From tradition to science: Possible mechanisms of ghee in supporting bone and joint health.

Ghee, a traditional form of clarified butter, has been used for centuries in Ayurvedic medicine for its numerous health benefits. Recent scientific studies have begun to elucidate the molecular mechanisms by which ghee may support bone and joint health. This review explores the bioactive components of ghee, including short-chain fatty acids (SCFAs), medium-chain fatty acids (MCFAs), and fat-soluble vitamins (A, D, E, K2), and their potential therapeutic effects on bone density, joint lubrication, and inflammation. SCFAs in ghee can potentially improve joint lubrication and reduce inflammation. MCFAs and conjugated linoleic acid (CLA) exhibit anti-inflammatory properties, modulating cytokine production and oxidative stress pathways. Vitamins D and K2 in ghee can play potentially crucial roles in calcium metabolism and bone mineralization, while vitamin A supports immune regulation and cartilage health. This review integrates traditional knowledge with contemporary scientific research, highlighting the potential of ghee as a complementary therapy for conditions such as osteoporosis and arthritis. By understanding the molecular mechanisms involved, future studies can focus on this field to shed a light on different effects of ghee on bone and joint health.

Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used.

PURPOSE: Core Bone Plug Fixation (CBPF) technique is an implant-less methodology for ACL reconstruction. This study investigates the effect of bone density on CBPF stability to identify the bone quality that is likely to benefit from this technique. METHODS: Artificial blocks with 160 (Group 1), 240 (Group 2), and 320 (Group 3) kg/m3 densities were used to simulate human bone with diverse qualities. These groups are representative of the elderly, middle age and young people, respectively. A tunnel was made in each test sample using a cannulated drill bit which enabled harvesting the core bone plug intact. Fresh animal tendon grafts were prepared and passed through the tunnel, so the core bone was pushed in to secure the tendon. The fixation stability was tested by applying a cyclic load following by a pullout load until the failure occurred. The selected group was compared with interference screw fixation technique as a gold standard method in ACL reconstruction. RESULTS: The Group 2 stiffness and yield strength were significantly larger than Group 1. The graft slippage of Group 1 was significantly less than Group 3. The ultimate strengths were 310 N and 363 N, in Groups 2 and 3, significantly larger than that of Group 1. The ultimate strength in fixation by interference screw was 693.18 N, significantly larger than the bone plug method. CONCLUSIONS: The stability of CBPF was greatly affected by bone density. This technique is more suitable for young and middle-aged people. With further improvements, the CBPF might be an alternative ACL reconstruction technique for patients with good bone quality. CLINICAL RELEVANCE: The CBPF technique offers an implant-less organic ACL reconstruction technique with numerous advantages and likely would speed up the healing process by using the patient's own bones and tissues rather than any non-biologic fixations.

Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review.

Multiplanar or global laxity in arthritic knee is rare, most of this patients have neuromuscular disorder (post poliomyelitis, spinal dystrophy) or history of knee trauma. Ligament insufficiency and severe bone loss is significant in this patient. The estimated prevalence for the concurrence of charcot marie-tooth (CMT) with myasthenia gravis (MG) suggests an extremely rare event. We have presented a 54-year-old female patient with CMT and MG complaining of progressive pain, swelling, and crepitation of the knee joints who had been undergone total knee arthroplasty (TKA) with rotating hinge prosthesis. She had an acute myasthenia crisis soon after operation with prolonged intubation and intensive care unit admission. Radiographies and physical examination revealed bilateral severe unstable arthritic knee joints and left knee posterior dislocation. Short-term postoperative follow-up revealed improved knee function and resolution of all symptoms in the operated side.

Iranian Joint Registry (Iranian National Hip and Knee Arthroplasty Registry).

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education.

Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery.

BACKGROUND: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. PURPOSES: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. METHODS: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. RESULTS: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53%) were torn and 19 tendons (48%) slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11). The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76). CONCLUSIONS: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model.

Intraarticular Administration of Tranexamic Acid Following Total Knee Arthroplasty: A Case-control Study.

BACKGROUND: Tranexamic acid (TXA) has received extensive attention in management of blood loss in orthopedic surgeries. However, the ideal method of TXA administration is still controversial. This study aims to determine whether intraarticular injection of TXA reduces blood loss after total knee arthroplasty (TKA). METHODS: Through a retrospective case-control study consecutive TKA patients receiving intraarticular TXA (Case group) were compared with similar patients undergoing TKA using traditional blood management strategy (Control group). Hemoglobin levels (Hb) before and after the surgery, need for transfusion, and reoperation due to massive blood loss were compared between the two groups. RESULTS: Fifty TXA patients were compared with 50 patients of the control group. There was no significant difference between the two groups in terms of age, gender, and preoperative Hb. Postoperative blood loss and transfusion rate were significantly reducedin TXA patients compared to the control group (P<0.05). CONCLUSIONS: Our study revealed that intraarticular administration of TXA reduces postoperative blood loss as well as need for blood transfusion in patients undergoing TKA.

Synovial hemangioma of the knee with recurrent effusion and pain: a case report.

Synovial hemangioma is a rare benign malformation of the synovium. It presents frequently in the knee with pain, tenderness, intermittent swelling and recurrent hemarthrosis. MRI can be helpful in diagnosis of synovial hemangioma. In this paper, we present a 45-year-old lady with chronic symptoms and obscure clinical symptoms for 35 years which finally diagnosed and managed arthroscopically as synovial hemangioma of the knee. The patient`s complaints resolved efficiently with no recurrence after one year.

Bilateral Synovial Knee Chondromatosis in a Patient with Rheumatoid Arthritis: Case-report and Literature Review.

We presented a female patient with RA complaining of progressive pain, swelling, and crepitation of the knee joints that was diagnosed with bilateral synovial chondromatosis (SC) of both knees. Radiographies revealed characteristic findings of SC including multiple calcified multifaceted loose bodies within both knees. Removal of cartilaginous segments as well as total synovectomy was performed arthroscopically on the left side and via open surgery on the right side. Short-term postoperative follow-up of our patient revealed improved knee function and resolution of all symptoms.

Result of shelf acetabuloplasty in adults: 20 years of follow-up.

The current study was conducted in order to examine the effectiveness of shelf procedure in symptomatic adult patients due to hip dysplasia. This study is retrospective and was performed on patients who had undergone surgery by one orthopaedic surgical team during the past 20 years. Twenty-three men and twenty-three women were enrolled in the study with a mean age of 29.3 years at the time of operation and they were followed up for a mean of 9.3 years. Shelf acetabuloplasty was performed unilateral in 30 patients and bilateral in 16 patients. Results demonstrated that mean Harris Hip Score and CE Angle significantly improved after the operation, while osteoarthritis got more severe post-operatively. The severity of osteoarthritis and the Harris Hip Score respectively significantly increased and decreased 14 years after the operation. Results also demonstrated that as the age of the patient was less, and the patient was more satisfied and the degree of osteoarthritis was less at the time of the operation, the mean change of the Harris Hip Score would be higher and the results of the operation would be more favorable. The preoperative osteoarthritis was significantly worse in to-be-operated hips than their control hips, this difference was not significant after the operation. And finally, although Harris Hip Score has been lower in to-be-operated hips before the operation, it was higher in these very same hips than the control hips after the operation. In short, according to this study although the shelf acetabuloplasty is a salvage procedure and cannot cover the femoral head concentrically like the modern redirectional osteotomies , but it is an effective procedure for a young patient to postpone the progression of the hip osteoarthritis (OA) once it occurs in order to perform reconstructive surgeries later when justified.