Background: Early detection and treatment of extensor mechanism rupture are essential for a long-term functional knee joint. In chronic cases, quadriceps muscle retraction and contracture make surgery difficult and results are less predictable. Objectives: The purpose of this study was to evaluate outcomes in the cases of late repaired patellar tendon ruptures. Methods: This study included patients with chronic patellar tendon rupture who were operated at Shafa orthopedic hospital from 2006 to 2013. Results: A total of ten patients were evaluated, presenting twelve cases of chronic patellar tendon rupture. Patients had a mean age of 34.4 years (range 18 -58). Seven cases were caused by a traffic accident and three by a fall. The mean length of time from injury to surgery was 23 months (range 3 -132). The mean time of follow-up was 6.2 years (range 3 -9). Cerclage wire reinforcements were applied in nine of the knees and the left three knees had fiber wire reinforcement. Tendon graft augmentation was applied in ten of the knees; six with semitendinosus and gracilis autograft, two with semitendinosus autograft, one with an Achilles tendon allograft, and one with a tibialis anterior allograft. Means for preoperative/postoperative active knee range of motion, extension lag, subjective international knee documentation committee score, and modified Cincinnati scores were 81/117, 32/2, 22.7/84.5 and 24/87, respectively. Wire breakage was seen on all nine knees but wires were removed in only two symptomatic cases. Conclusions: Good to excellent results were obtained in terms of functioning with operative treatment of chronic patellar tendon rupture. Direct repair with autogenous or allogenic graft augmentation and cerclage wire reinforcement and postoperative cast immobilization are recommended.

Background: Total hip arthroplasty (THA) is regarded as the most successful and common surgical approach in orthopedic surgeries. Several surgical approaches have been described for THA to introduce minimally invasive surgical exposures. Posterolateral and lateral approaches are traditional and still most commonly used approaches for primary THA. In deciding which approach to use, consideration of complications, and clinical and radiological outcomes, using one approach or another should be evaluated. Objectives: The purpose of this study was to compare the early postoperative outcomes of posterolateral and lateral surgical approaches. Patients and Methods: The current study was conducted on a group of 134 primary hip arthroplasty of 120 patients who had undergone THA surgery at Shafa Orthopedic Hospital in Tehran, Iran, from March 2011 to October 2014. The lateral approach was used in 79 hips and, posterolateral approach was used in 55 hip based on surgeon's preference. Two groups were assessed considering the following outcomes: clinical evaluation including Harris hip score (HHS), blood loss, blood transfusion, hemoglobin level, infections, deep vein thrombosis (DVT) and dislocation, as well as radiological evaluation including the proximal femur fracture, limb length discrepancy and cup inclination angle. The follow-up for both groups was at 6, 12, 24, 36 and 48 weeks after the surgery. Results: There was no significant difference between the two approaches regarding demographic characteristics, HHS, blood loss, transfusion, hemoglobin level, dislocation and cup inclination angle. However, there was a significant difference in the incidences of infections, DVT, proximal femur fracture and discrepancy of limb length between the two approaches. Conclusions:The results of this study indicate that both lateral and posterolateral approaches offer similar early clinical outcomes and some different radiological outcomes.

Background: Quadriceps tendon ruptures (QTR) are uncommon injuries of knee extensor mechanism. Although immediate repair is necessary to re-establish knee extensor continuity, favorable outcome of QTR reconstruction even several years after injury is reported. Objectives: The outcome of acute and chronic QTR is rarely investigated. The current study aimed at evaluating the objective and subjective measures of outcome following the surgery of acute and chronic QTR.

Background: Recently, opening-wedge high tibial osteotomy (HTO) has attracted much interest due to its advantages over closingwedge HTO. However, it has been reported to influence the posterior tibial slope (PTS), potentiating the knee for subsequent complications.Objectives: This study aimed at evaluating: 1. How open-wedge HTO changes the PTS, and 2. how the PTS evaluation method influences the extent of the PTS change. Methods: Patients with genu varum deformity, who underwent HTO at the center of the current study were included. Tomofix plate or Podo plate with or without bone graft were used for fixation purposes. The pre-and post-operative assessment of the PTS was performed using three different evaluation methods, including tibial anatomical axis (TAA), fibular anatomical axis (FAA) and posterior tibial cortex (PTC).Results: A total of 119 knees from 83 patients, with mean age of 31.32 ± 10.1 years and mean follow-up of 3.1 ± 1.9 years, were included in this study. Medial compartmental osteoarthritis was the most frequent type of etiology. The pre-operative PTS was 13.16, 13.81 and 11.55 using the TAA, FAA and PTC method, respectively. The post-operative PTS was 12.59, 12.95 and 10.77 using the TAA, FAA and PTC method, respectively. The change of PTS was not statistically significant using either methods. Conclusions: A negligible reduction of less than 1º was observed in the PTS of patients following opening-wedge HTO. The PTS assessment was not affected by the choice of evaluation method.