Tehran University Medical Journal

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Background: Rotator cuff tendon tear injury is one of the most frequently seen orthopaedic conditions, and surgical repair of rotator cuff tears is a common procedure. The purpose of the present study was to determine the results of full-thickness rotator cuff repair and to look for predictors of outcomes.

Methods: we studied 27 patients (17 men and 10 women with a mean age of 57.7 years) who underwent open rotator cuff repair surgery for full-thickness tear between 2001 and 2005 at the Imam Khomeini Hospital and were subsequently followed-up for 6 and 12 months after surgery. The shoulder function was assessed by Constant classification and factors potentially associated with outcomes were

Results: The mean of preoperative Constant score (CS) was 45.8 ± 14.1 after 12 months, 6 patients (22.2%) had good results and 21 patients (77.8%) had excellent result according to CS. Pain relief was generally satisfactory. Using multiple regression analysis, treatment was significantly correlated preoperative CS and acromio-humeral interval (AHI) however, no correlation was found between the result of the treatment and pretreatment atrophy, tear size, acromial morphology, preoperative symptom duration and age.

Conclusion: In this study, a standard rotator cuff repair technique reduced pain severity and was associated with good results, however larger studies are necessary to define the long-term outcome of this procedure.

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Background: Acupuncture is one of the most effective methods of alleviating pain in different situations including chronic and acute pain management. The aim of this study was to evaluate the effectiveness of acupuncture in the reduction of post-operative pain after hernia repair.

Methods: In this placebo-controlled, double-blinded clinical trial, we enrolled 60 male patients aged 30 to 60 years old with an ASA physical status of I or II undergoing elective inguinal hernia repair under general anesthesia in Imam Khomeini Hospital, Tehran, Iran. All patients experienced standard anesthetic and surgical procedures. After completion of the operation and while the patients were still under general anesthesia, they were randomly assigned to two groups: acupuncture (with stimulation of GV2, GV4 and SP6 points with sterile acupuncture needles), and control (with sham acupuncture stimulation). After termination of anesthesia, during the first six hours, the pain intensity was evaluated hourly. Pethidine (25 mg) was administered for the patients when necessary. Pain intensity and pethidine use were recorded and compared between the two groups.

Results: The mean age of two groups did not differ. Pain intensity was significantly lower in the acupuncture group between the second and fifth postoperative hours. Moreover, pethidine use was significantly lower in the acupuncture group versus the control group during the first six hours after surgery (12.07±7.5 mg vs. 12.91±6.5 mg, respectively p=0.0001).

Conclusion: The application of acupuncture in patients is associated with a marked decrease in pain after inguinal hernia repair and does not have any serious complications. Acupuncture is strongly recommended for all post-operative patients.

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Background: Inguinal hernia accounts for about 80% of all hernias and are the most common surgical procedure done in infants. There are different methods for repairing of inguinal hernia such as tissue repair rate of recurrence by this method is 1-3%. The purpose of this study was to introduce new method for this surgery and assessing recurrence and complications.
Methods: This was a semi clinical trial. 174 patients were considered after five years. (During 1998-2002). In this method after removing of hernia's sac, the floor of inguinal canal was torn in two layers continuously. One of them was torn from cooper ligament to fascia transversalis and the other one was torn from inguinal ligament to conjoint tendon and finally the fascia of external muscle was torn on spermatic cord. The patients were assessed by a questionnaire composed of two sections one about the site of inguinal hernia and age of patients and the other was composed of questions about complication and recurrence of surgery. Data was compared to other conventional tissue repair using Z test.
Results: The mean age of patients were 28-48 years, 164(94%) were males and 10(5/7%) were females, 59(34%) of patients had left inguinal hernia (56 male and 3 female), 92(52%) had right inguinal hernia (88 male and 4 female) and 23(13%) had bilateral inguinal hernia (20 male and 3 female). Two patients (1/1%) had recurrence two years after surgery and no complication were seen after 5 years.
 Conclusions: There were no significant difference between methods of surgery (1/1% recurrence) and other conventional tissue repair methods (1-3% recurrence). More long evaluation is required to recommend this fast and simple method for routine repair of inguinal hernias.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Flexor tendon injury is one of the unanswered problems in reconstructive surgery of the hand. Although pull out method is one of the best reconstructive approaches but still is controversial. Surgeons prefer immobilization to prevent laceration at the site of the suture but it may cause adhesion and lead to surgical failure. The aim of this study was to perform a new surgical method to achieve a tendon repair without these problems.
Methods: In this case-series study, 80 fingers with flexor tendon impairment selected and divided into four groups (tendon laceration & avulsion, tendon graft reconstructed in 1 & 2 stages) then patients were surgically treated by the new technique. The most important aspect of the technique is the placement of the suture in the direction of strength therefore, following any tension the suture would be tighter and this point help us to mobilize the injured tendon immediately after the surgery then we analyzed the results depends on the patient's group.
Results: The pull out and surgical (functional) results were evaluated. 97% of the pull out results were good and 3% were poor and surgical results were 23.9% excellent, 52.2% good, 17.9% fair and 6% poor.
Conclusion: Depend on the acceptable results, immobilization in these patients is unnecessary & active and passive range of motion would be gradually increased as soon as possible. However biomechanical studies would be beneficial to evaluate this suture influence and designing future studies to compare this technique with old methods would be essential.

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Background: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months.

Methods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months), the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score). The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated.

Results: According to the Rowe scale, 12 patients (40%) had an excellent score 13 (43%), a good score 4 (13%), a fair score and 1 (4%), a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation). The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder.

Conclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

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Background: Spinal cord injury (SCI) is a significant medical and social issue, leading to varying degrees of sensory and motor impairments. Most men experience sexual dysfunction and fertility problems. These issues can be partially attributed to pathophysiological mechanisms, including damage caused by reactive oxygen species (ROS). Targeted antioxidant therapy can significantly reduce oxidative stress and neuro inflammation. This study sought to examine the impact of selenium and astaxanthin on sperm parameters and the recovery of sensory-motor function in rats with spinal cord injury (SCI).
Methods: This experimental study utilized the rat animal model and was carried out at the Neuroscience Research Center Laboratory of Tabriz University of Medical Sciences from December 30, 2022, to November 27, 2023. Fifty adults male Wistar rats were randomly allocated into five groups of ten: control, sham, SCI, selenium-supplemented, and astaxanthin-supplemented. Except for the control and sham groups, spinal cord injury was induced in all other groups. Six weeks after the injury and upon completion of the treatment, the effects of selenium and astaxanthin supplementation on sperm parameters and spinal cord repair were assessed. The Basso, Beattie, and Brenham (BBB) scale was employed to evaluate motor function, while the Von Frey test was utilized to assess sensory status.