Introduction: Hallux valgus is a prevalent deformity of the forefoot, characterized by deviation of the great toe (hallux) toward the second toe and prominence of the metatarsal, along with the formation of a bony structure known as a bunion on the medial edge of the foot. The purpose of this retrospective study was to compare the efficacy, VAS pain scale scores, and patient satisfaction between the Chevron and SERI (Simple, Effective, Rapid, Inexpensive) surgical techniques in the correction and treatment of moderate halluxvalgus. Method: This was a non-randomized clinical trial of 70 patients who underwent surgery for correction of hallux valgus using one of two techniques (Chevron technique, n = 35; SERI technique, n = 35) at Baqiyatallah Hospital in the second half of 2022. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured preoperatively and one year after the operation using radiographic and medical records. Patient pain levels were evaluated using the Visual Analog Scale (VAS), and subjective satisfaction was also assessed. Both parameters were evaluated and documented in patients' medical records. Data were analyzed using SPSS software version 26, with comparisons made using the t-test and chi-square test. Result: In the preoperative evaluation, the mean intermetatarsal angle (IMA) was 12.97 +/- 1.70 (range: 11.27-14.67) in the SERI group and 12.08 +/- 1.24 (range: 10.84-13.32) in the Chevron group. The mean preoperative hallux valgus angle (HVA) was 32.80 +/- 3.26 (range: 29.54-36.06) in the SERI group and 32.17 +/- 1.94 (range: 30.23-34.11) in the Chevron group . At the one-year postoperative follow-up, the mean IMA was 8.14 +/- 1.50 (range: 7.64-10.64) in the SERI group and 9.37 +/- 1.03 (range: 8.34-10.40) in the Chevron group. The mean postoperative HVA was 10.28 +/- 1.60 (range: 8.68-11.88) in the SERI group and 14.4 +/- 1.41 (range: 12.99-15.81) in the Chevron group. Postoperative HVA and IMA measurements showed a statistically significant difference between the two groups (P < 0.05). The SERI group experienced significantly lower pain levels compared to the Chevron osteotomy group (P < 0.05). Additionally, patient satisfaction was significantly higher in the SERI group compared to the Chevron group (P < 0.05). Conclusion : The results of this study demonstrate that the SERI technique provides higher patient satisfaction and lower pain levels compared to the Chevron technique at the one-year follow-up. This study showed better surgical outcomes with the SERI technique for moderate hallux valgus.
Introduction: Over-pronated feet (OPF) are associated with altered lower-limb mechanics and elevated injury risk during running. Longterm training on different sport surfaces may modulate neuromuscular control, including knee muscular co-contraction; however, surface-specific adaptations in individuals with OPF remain insufficiently characterized . To determine the long-term effects of training on natural grass, artificial turf, and synthetic surfaces on knee muscular co-contraction during running in individuals with OPF. Method: In this randomized controlled trial (IRCT20170806035517N5), thirty-two adults (aged 18-30 years) with clinically diagnosed OPF were randomly allocated to one of three intervention groups (natural grass, artificial turf, or synthetic surface) or a no-training control group. The intervention groups completed a supervised, eight-week running program with standardized frequency and progression. Surface electromyography (sEMG) was used to quantify knee muscular co-contraction during treadmill running at a controlled speed. General co-contraction and directed flexor-extensor co-contraction indices were computed over discrete stance sub-phases (heel-contact, mid-stance, and push-off) using established processing pipelines. Assessments were performed pre-and post-intervention by the same blinded operators. Group-by-time effects were examined for primary outcomes, with alpha set at 0.05. Result: No significant changes emerged for general knee co-contraction across time or between groups. In contrast, significant group-by-time interactions were observed for directed flexor-extensor co-contraction during mid-stance (p = 0.035) and push-off (p = 0.020), indicating that training induced surface-specific neuromuscular adaptations rather than uniform joint stiffening. A main effect of time was also noted at heel-contact (p = 0.050), consistent with a generalized training-related modulation early in the stance phase. Collectively, these patterns suggest that extended exposure to distinct surfaces selectively re-tunes knee muscle coordination strategies in individuals with OPF without globally increasing co-contraction. Conclusion : Eight weeks of running training on different surfaces prompted targeted adjustments in knee flexor-extensor coordination in runners with OPF, while general co-contraction remained unchanged. Although such adaptations may be beneficial for control, they might not fully mitigate injury risk in this at-risk population. Individualized surface selection alongside integrative neuromuscular conditioning should be considered in rehabilitation and return-to-running planning for individuals with OPF.
Introduction: Total hip arthroplasty (THA) is an effective treatment for advanced hip conditions, yet postoperative dislocation remains a significant complication, especially in patients with spinal disorders. Altered spinopelvic alignment and reduced spinal mobility can lead to prosthetic instability. Given the growing prevalence of coexisting conditions, this study aimed to develop a predictive model to identify individuals at increased risk of hip dislocation after THA with spinal abnormalities. Method: This descriptive cross-sectional study was conducted over 10 years, until 2023, at Shohada Hospital, including 225 patients (75 with spinal disorders and 150 controls) who experienced hip dislocation after total hip arthroplasty. Key variables, including demographic data, surgical factors, comorbidities, and medication history, were analyzed. Result: In this study, two predictive models were developed to assess the postoperative risk of hip dislocation in patients with spinal disorders. Model I, based on logistic regression, included 14 variables and showed moderate discrimination (C-index=0.67) but limited calibration and low R-2 (0.04). Model II, using elastic net regression, selected nine key predictors-including hip rotation, anemia, BMI 30-35, and certain medications-and achieved better discrimination (AUC=0.73), though with similarly low explanatory power (R-2 = 0.02). Conclusion : This study identified demographic variables (age, BMI), clinical factors (history of psychosis, preoperative anemia), surgical parameters (type of femoral fixation, preoperative hip internal rotation, surgical indication), and medication use (antiepileptic drugs, muscle relaxants, antidiabetic medications) as significant predictors of postoperative hip dislocation risk following total hip arthroplasty in patients with spinal disorders.
Introduction: Investigation of ground reaction forces and electromyographic activity can help clinicians examine mechanical changes in the feet of individuals in pronation during rehabilitation. Method: Twenty adult males with pronated feet and twenty healthy adult males volunteered to participate in this study. A force plate was embedded in the middle of an 18-m walkway to collect ground reaction forces. Muscle activity was recorded using an EMG system. Ground reaction forces and lower limb muscle activities were recorded during walking with and without foot orthoses. A two-way ANOVA with repeated measures was used for statistical analysis. Result: Paired-wise comparison demonstrated lower peak medial ground reaction force, peak anterior and posterior ground reaction forces, peak negative free moment, and time-to-peak of medial ground reaction force during walking with foot orthoses than without them. Results did not show any significant group-by-foot orthoses interactions for ground reaction force components during walking. Significant group-by-time interactions were found for rectus femoris activities. Post-hoc analysis demonstrated lower rectus femoris activity in the healthy group and greater rectus femoris activity during loading phases while walking with foot orthoses compared with without them. Conclusion : Double-density foot orthoses can effectively alter ground reaction forces and muscle activations in individuals with pronated feet, potentially reducing the risk of injury and improving walking mechanics.
Introduction: Kienbock disease is defined by avascular necrosis of the lunate bone. If left untreated, the condition often progresses, leading to bone collapse, wrist shortening, and the need for ankle fusion. In this study, we performed a novel surgical method for treating Kienbock disease. We evaluated and compared the outcomes of lunate decompression with and without bone marrow injection in patients affected by Kienbock disease. Method: In this study, 20 patients with Kienbock disease stages I to IIIa were assessed in two groups: one group received core lunate decompression. In contrast, the other group underwent core lunate decompression followed by an injection of bone marrow. This study took place from April 2015 to April 2016. The researchers assessed the patient's pain levels, range of motion, functional disability, and radiographic indices before and one year after the procedure. Result: The average age of patients in the Bone Marrow (BM) group was 35.66 years (standard deviation: 13.02), compared to 30.33 years (standard deviation: 0.66) in the control group (P = 0.126). The mean postoperative Mayo score for the BM group was 88.12 (standard deviation: 6.51), while the control group had a mean score of 76.66 (standard deviation: 2.88) (P = 0.126). Additionally, the mean postoperative performance score in the BM group was 24.37 (standard deviation: 1.76), compared to 18.33 (standard deviation: 2.88) in the control group (P = 0.09). Bone vascularization and mineralization were more significant in the BM group than in the control group. Conclusion : The results of this study indicate that core lunate decompression is an effective treatment for Kienbock disease. The outcomes in the BM group were significantly better than those in the control group. Additionally, improvements in bone density and radiological changes were observed in the BM group. However, further studies with larger sample sizes and longer follow-up durations are necessary for a more comprehensive evaluation of the BM treatment.
