Aim of the work: Translation and validation of three commonly used knee scores to Arabic language: the Lysholm Knee Score (LKS), the Oxford Knee Score (OKS), and IKDC Subjective Knee Form. Methods: Our work focused on translation and validation of the LKS, OKS and IKDC. Construct validity was assessed by comparing the LKS, OKS, and IKDC Subjective Knee Form and previous Arabic translated version of Knee injury and Osteoarthritis Outcome Score (KOOS). Test−retest reliability, internal consistency, and construct validity were assessed, using Intraclass Correlation Coefficient (ICC), Cronbach's alpha, and Pearson correlation coefficient (r). Results: Reliability was excellent for the Arabic IKDC subjective form (0.95), while the Arabic LKS and the Arabic OKS were good: 0.8 and 0.85, respectively. The Cronbach's ά was excellent for the Arabic LKS and Arabic OKS: 0.9 and 0.90, respectively, while the Arabic IKDC subjective form was good (0.89). Construct validity was high for the Arabic LKS and the Arabic OKS: 0.7 and 0.913, respectively, while the Arabic IKDC was moderate (0.4) in cases of ACL and meniscus injuries and mild (0.18) in cases of osteoarthritis. Conclusion: Arabic LKS and Arabic OKS were reliable and valid scores for patients complaining of ligamentous injuries, meniscus injuries, and osteoarthritis to be used for Arabic-speaking people, while the Arabic IKDC had excellent reliability and mild validity in cases of osteoarthritis and moderate validity in cases of ACL and meniscus injuries.
Surgical treatment is considered to be the best therapeutic modality for severe hemorrhoidal disease. Different surgical methods of hemorrhoidectomy aim to decrease pain, bleeding, stenosis and discharge. The aim of this study was to evaluate the efficacy of harmonic scalpel hemorrhoidectomy. During a period of seven months, 54 consecutive patients with third- and fourth-degree hemorrhoids were prospectively randomized for harmonic scalpel hemorrhoidectomy (HS) or Milligan-Morgan procedure (MM). These patients were examined at one, two, and six weeks after the operation. All patients had a lower gastrointestinal investigation prior to operation to exclude other colorectal pathologies. All patients had the same kind of preoperative preparation and analgesia during the postoperative course. Pain was assessed using a visual analog scale from 0 to 10. Patient satisfaction was defined as decrease or absence of symptoms and return to normal daily activities. HS groups included 29 patients, while the MM group had 25 patients. There as no difference between the groups in terms of age, gender, hemorrhoidal degree and indication for operation. The types of intra-operative anesthesia administered to the two groups were similar. Duration of surgery was significantly higher in the MM group ( p<0.0001). Postoperative hospitalization was longer in the MM group ( p<0.0001), and the pain degree was higher in MM group ( p<0.0001). No significant difference was noted in the overall amount of analgesics used in the two groups at week 1, although it was significantly higher in the MM group 2 and 3 weeks after the operation. Early complication occurred more frequently in the MM group but overall the difference was not statistically significant. In conclusion, harmonic scalpel hemorrhoidectomy is virtually a bloodless operation with minimal tissue damage. It is associated with significant less postoperative pain and a fast return to normal activity.
Aim: Evaluation of clinical and radiological outcomes following meniscal repair using different arthroscopic techniques for all meniscal tears amenable for repair. Methods: Sixty-one patients were involved in a prospective study; all cases presented with meniscal tears underwent arthroscopic meniscal repair from December 2016 to December 2017. Outcomes involved the site of tear, the repair technique, and associated injuries. The International Knee Documentation Committee Score (IKDC) and Tegner Lysholm Knee Score were used to analyze the clinical and functional outcomes postoperatively. Results: Of the 61 patients, 50 patients (81.9%) had meniscal tear associated with isolated ligamentous ACL injury, 6 cases had corrective osteotomy with ACL reconstruction to correct concomitant genu varus, 2 cases (3.3%) had meniscal tear associated with isolated ligamentous PCL injury, and 9 patients (14.8%) presented with isolated meniscal tear; IKDC was preoperatively (44.52 ± 8.79), postoperatively at 6 months (90.97 ± 6.75) and at 12 months (92.27 ± 2.68) with P-value (0.001). Tegner Lysholm score was preoperatively (52.16 ± 12.22), postoperatively at 6 months (88.03 ± 6.84) and at 12 months (93.26 ± 2.95) with P-value (0.001). Fifty eight patients (95.1%) had no postoperative symptoms at 6 and 12 months’ follow-up. The remaining 3 cases (4.9%) underwent partial meniscectomy due to persistent postoperative clinical symptoms with no signs of healing in MRI. Conclusions: Our study concluded that arthroscopic meniscal repair is an effective way in the management of meniscal tears regarding clinical and functional outcomes.
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