Background and Objective: Septic arthritis is a joint infection that causes metabolic and physiological disorders and if not diagnosed and treated on time can cause severe damage and disabilities. In this study, the effect of intravenous dexamethasone on septic arthritis, and the recovery process of the disease have been evaluated. Methods: In a non-randomized double blind clinical trial 60 patients assigned in two groups of 30 patients each were evaluated. After diagnosis of septic arthritis, group one received a dose of 0.15mg / kg / QD of dexamethasone and group two received the same amount of normal saline for four days. Then the patients were evaluated for treatment duration, inflammation and redness relief, joint movement and ESR and CRP levels. Results: After data collection they were compared with the X2 test, t-test, ANOVA and Mann-Whitney statistical test and were analyzed using SPSS18 software. Treatment duration was 3.27 ± 1.04 days, joint movement was 50.67 ± 9.7 degrees, inflammation and redness relief was seen after 4.1 ± 0.32 days, a decrease of 19.3 ± 2.89 in ESR levels were seen and reduction in CRP levels showed a statistically significant difference (P <0.05). Conclusion: In patients with septic arthritis in addition to routine antibiotic therapy, receiving intravenous dexamethasone can reduce the clinical symptoms of the disease symptoms and also accelerate recovery and return to daily activities.

Background: Surgical treatment of basicervical femoral neck fractures, which are biomechanically similar to intertrochanteric fractures, is an internal fixation by dynamic hip screw (DHS) and anti-rotation screw. Since one of the remarkable complications of this surgical procedure is device failure, we aimed to make a comparison between bipolar hemiarthroplasty and the DHS plate fixation in elderly patients with basicervical femoral neck fracture. Methods: In this randomized controlled clinical trial study, 60 patients with femoral neck fractures were randomly divided into two groups of DHS fixation (control group, n = 30) and bipolar hemiarthroplasty (intervention group, n = 30). Harris Hip Score (HHS) questionnaire and the Visual Analogue Scale (VAS) for pain assessment were used for functional evaluations. Postoperative complications were evaluated at 6 months and one year postoperatively. Results: The mean age was 73.95 ± 9.85 years in the hemiarthroplasty group and 74.22 ± 7.85 years in the internal fixation group. Three patients in the internal fixation group and 6 patients in the hemiarthroplasty group were excluded. HHS in 6 months and one year after surgery in the intervention group was dramatically higher than the control group. There were no noticeable changes in VAS scores between the two groups. Two cases of device failure happened in the control group. Conclusions: It seems that bipolar hemiarthroplasty is more effective than internal fixation by DHS plate in improving the patient’s quality of life, considering higher HHS scores, earlier patient mobilization, shorter hospital stay, lower device failure rate, and lower revision rate

Background: The purpose of this study was to evaluate the effect of intravenous tranexamic acid (TXA) on the blood loss volume during surgery and surgeon's satisfaction in intertrochanteric fracture surgery. Methods: A total of 62 patients with intertrochanteric fracture were involved in the study and accidentally categorized into two groups. In the control or first group, patients were medicated with placebo (age: 69.2 ± 6.1 years old) and in the second group or intervention, they received 1 g injection of TXA (age: 69.7 ± 6.4 years old). Intraoperative bleeding was measured by the amount of blood in the suction bottle and amount of gauze utilized and postoperative blood loss was measured by the amount of blood in the drain 48 hours after surgery. Also, hemoglobin (Hb) levels were compared before and after surgery. In the end, the surgeon’s satisfaction was measured by Likert scale. Results: The difference in the amount of intra-operative bleeding was significant between the groups (P < 0.050). The mean number of utilized gauze in the intervention group was meaningfully less than the placebo group (P < 0.050). The mean Hb in the control group was considerably inferior to the intervention group (P < 0.050). The respect of patients in need of transfusion in the placebo group was outstandingly superior to the intervention group (P < 0.005). Surgeon satisfaction in the intervention group was considerably greater than the control group (P < 0.050). Conclusion: The use of intravenous TXA during intertrochanteric fracture surgery can reduce hemorrhage during surgery, reduce the need for blood products, and finally improve the surgeon’s satisfaction.

Background: Open wedge high tibial osteotomy (OWHTO) is commonly utilized to correct genu varum. To decrease various complications of OWHTO, some modifications are needed. Methods: In a parallel randomized controlled clinical trial, 42 patients were divided into two groups: conventional OWHTO (control group) and OWHTO with the cut in the sagittal plane or distal tubercle osteotomy (OWHTO/DTO) (intervention group). Evaluation of the following items was conducted pre- and post-operatively: Knee Society Score (KSS) questionnaire, incidence of postoperative complications, patellar height by Blackburne-Peel (BP) ratio and Insall-Salvati Index (ISI), posterior tibial slope (PTS), tibiofemoral angle (TFA), Q-angle, medial proximal tibial angle (MPTA), three joint alignment radiography, and union radiological parameters. Results: The differences between preoperative and postoperative variables including the KSS, PTS, TFA, BP Index (BPI), ISI, MPTA, and Q-angle within the intervention and control groups were not statistically significant. In four cases (3 in the control group and 1 in the intervention group), the delayed union was observed but the complete union was achieved after a mean of 23 weeks. No nonunion was observed. Conclusion: Our results showed equal effectiveness for OWHTO/DTO compared with the conventional OWHTO.