Purpose: Usually, about 25% of the patients treated with corticosteroids after kidney transplantation suffer from the complication of Avascular Necrosis (AVN) of the femoral head. This study aims to compare the effect of Neuromuscular Electric Stimulation (NMES) and traditional treatment (infrared and decrease weight-bearing) on Harris hip score. Methods: Twenty patients who developed AVN of the femoral head after kidney transplantation were divided into two groups. The first group was treated by NMES and stretching and strengthening exercises 3 sessions a week for 3 months. The second group was treated by Traditional Treatment (TT) and stretching and strengthening exercises 3 sessions a week for 3 months. Results: Harris hip score component was measured before the intervention and then three months after the intervention using the t-test. After the intervention, significant differences were found between both groups in pain, support, distance walked, limping, putting on shoes and socks, climbing stairs, sitting, flexion (all P<0. 001), external rotation (P=0. 014), abduction (P=0. 030), adduction (P<0. 001), public transportation (P=0. 010), and total hip score (P<0. 001). Conclusion: TT exercises accompanied by NMES were more effective than TT alone for AVN of femoral head patients and could stop the progressive worsening of hip joint mobility.

Background and Objectives: Intertrochanteric fracture is a prevalent condition among the elderly that affects many people annually in both health and financial status. Type A2 intertrochanteric fracture is treated with surgical internal fixation either through a cephalomedullary nail (CMN) or a dynamic hip screw (DHS). This study compares radiological and clinical outcomes of CMN and DHS devices in patients with type A2 intertrochanteric fractures. Methods: In this retrospective cohort study, hospitalized patients with A2 intertrochanteric fracture who were treated with either CMN or DHS devices from 2014 to 2023 were included in the study. All participants were assessed retrospectively regarding radiological outcomes (nonunion, varus malunion, and femoral medialization percentage) clinical outcomes, and incidence of pulmonary thromboembolism and deep vein thrombosis.  Results: A total number of 194 patients were included in the study. The patients who were operated on with DHS showed a better result regarding the incidence of varus malunion compared to CMN (P=0.009), while the incidence of nonunion and union failure, and percentage of femoral medialization showed no significant difference between groups. Despite a comparable total score of modified Harris hip score in both groups (P=0.669), DHS surgery had a better outcome in the walking distance status component (P=0.043). Conclusion: Despite better outcomes of DHS surgery regarding the incidence of varus malunion and walking distance status, other outcomes of both groups did not show a significant difference. However, more prospective studies with multiple systematic follow-ups and radiographs are needed to confirm these findings.

Background: Femoral Neck Fracture (FNF) is prevalent in young people. It is mostly due to high-energy trauma and creates many challenges in surgical repair. A few patients with hip fractures can fully recover from the injury and act independently in their daily activities. In this study, we evaluated the results of FNF operation in patients younger than 60 years. Objectives: This study was conducted to evaluate the outcome of femoral neck surgery in young patients and comparison the complications according to types of surgery, age, delay and type of FNF fracture. Methods: This study was a retrospective-prospective descriptive and analytical study on patients 15 to 60 years old with FNF from 2013 to 2017. The surgical efficacy and its results were evaluated using the Harris hip Scale (HHS). The obtained data were analyzed in SPSS version V. 24. Results: The Mean± SD age of 53 study patients was 42. 07± 12. 5 years. The Mean± SD femoral neck shortening was 7. 05± 5. 42 mm, and the HHS score was 82. 7± 6. 9. Avascular Necrosis (AVN) was seen in 10 (18. 9%), malunion in 11 (20. 8%), nonunion in 1 (1. 9%) and failure in 3 (5. 7%) patients. Eight patients had reoperation procedures. The type of fracture, delay in surgery, type of operation, and the shortening of the femoral neck were predictive factors of postoperative complications (P<0. 05). Conclusion: According to this study, reducing the delay for surgery, increasing anatomic reduction, and preventing the shortening of the femoral neck can improve the quality of life, reduce complications, and decrease the economic burden.

Objectives: The increasing number of total hip arthroplasties (THA) has led to increased patient demands and expectations, making it crucial to assess patients' ability to "forget" their implants in daily life. This study aimed to determine the reliability and validity of a Persian version of the Forgotten Joint score (P-FJS) in THA patients. Methods: The questionnaire was translated bidirectionally with the permission of the questionnaire designer. Data were collected from 2018 to 2020 and included 142 patients who had undergone THA by the same surgeon at least one year ago. Participants completed the FJS questionnaire twice within a one-week interval, and the validity, reliability, and feasibility of the questionnaires were assessed using statistical tests on the HHS and OHS forms completed by all participants. Results: In 142 patients (52. 1% male) with a mean age of 65 ± 0. 5 years who answered the questionnaires, P-FJS correlated strongly with OHS and HHS. The internal consistency (α = 0. 91) and reproducibility of the questionnaire were excellent. None of the floor and ceiling effects were detected. Conclusion: The P-FJS questionnaire in the THA is considered a legitimate, repeatable, and self-administered survey that can be compared to its English-language counterpart. In addition, it is noteworthy that this version does not show any floor or ceiling effects. Level of evidence: III

Background: Management of acetabular bone defects, especially massive ones, is a challenging issue for surgeons during total hip arthroplasty (THA). Inadequate bone coverage can lead to weakness of acetabular component fixation and instability, and finally, failure of surgery. In recent decades, different techniques and methods have been reported in literature to manage these defects according to their sizeandlocation. However, the routine use of manyof thesenewmethodsis impossible in the majority of patients because of existing financial limitations. The aim of the present study was to evaluate the clinical and radiographic outcomes of THA with acetabular defect reconstruction using shelf-autograft. Methods: This study was designed and conducted in two phases of retrospective and prospective. Between 2012 and 2017, 423 THA surgeries were performed in two hospitals by senior surgeon. A total of 38 THA procedures using shelf autograft were performed. The short-term clinical and radiological results were evaluated in the present study. Results: The mean coverage angle by graft was 45. 5  7. 3% (range: 33-72%) and horizontal coverage percentage by graft was 79. 3  12. 8% (range: 54-100%). After a mean follow-up of 26 months (range: 12-56 months), no evidence of instability was found in any of these hips. Considering loosening and revision as an end-point, the survival rate was 100%. The patients’ mean Harris hip score (HHS) improved from a mean of 35. 50 9. 11 preoperatively to 95. 10 4. 71 at the last follow-up. Rigid fixation of graft to host bone, medial insertion of acetabular cementless cup, and avoidance of lateral or high hip center were found to result in excellent THA with shelf graft outcomes. Conclusions: Despite the development of more advanced methods to manage acetabular defects during total hip replacement, using shelf-graft is a valuable and accessible strategy for hip surgeons, and by the use of suitable techniques, we can expect excellent outcomes even in massive defects.