Background:Avascular necrosis (AVN) of femoral head is one of the multifactorial pathologies, which can disturb hip joint and its range of motion. There have been several therapeutic methods for this pathology, but the results are controversial. Some studies show that core compression prevents the progress of the disease and its symptoms. This study aims to explore this issue.Materials and Methods:This clinical trial was conducted on patients who were diagnosed with AVN of femoral head stage I, IIA, at educational hospitals of Isfahan in 2010. The patients who met the inclusion criteria and suffered from AVN of femoral head stage I, IIA for any reason (primary or secondary), entered the study. Six and 12 months after surgery, final assessment in terms of range of motion, return to work, and severity of pain based on vancouver associated score (VAS) was made and recorded. The duration of hospitalization and rate of infection were also recorded. The data were entered into and analyzed by the SPSS software.Results:Mean and standard deviation of pain severity before surgery was 6.82 ± 1.74 in the participants. After 6 months, pain severity reduced to 4.05 ± 1.29, and after 12 months, it reached 2.41 ± 1.82. On the basis of analysis of variance with repeated observation, the severity of pain was significantly reduced in 1 year (P<0.001).Conclusion:It can be concluded that core decompression in patients with AVN of femoral head stage I, IIA can improve pain in hip area and increase range of motion.
Background:Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA.Materials and Methods:Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group (n = 46) and debridement alone including removing of all osteophytes was performed on the control group (n = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP.Results:The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months).Conclusions:PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation.
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