bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Dissatisfaction Following Total Knee Arthroplasty (Systematic Review and Meta-Analysis)
Authors: Badawy Basem Ahmed , EL-Ghazaly Sherif Ahmed , Ashoub Mostafa Mamdouh 
Published: August 2023

Background
TKA is a very successful form of treatment for degenerative osteoarthiritis of the knee. The demand for TKA is growing around the world because of the aging population and the need to preserve people's quality of life. However, one in every 300 knee arthroplasties, pain without any known explanation will be present. The pain may occur either at rest or with movement. The knee may have a good range of motion, and objective evaluation of the prosthesis may show a perfect result, with good positioning of the implants seen on radiographs, yet the patient complains of pain. Adequate assessment of this condition is important for orthopedists who carry out TKA.

Objective
To identify the causes and predictors of patient`s dissatisfaction after complicated TKA (eg., component malalignment, post early/late infection, patellar tendon rupture, … etc), factors of residual pain during activities of daily living and/or at rest, relation of pain and function in determining dissatisfaction, improvement of TKA outcome measures.

Patients and Methods
The review included Randomized controlled trials (RCT) that studied patient dissatisfaction particularly related to pain following TKA. Also, we included cluster RCTs, controlled (non randomized) clinical trials, prospective comparative cohort studies, and case – control studies. Cross –sectional studies, case series, and case reports were excluded. Only studies on human subjects were included (studies on patients having TKA).

Results
25 studies were included from 2009 to 2019; 24 were prospective studies and one prospective randomized control trial.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
There was a need to consider new interventions to promote mental health and wellness amongst patients receiving TKA but this should, of course, be subjected to evaluation of its costs and benefits before implementation. Further research is needed to quantitatively analyze the discontentment factors that emerged from this study.
Open versus Arthroscopic in Management of Tennis Elbow. A Systematic Review
Authors: ElMahy Mohammed Mostafa M , Mohamed Amr Mostafa , Hussein Diaa Eldin Abdelhay Ahmed 
Published: August 2023

Background
Treatment of resistant tennis elbow (lateral epicondylitis) still challenging, which may require surgery in order to gain pain relief and improve function.

Aim of the Work
The aim of this study is to systematic review and meta-analysis arthroscopic to open surgery for resistant TE regarding ROM, grip strength, DASH score, VAS, and complications.

Methodology
This study was approved by the Ethics Committee of Ain Shams University Faculty of Medicine. Written informed consent was not needed because of the study design (systematic review). We included randomized control trails (RCTs), controlled clinical trials, retrospective cohort studies, case series studies and we excluded case reports, cross sectional studies, non English study. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria.

Results
Our systematic review found that the most relevant conclusion from the current study is that there is a significant difference between the 2 operative techniques when examining VAS score, Mayo elbow performance score, grip strength, DASH score and time to return to work in favor of arthroscopic technique. While the arthroscopic surgery had a longer surgical time than the open technique. Additionally, it was found that the complication rates, DASH score, range of motion and failure rates were similar between the arthroscopic and the open technique.

Conclusion
We found a similar effectiveness of both arthroscopic and open techniques in improving failure risk, complication rate and range of motion postoperative in the treatment of tennis elbow. There is significant difference between arthroscopic and open surgery with regards to self-reported function (DASH), pain intensity (VAS) at follow up, time to return to work and grip strength postoperative in favor of arthroscopic technique. The current meta-analysis found that arthroscopic surgery had a longer surgical time than the open surgery for lateral epicondylitis.
Role of Denosumab in the Management of Aneurysmal Bone Cysts
Authors: Mohamed Mohamed Abdel Hameed Deif , Mostafa Mohamed Abdel Rahman , Elseddawy Ashraf Mohamed 
Published: August 2023

Background
The management of aneurysmal bone cysts (ABCs) has evolved and less invasive methods have been tried. Denosumab is a monoclonal antibody that inhibits osteoclasts. It is effective in giant cell tumours of bone (GCT) and based on the immunohistochemical similarity and relationship between GCTs and ABCs, Denosumab may also be effective in the treatment of ABCs.

Aim of the Work
This study aims to assess the therapeutic importance, effectiveness and side effects of denosumab administration in the management of aneurysmal bone cysts.

Materials and Methods
Embase, Cochrane Library, and MEDLINE/PubMed databases were searched for the articles published from Jan. 2013 to May 2021 that reported the efficacy and safety of denosumab in patients with aneurysmal bone cysts (ABCs).

Results
Thirteen studies were reviewed, involving a total of 40 patients who had aneurysmal bone cysts and were treated with denosumab. Of the 13 studies, 82.5% of the patients were from case series studies (33 patients) and 17.5% were from case reports (7 patients). The clinical response rate for denosumab as a treatment for aneurysmal bone cysts was 94.7%, with statistical significance (P &lt; .0001). No treatment-related deaths occurred in the reviewed studies.

Conclusion
We conclude that denosumab represents an effective treatment option for patients with ABC especially when high surgical morbidity is expected. Although denosumab therapy is associated with minimal complications, however, relapse following cessation of treatment is still possible. Finally, denosumab is a potentially safe and promising modality for medically managing ABCs that requires further investigation with prospective clinical trials.
Unicompartmental Knee Arthroplasty versus Total Knee Arthroplasty in Treatment of Unicompartmental Knee Osteoarthritis
Authors: Osman Wael S A , Mounir Ayman F , Yusuf Mohamed A 
Published: August 2023

Objectives
This is a systematic review conducted to compare the outcomes between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA).

Material and Methods
Collection of data from different websites in the period from 2010 to May 2021 that studied UKA or TKA in treatment of knee osteoarthritis (OA). Comparison was made between the two techniques was performed of 12 literatures according to the study criteria and the PRESMA figure.

Results
There is no difference in age between the two techniques, however, there is a significant difference in gender and BMI (P &lt; 0.05). The mean follow-up period of the patients was 4.14 ± 3.05 years and 3.94 ± 2.65 years in UKA and TKA groups, respectively. There is good improvement of VAS, KSS, OKS, KSS, WOMAC, ROM postoperatively regarding both techniques.
Effect of a New Antibiotic Protocol Adopted by ASU Hospitals on Patients with Intra-Medullary Nailing of Femoral and Tibial Diaphyseal Fractures as Regard Post-Operative Infection
Authors: El Zaher El Zaher Hassan , Abuzaid Mohamed Hamza , El Abd Mostafa Aly 
Published: August 2023

Background
This study postulated that systemic antibiotic prophylaxis delivered preoperatively in intramedullary nailing of femur and tibia procedures significantly reduces the incidence of infection. Prophylactic antibiotics should be taken IV before skin incision by 30-60 minutes and no need for antibiotics more than 24 hours after operation. This protocol of antibiotics has multiple benefits such as saving a lot of money, decrease the risk of surgical site infection and decrease antibiotic resistance.

Aim of the Work
To assess the effect of antibiotic choice, duration on prevalence of surgical site infection among patients with intramedullary nailing of femoral and tibial fractures, and identify risk factors.

Patients and Methods
This study conducted on 50 cases of femoral and tibial fractures admitted from Al-Demerdash University Hospital in the period from June 2019 to December 2020 with age ranged from 18 to 56 years and with mean ± SD of 28.14 ± 10.14. This study was based on the antibiotic protocol adopted by Ain Shams University Hospitals that we give first generation cephalosporin (zinol) for all patient undergoing intramedullary nailing of femur and tibia, 30 – 60 minutes before skin incision and for 24 hours post-operative.

Results
The results of this study showed 1 case infected postoperative from 50 cases with a percentage of 2%, by this result we found that by studying the risk factors for infection there was no specific risk factor for infection except for obesity and diabetes. By studying of the results of application of our new antibiotic prophylaxis protocol in our hospital (Ain Shams University Hospitals) from the period from 6-2019 to 12-2020 the new protocol have the benefits of the following: Decrease of the total percentage of infection in all orthopedic surgeries in our department to less than 2%, Presence of fixed, known and effective prophylactic antibiotic protocol in our hospital unlike before every surgeon has his opinion about type and dose of antibiotics causing less controversy and confusion among surgeons in the practice of postoperative antibiotic use.

Conclusion
This study postulated that systemic antibiotic prophylaxis delivered preoperatively in intramedullary nailing of femur and tibia procedures significantly reduces the incidence of infection.
A Systematic Review of the Clinical Efficacy of Oxidized Zirconium as a Bearing Surface in Hip Arthroplasty
Authors: Fekry El-Husseini Timour , Ashoub Moustafa Mammdouh , Ahmed Mohammed Sayed 
Published: August 2023

Background
Total hip replacement (THA) is an established treatment for end stage hip arthritis providing reliable pain free function. The long-term survival of THA depends on multiple factors, But aseptic loosening and wear induced osteolysis are most common causes of failure and search for alternative bearing surfaces became an important issue.

Aim of the Work
Our aim in this study is to evaluate efficacy of Oxide zirconium femoral head as a bearing surface in Total hip arthroplasty patients regarding clinical and radiological outcomes.

Patients and Methods
The types of study was a prospective and retrospective comparative cohort studies. Search results were conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart was produced based on the search results and the inclusion/exclusion criteria.

Results
OxZr was found to be less sensitive than CoCr to these variations and maintained a lower coefficient of friction when articulated with UHMWPE, even in poor lubricants.

Conclusion
Most of studies which were included in this review reported no significant differences in the mean polyethylene wear rate, survival rate, mean postoperative clinical subjective scores and complications’ rate of patients treated with OxZi femoral heads compared with the respective mean wear values of those who treated with CoCr femoral heads, While OxZi is offered at a cost premium, it seems that this type of alternate bearing surface is not clinically superior to the traditional metal bearing surface inTHA.
Bipolar Hemiarthoplasty versus Proximal Femoral Nail in Management of Unstable Intertrochanteric Femur Fracture
Authors: Khairy Amr , Mostafa Sherif , Khalil Eldeeb Mostafa Ebrahim Sayed 
Published: August 2023

Background
Intertrochanteric fractures (ITFs), commonly occurred in the elderly, are still a big challenge for orthopedic surgeons due to the multitude of co-morbidities and high 1-year mortality rate associated with them.

Aim of the Work
The aim of this study is to review systematically studies about the use of bipolar hemiarthoplasty versus proximal femoral nail in management of unstable intertrochanteric femur fracture.

Patients and Methods
We included randomized control trails (RCTs), controlled clinical trials, retrospective comparative cohort studies and prospective comparative cohort studies and we excluded case reports, case series studies, cross sectional studies and non English studies. Search results was conducted to systematic review management software and manually screened for eligibility to be included. Surgical treatment of unstable intertrochanteric femur fractures by bipolar hemiarthoplasty versus proximal femoral nail.

Results
Regarding the patients included in the review there is no significant difference in the age or sex between the two groups of comparison. This review provides us with enough evidence regarding the superiority of PFN, which being a significantly faster surgery and has relatively lower incidence of intraoperative blood loss this in turn provides general wellbeing to the patient and gives better function. Although there is no significant difference between two group of comparison regarding percentage of failure and percentage of reoperation, PFN shows the superiority of duration of hospital stay which could be beneficial for the mental health of the patients, which adds to their overall quality of life, also PFN show the superiority regarding percentage of infection, decreasing patient suffering and risk of reoperation, also PFN show the superiority regarding percentage of mortality increasing life expectancy of patients, percentage of DVT decreasing pulmonary complications and also PFN show the superiority regarding Harris hip score so show better outcomes.

Conclusion
PFN proves itself as a better modality than hemiarthroplasty in unstable intertrochanteric femur fractures in the elderly, with decreased post-operative mortality and better functional results. Hemiarthroplasty is best reserved for individuals with short life expectancies who require immediate weight bearing and mobilization.
Outcomes of Four in One Osteosynthesis in the treatment of Congenital Tibial Pseudarthrosis: A Systematic Review
Authors: Samir Shady , Kersh Mohamed Ahmed Al , Ayoub Muhammad Ahmad Muhammad 
Published: August 2023

Background
CPT has a natural history of recalcitrant nonunion, bone atrophy, progressive LLD and deformity, and persistent refracture even after surgical union.

Aim of the Work
The aim of treatment for CPT is to achieve and sustain union.

Methodology
Studies were considered eligible if the authors described the surgical procedure of tibial pseudarthrosis, patient‘s clinical and/or functional outcomes were reported, any complications intraoperatively and post-operatively were reported, the full- text articles were available, and the articles were written in English. The MED-LINE database, PubMed, science direct, Cochrane Register of Controlled Trails (The Cochrane Library), and Google Scholar were searched upon using the following keyword: congenital tibial pseudarthrosis, CPT, tibiofibular fusion, tibiofibular osteosynthesis, four in one osteosynthesis, tibia and fibula one mass fusion, Paley x method, and cross union.

Results
The cumulative data extracted provided 96 patients in 6 papers of which 60% were male and the other 40 % were females. The mean age was around 4.1 Years ranging from the first year till nearly eleven years old and the mean follow up was around 4.1 Years. The percentage of patient with neurofibromatosis type 1 was 53.13 % and 41.1 % had previous surgical intervention. All studies have mentioned that cross sectional area of healing mass increased and the relative crosssectional area was large in comparison to proximal shaft or proximal metaphysis. Unfortunately, no single method of assessing the cross-sectional area and relative cross-sectional area were used by different authors.

Conclusion
According to the findings of our research, cross sectional area is the most important factor in preventing refracture. New technology and therapeutics will emerge as new pharmacologic therapeutics and a deeper understanding of this disease emerge. Meanwhile, the best current combination treatment for CPT is hamartoma resection, periosteal grafting, bone grafting, Cross union, internal rodding, external fixation, tibiofibular Cross union, BMP, and bisphosphonate.
Posterolateral Plate vs. Lateral Plate in Fixation of Weber B Ankle Fractures. A Systematic Review/Meta-Analysis
Authors: Kamel Ahmad Samy , El-Sayed Awad Mohammed , El Raffa Nabil Wafik Anwar Hassan 
Published: August 2023

Introduction
Ankle fractures represent 10% of all fractures making it the second most common lower limb fractures after hip fractures. Danis-Weber classification describes the injury based on the location of the lateral malleolar fracture as type A, B and C. Management of type B ankle fracture is often surgical through open reduction and internal fixation by plate and screws. The plate can be positioned laterally or postero-laterally.

Aim of work
To compare between posterolateral plate versus lateral plate in management of DanisWeber type B fibular fracture.

Materials and methods
A systematic review and meta-analysis in which search strategy done from 2000 to 2020. This study is done on 4 articles with total number of participants 333. The outcomes of interest are operative outcome, functional outcome measured by AOFAS and Olerud and Molander scoring system, complication rates outcome.

Results
Posteo-lateral plate is superior in less hardware irritation. Regarding operative timing, wound infection, screw loosening and functional outcomes both techniques are comparable with no statistically significant difference.

Conclusion
Both techniques are comparable with no stasticially difference regarding operative time, wound infection, screw lossening and functional outcomes. However, fixation of lateral malleolar fracture by posteo-lateral plate is superior in less hardware irritation.
Antegrade Intramedullary Pinning versus Retrograde Intramedullary Pinning versus Transverse k-Wires Fixation of Neck of 5th Metacarpal Fracture: A Systematic Review
Authors: Elkhateeb Tameem Mohamed Shafik , Hamed Islam Koriem Fattouh , Elattary Sayed Hussein Mohamed 
Published: August 2023

Background
The 5th metacarpal fractures accounts for 40% of all hand fractures. Neck fractures are the commonest, as it is the weakest point in metacarpals, and accounts for about 10% of all hand fractures. Improper management of hand fractures has negative economic effect due to disabilities that occur to hands of workers, athletes and housewives.

Objective
To do a systematic review on literature that compares between using the antegrade verses retrograde intra-medullary k-wires and transverse pinning techniques in treatment of fifth metacarpal's neck fracture (boxer's fracture) regarding union, functional outcome and complications.

Patients and Methods
Recent clinical trials or cluster trials, prospective and retrospective comparative cohort studies. Search results will be uploaded to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be introduced on the search results and the inclusion/exclusion criteria.

Results
Application of inclusion and exclusion criteria to study abstracts yielded 8 articles. The full-text articles for these 100 studies were then reviewed and subjected to our inclusion criteria. A total of 8 articles were eligible for final systematic review.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2022.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Despite the limitations of this review, we found some evidence that the IM technique could have advantages over the use of transverse pinning in the treatment for the fifth metacarpal neck fractures. The quantitative analyses indicated probable better efficacy of IM particularly in relation to VAS, TAM, active ROM of the fifth ray and residual angulation. Our results can fit into the context of current practice where many hand surgeons consider the IM technique as their preferred method to treat neck fractures of the fifth metacarpal.
Mono-Focal Distraction Osteogenesis in Management of Traumatic Bone Loss (Systematic Review of Literature)
Authors: Abou-Seif Salah Abdelgawad , Kotb Mohamed Ismail , Abdelwahab Mahmoud M , El Rahman Shady Ahmed Abd 
Published: August 2023

Background
Traumatic bone loss poses a serious problem for orthopedic surgeons added to the long standing risk of infection implied by open type fractures.

Aim of the Work
This study aims to assess the efficacy of distraction osteogenesis in compensating bone defects using the Paley score for functional and radiological outcomes.

Methodology
We searched the literature through PubMed database with publication date restricted to 10 years range from 2009-2019 English literature of prospective studies only were selected with strict inclusion criteria where repeated articles were excluded unless they presented follow up with functional outcome data about cases. Seven studies were included satisfying the predetermined inclusion criteria with total of 242 cases. Patients’ data were collected and analyzed with only: 176 cases mentioned demographic data with average age of ‘37’ and no comorbidities to decrease the risk of bias in our results. 125 patients had fractures in tibia without soft tissue loss and 51 patients needed skin grafting, 3.4% of total cases underwent late amputation, 14.2% experienced pin tract infection.

Results
Our results appear to demonstrate the efficacy of mono-focal distraction osteogenesis technique in compensating long bone defects of the lower limbs in traumatic events. We isolated studies reporting exclusively on either proximal tibia or distal tibia bone defects compared the respective outcomes of interest in the absence of statistical heterogeneity. The only significant difference that could be established was a four-fold decrease of the likelihood of fair functional results in the ‘distal tibia’ subgroup compared with the ‘proximal tibia’ subgroup. In distal tibial defects, we explored the impact of the size of a bone defect and duration of external fixation on outcomes of interest. We noticed a 3.7-times increase in the odds of re-fracture when the size of the distal tibial defect exceeded 8 cm

Conclusion
Mono-focal distraction osteogenesis (Ilizarov method) is effective in managing bone defects larger than 3 cm² however for defects larger than 8cm² there’s increased risk of re-fracture.