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Non Vascularized Bone Graft versus Core Decompression in Treatment of Early Stages of Non Traumatic Hip Osteonecrosis

A vascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years. Treatment of a vascular necrosis depends mainly on early diagnosis which mainly based on clinical findings, x-ray finding & MRI.A variety of non-vascularized bone grafting techniques have been proposed with varying degrees of success as treatment alternatives for osteonecrosis of the femoral head. The success of these procedures may be enhanced using ancillary growth and differentiation factors. Patients & Methods: We retrospectively reviewed 37 patients (44 hips) with osteonecrosis of the femoral head between May 2007, and March 2011, divided into two groups. Group A include 17 patients (22 hips) with osteonecrosis of the femoral head who had non vascularized bone grafting procedures done for them. Minimum follow-up was 12 months. We compared the outcomes in this cohort to similar hip number (22 hips) in 20 patients treated with core decompression only (group B). We used Phemister technique to make a window at the posterior aspect of greater trochanter to remove necrotic bone and packed the excavated area with autogenous cancellous bone graft taken from ipsilateral iliac crest or leave it without bone graft (decompression only). Results: We report the result of treatment for femoral head avascular necrosis depending on Ficat classification stage I, II, & III. The minimum follow up was 12 months (12m-36m).The success percentage of hips in our cohort of patients with non-vascularized bone grafting group A are 86% (19 of 22 hips), which is higher than group B 63% (14 of 22 hips) with core decompression alone. Conclusion: These procedures (core decompression and autogenous cancellous bone graft) effectively reduce donor site morbidity and may defer joint arthroplasty in selected patients & it is more effective than core decompression alone in treating early stages of femoral head osteonecrosis.

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Metabolic syndrome in obese versus non-obese persons In basrah

Background: The prevalence of obesity is continuously rising world-wide. Obesity is an important risk factor of cardiovascular disease (CVD), metabolic syndrome (MS), and type 2 diabetes (T2D).
Objective: To estimate the frequency of MS in obese versus non-obese subjects in Basrah, Iraq .
Methods: This is a prospective clinical study performed in Al-Sadr Teaching Hospital, Basrah, and included 86 obese subjects (with a BMI ≥ 30), 39 males and 47 females, and 132 non-obese subjects ( with a BMI < 30 ), 60 males and 73 females as a control group. Measurement of height, weight, waist circumference (WC), blood pressure ( BP ), fasting blood glucose ( FBG ), total cholesterol (TC), triglycerides (TG ) and high density lipoprotein-

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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
Stress Analysis of the Hip Bone

The bony pelvis has a major role in weight transmission to the lower limbs. The complexities of its geometric form, material properties, and loading conditions render it an open subject to biomechanical analysis.

 The present study deals with area measurement, and three-dimensional finite element analysis of the hip bone to investigate magnitudes, load direction, and stress distribution under physiological loading conditions.

 The surface areas of the auricular surface, lunate surface, and symphysis pubis were measured in (35) adult hip bones. A solid model was translated into ANSYS parametric design language to be analyzed by finite element analysis method under different loading conditions.

The surface

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Publication Date
Mon Jan 02 2012
Journal Name
Journal Of The Faculty Of Medical Baghdad
Publication Date
Sat Jan 02 2016
Journal Name
Iraqi Postgraduate Medical Journal
Wallplasty Versus Non Wallplasty in Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction

Abstract ABSTRACT:BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) is one of the most commonly performed orthopedic procedures. Technical factors especially correct tunnel placement play major role in its success. However its failure rate is still high (10%), and impingement of the graft on the posterior cruciate ligament (PCL) and the medial wall of the lateral femoral condyle is an important cause of failure. Wallplasty is a technique used to prevent graft impingement, but there is no consensus on its routine use.OBJECTIVE:Is to compare between the postoperative knee functional outcome and stability of arthroscopic ACLR performed with wallplasty versus those performed without wallplasty.PATIENTS AND METHODS: A prospective exp

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Publication Date
Mon Jan 02 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Comparative study between ultrasound findings and intra-operative findings in non-traumatic Abdominal Pain:

Background: acute abdominal pain is one of the most common presentations in surgical wards. Ultrasound has been grown in popularity as an easy, quick and non-invasive imaging the abdomen. US is very useful means of non-invasively, modality for assessment of acute abdominal pain.
Objective: Study of the most common acute none traumatic abdominal diseases in adult patients admitted to Baghdad Teaching Hospital in department of surgery .Correlate the operative findings with sonographic features as to make the initial diagnosis of the diseases included in this study. Compare the diagnostic yield of abdominal ultrasound with that of computed tomography (CT).
Methods :The present study included eighty nine consec

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Internal Fixation And Bone Grafting Of Non-Union Humeral Diaphyseal Fracture

Background: Humeral diaphyseal fracture usually
heals with closed methods but when nonunion
develops then it needs surgical intervention in the
form of plating and bone grafting, intramedulary
nailing (open or closed simple or interlocking nails)
and external fixators (circular or one plane fixator).
In our unit we treated non union humeral
diaphyseal fracture with plating and bone grafting
shortening of fracture ends up to 4 to 5cm when
needed. Methods: This study was conducted at
Orthopaedic Department of AL-Sadar General
Hospital from January 2004 till December2005 .
We included 20 cases with atrophic non-union in
12(60%) and hypertrophic non-union in 8 (40%)
patients. All atrophic non-union w

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Publication Date
Sun Jul 03 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
A study of 82 patients of non-traumatic terminal ileal perforation in Al-Kindy teaching hospital.

Background typhoid fever is the commonest cause of non traumatic terminal ileal perforation in our study with a grave postoperative morbidity & mortality depending upon preoperative time delay &/or type of surgical intervention practiced. 
Objective to evaluate the frequency of non traumatic causes of terminal ileal perforation, their presentations,perforation-operation interval effect on complications, as well as different modalities of treatment and their complications.
Methods the study is a prospective study of 82 patients with perforation of terminal ileum diagnosed by explorative laparatomy in Al Kindy teaching hospital ,Baghdad, Iraq from April 2008- December 2010, all of the patien

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Publication Date
Sat Mar 14 2020
Journal Name
Medico-legal Update,
Scopus
Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The role of multi-detector CT (MDCT) in patients presented with non-traumatic acute abdominal conditions

Background: Acute abdominal pain classically refers to pain within the abdomen that has been present for less than 7 days from the time of presentation. The use of CT scan in the evaluation of acute abdominal pain has increased to a large extent due to high accuracy of CT in the diagnosis of specific diseases like appendicitis and diverticulitis, especially with the use of multidetector CT scanners. It has been shown that the use of intravenous contrast media increases the diagnostic accuracy of CT scan examination, with a positive predictive value of 95% in the cases of acute appendicitis. The accuracy of CT scan imaging in patients with acute abdominal pain was not affected by the lack of entral contrast material.
Objectives: To eva

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Coronary Angiographic Findings in Diabetic Patients Versus non-Diabetics with Coronary Heart Disease

Background :Atherosclerosis is the most
frequent underlying cause of ischemic heart
disease and a major cause of death all over the
world. This study was carried out to analyze and
compare the angiographic findings in patients
with diabetes mellitus versus non diabetics with
coronary heart disease , and to correlate these
findings with some risk factors for coronary
heart disease.
Methods: A total of 100 patients were studied,
50 with diabetes mellitus, and 50 non diabetics.
This study was carried out at Al-Sadr teaching
hospital in Basrah, Southern Iraq during the
period April 2009- September 2009. All patients
were known to have coronary heart disease. Risk
factors for coronary heart disease

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