Background:The degree of patient's suffering in association with radiological evidence of osteoarthritis (OA) determines the time point of surgery. Thus, a more clear understanding of the association between clinical and radiological symptoms of OA is necessary. Objectives: Here we aim to evaluate how clinical and radiographic symptoms of patients are associated with each other in an Iranian Knee OA population. Methods: In a cross -sectional study, patients with knee OA were recruited. The diagnosis of OA was made using the criteria of American College of Rheumatology (ACR) Classification. Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) was used as an indicator of self-reported disability. The Kellgren -Lawrence index was used for OA grading.Results: A total of 96 OA patients, including 77 females and 19 males, with a mean age of 53.27 ± 10 years, were included. The OA was graded as I, II, III, and IV in 28, 35, 19, and 14 patients, respectively. The mean WOMAC score was 55.2 ± 20.5, ranging from 6.3 to 100.The WOMAC score was not significantly correlated with the grade of OA (p = 0.1, r = -0.188). When we stratified the patients based on their gender, a strong correlation was observed between WOMAC scores and OA grade in male patients (p < 0.001, r = -0.882), while it was still non -significant in female patients (p = 0.9, r = 0.002). Conclusions: Self -reported disability is associated with radiographic symptoms in male patients with knee OA, but not in females.Hence, the orthopedic surgeons should consider this discrepancy in their decision -making process to decide appropriately about the choice of therapy.Given the role of clinical symptoms in the appropriate selection of OA patients as TKA candidates, a more clear understanding of the association between clinical and radiological symptoms is necessary.

Background:Fractures of the knee account for about 6% of all trauma admissions. While its management is mostly focused on fracture treatment, it is not the only factor that defines the final outcome.Objectives:This study aimed to study objective and subjective outcomes after proximal tibial versus distal femoral fractures in terms of knee instability and health-related quality of life.Patients and Methods:This retrospective, cross-sectional, cohort study was carried out on 80 patients with either isolated proximal tibial (n = 42) or distal femoral (n = 38) fractures, who underwent open reduction and internal fixation. All the fractures were classified based on the Schatzker and AO classification for tibial plateau and distal femoral fractures, respectively. The patients were followed and examined by an orthopedic knee surgeon for clinical assessment of knee instability. In their last follow-up visit, these patients completed a Lysholm knee score and the short-form (SF) 36 health survey.Results:Among the 42 tibial plateau fractures, 25% were classified as Schatzker type 2. Of the 38 distal femoral fractures, we did not find any type B1 or B3 fractures. The overall prevalence of anterior and posterior instability was 42% and 20%, respectively. Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) injuries were detected clinically in 50% and 28%, respectively. The incidence rates of ligament injuries in tibial plateau fractures were as follows: Anterior Collateral Ligament (ACL) 26%, Posterior Collateral Ligament (PCL) 7%, MCL 24%, and LCL 14%. Medial collateral ligament injury was the most common in the Schatzker type 2 (50% of the injuries). Distal femoral fractures were associated with ACL injury in 16%, PCL in 13%, MCL in 26% and LCL in 14%. However, final knee range of motion (ROM) and function (Lysholm score) were not associated with fracture location. No statistically significant difference was observed between the two groups, except for the valgus stress test at 30°knee flexion, which was more positive in tibial fractures. All eight domains of SF-36 score in the distal femoral and proximal tibial fractures were significantly different from the normal values; however, there were no statistically significant differences between femoral and tibial fracture scores.Conclusions:Although ROM is acceptable in knee joint fractures, instability is common. However, it seems that knee function and quality of life are not associated with the location of the fracture.

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Introduction: Consumption of anabolic-androgenic steroids (AAS) is described as a major factor in tendon weakening process. The reports of bilateral quadriceps tendon rupture (QTR) following the AAS consumption are very rare. The current study described a case of simultaneous bilateral QTR following a low-energy trauma in a body builder with the history of ASS consumption. Case Presentation: A 32-year-old male body builder was referred to under study center with a history of falling down from the stairs nearly 2 weeks earlier. Magnetic resonance imaging (MRI) showed QTR in both knees from superior pole of patella. He denied any major trauma to explain the recent problem. Thus, the QTR was attributed to a low-energy trauma. While ruling out the tendon weakening conditions promptly, the history of oral and intramuscular consumption of AAS was noted. The patient was operated to repair QTR. At the last follow-up session, he was able to actively straighten his legs. The consumption of AAS was discontinued afterward. Conclusions: Consumption of AAS by athletes has considerably increased during the last few decades. An appropriate warning of orthopedic surgeons regarding AAS side effects is necessary in order to recognize the predisposing factor of tendon rupture in similar circumstances and address the case properly.