 and 3 of benign laparoscopic gynecologic surgeries with or without MBP. The visualization and bowel handling were assessed by the primary surgical team and a questionnaire was later obtained. The outcomes included intraoperative surgical view and bowel handling, preoperative and post-operative patient signs and symptoms. The patients were also assessed in respect to discomfort prior and after the surgery, this assessment was obtained using a questionnaire. The gathered data was analyzed using IBM’s SPSS v26 software.
Results: there was no difference in intraoperative visualization and bowel handling between the two groups. We also found no clinical improvements in respect to discomfort and symptoms. MBP even increased the distention rate amongst patients (P-value=0/04). We tried to evaluate whether MBP had any effects on haemorrhage and blood loss during the surgery and to assess this we compared hemoglobin levels before and after the surgery. We compared the subtracted values between the two groups and found no significant difference (T-test=1.135, P=0/259) (see table 4). However, hospitalization duration was about 5 hours longer in the group who received MBP.
Conclusion: MBP with normal saline enema does not improve intraoperative visualization and bowel handling. And it also does not reduce patient complication rates and post-operative symptoms either. MBP also increases hospitalization duration and puts extra pressure on the healthcare system. Therefore, a normal saline enema is not recommended before benign gynecologic laparoscopic surgeries.
 

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