الكتب والنشرات العلمية

قائمة المقالات العلمية والنشرات الدورية الخاصة بالدكتور سميح الطرابيشي

  • Operative Procedure for Primary TKR, How to Increase ROM
  • .A unique pattern of Peri-Prosthetic Fracture Following Total Knee, Arthroplasty. The Insufficiency Fracture
  • Achieving Deep Flexion, After Primary Total Knee Arthroplasty
  • Anatomic tibial component design can increase tibial coverage and rotational alignment accuracy: a comparison of six contemporary designs
  • ?Can an Anterior Quadriceps Realise Improve Range of Motion in the stiff Arthritic Knee
  • .Importance of Full Flexion After Total Knee Replacement in Muslims Daily Lifestyle
  • .Knee Kinematics of High-Flexion Activates of Daily Living Performed by the Male Muslims in the Middle East
  • Primary Repair of latrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique
  • Special Considerations in Asian Knee Arthroplasty
  • Special Considerations in Asian Knee Arthroplasty searchgate
  • Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique
  • THINGS YOU SHOULD KNOW ABOUT ASIAN KNEE BEEORE DOING. TQIALKNEEREPLACEMENT
  • Tranexamic Acid to Reduce Blood Loss After Bilateral Total Knee Arthroplasty
Operative Procedure for Primary TKR, How to Increase ROM
Operative Procedure for Primary TKR: How to Increase ROM

Samih Tarabichi, Ahmed El-Naggar, and Mohamed Adi

Deep knee flexion is a real concern for Middle Eastern and Asian patients undergo- ing total knee replacement . Since many daily activities, such as praying, dining, or using the oriental toilet, and many social encounters such as attending the Shaikh’s majlis are carried out on the ground. It has been shown that during prayers, people routinely flex the knee between 150 and 165°, 20–30 times each day

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.A unique pattern of Peri-Prosthetic Fracture Following Total Knee, Arthroplasty. The Insufficiency Fracture
A Unique Pattern of Peri-Prosthetic Fracture Following Total Knee Arthroplasty: The Insufficiency Fracture

Alisina Shahi, MD a, Usama Hassan Saleh, MD a, Timothy L. Tan, MD b, Mohamed Elfekky, MD a, Samih Tarabichi, MD a

abstract

An isolated periprosthetic compression fracture following total knee arthroplasty has not been described in periprosthetic fracture classifications. Thus, the purpose is to describe this unique type of fracture based on clinical and radiographic analysis and identify the incidence and potential risk factors of this fracture. A retrospec- tive chart review was performed from a database of 5864 primary total knee. A total of 56 (0.9%) periprosthetic fractures were identified with 15 (26.8%) of them demonstrating an isolated lateral compression fracture. Patients exhibiting this fracture pattern had a mean preoperative varus deformity of 176.3° and had poor bone quality (T score: −2.1). It is important to recognize that a compression fracture is not an infrequent finding and that further workup maybe warranted when clinical suspicion is high

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Achieving Deep Flexion, After Primary Total Knee Arthroplasty

Achieving Deep Flexion
After Primary Total Knee Arthroplasty

Samih Tarabichi, MD, MS, FRCSC, FAAO, Yasir Tarabichi, and Marwan Hawari, MD

Abstract

Total knee arthroplasty patients often have difficulty performing activities involving flexion beyond 130°. The NexGen LPS Flex (Zimmer Inc, Warsaw, Ind) mobile bearing implant accommodates up to 155° of flexion. Two hundred eighteen total knee arthroplasties were performed using this implant on 125 patients over a 2-year period with a minimum of 5 years follow-up. All data were collected prospectively. Forty-four percent of preoperative cases had full flexion (ie, 140° active flexion and ability to kneel with thigh/calf contact for 1 minute). Five-year data showed an average flexion of 140° ± 11.5° and flexion greater than 140° in 103 knees (68%). There were no differences in patellofemoral pain levels, complications, or Knee Society scores despite our patients having, on average, an increase in flexion and function. Keywords: total knee arthroplasty, knee flexion, rotating platform, mobile bearing, posterior stabilized, deep flexion

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Anatomic tibial component design can increase tibial coverage and rotational alignment accuracy: a comparison of six contemporary designs

Anatomic tibial component design can increase tibial coverage and rotational alignment accuracy: a comparison of six contemporary designs

Yifei Dai · Giles R. Scuderi · Jeffrey E. Bischoff · Kim Bertin · Samih Tarabichi · Ashok Rajgopal

Abstract

Purpose The aim of this study was to comprehensively evaluate contemporary tibial component designs against global tibial anatomy. We hypothesized that anatomically designed tibial components offer increased morphological fit to the resected proximal tibia with increased alignment accuracy compared to symmetric and asymmetric designs. Methods Using a multi-ethnic bone dataset, six contem- porary tibial component designs were investigated, includ- ing anatomic, asymmetric, and symmetric design types. Investigations included (1) measurement of component conformity to the resected tibia using a comprehensive set of size and shape metrics;  assessment  of componentoverage on the resected tibia while ensuring clinically acceptable levels of rotation and overhang; and (3) evalu- ation of the incidence and severity of component downsiz- ing due to adherence to rotational alignment and overhang requirements, and the associated compromise in tibial cov- erage. Differences in coverage were statistically compared across designs and ethnicities, as well as between place- ments with or without enforcement of proper rotational alignment

Results Compared to non-anatomic designs investigated, the anatomic design exhibited better conformity to resected tibial morphology in size and shape, higher tibial coverage (92 % compared to 85–87 %), more cortical support (pos- teromedial region), lower incidence of downsizing (3 % compared to 39–60 %), and less compromise of tibial cov- erage (0.5 % compared to 4–6 %) when enforcing proper rotational alignment

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?Can an Anterior Quadriceps Realise Improve Range of Motion in the stiff Arthritic Knee

?Can an Anterior Quadriceps Release Improve Range of Motion in the Stiff Arthritic Knee

Samih Tarabichi, MD, MS, FRCSC,* and Yasir Tarabichi, MDy

Abstract

We hypothesize that tethering adhesions of the quadriceps muscle are the major pathological structures responsible for a limited range of motion in the stiff arthritic knee. Forty-two modified quadriceps muscle releases were performed on 24 patients with advanced osteoarthritis scheduled for total knee arthroplasty. The ranges of motion were documented intraoperatively both before and immediately after the release. Passive flexion improved significantly in all patients (mean, 32.4° of improvement, P b .001) following a modified quadriceps release, despite any presence of osteophytes or severe deformities. These results strongly implicate adhesions of the quadriceps muscle to the underlying femur, which prevent the distal excursion of the quadriceps tendon, as the restrictive pathology preventing deep flexion in patients with osteoarthritis. Keywords: quadriceps excursion, quadriceps, excursion, quadricepsplasty, quadriceps release, release, knee flexion, range of motion, osteoarthritis, total knee replacement.

.Importance of Full Flexion After Total Knee Replacement in Muslims Daily Lifestyle

Importance of Full Flexion After Total Knee Replacement in Muslims’ Daily Lifestyle

Samih Tarabichi MD FRCS, Yasir Tarabichi, Abdul Rahman Tarabishy MD, Marwan Hawari MD
American Hospital Dubai, Dubai, United Arab Emirates

Abstract

Previous studies show that total knee replacement (TKR) patients have difficulty performing cer- tain tasks involving deep knee flexion which are part of activities of daily living (ADL). Muslims’ lifestyles heavily depend on the ability to fully flex the knee, and many daily activities, such as praying, social encounters (attending the Sheikh’s majlis), dining or even using the hole bathroom, are carried out on the ground. The LPS Flex implant has been designed to accommodate this by giving up to 165 degrees of flexion. One-thousand and thirty-two (1032) TKRs were performed on patients diagnosed with osteoarthritis using the LPS Flex mobile bearing implant over a five year period with a minimum of 1 year post-operative follow up. The results were then compared to a series obtained from the Zimmer Feedback database which is man- aged independently by the Audit and Research Office, Department of Orthopaedic and Trauma Surgery, University of Dundee, Dundee, Scotland, United Kingdom. 44% of pre-op cases had full flexion as per our set criteria. There were no apparent differences in patello-femoral pain levels, complications or Knee Society score despite the fact that our patients had, on average, an increase in maximum flexion along with an increase in functional ability. The knee score failed to assess this improved functionality of patients who had full flexion; a new diagnostic method is therefore needed. The results indicate that the implant allows patients to maintain a high degree of flexion and function post-operatively, with few complications.

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.Knee Kinematics of High-Flexion Activates of Daily Living Performed by the Male Muslims in the Middle East

Knee Kinematics of High-Flexion Activities of Daily Living Performed by Male Muslims in the Middle East

Stacey M. Acker, PhD,* Robert A. Cockburn, BSc Eng,* Janet Krevolin, PhD,* Rebecca M. Li, BSc Eng,* Samih Tarabichi, MD,y and Urs P. Wyss, PhDz

Abstract

Full flexion is critical for total knee arthroplasty (TKA) patients in the Middle East, where daily activities require a high range of motion in the lower limb. This study aimed to increase understanding of the knee kinematics of normal Muslim subjects during high-flexion activities of daily living, such as kneeling, Muslim prayer, sitting cross-legged, and squatting. The early postoperative kinematics for a select group of Muslim, high-flexion TKA patients are also reported. Mean curves were compared between the normal group and the TKA group. During kneeling, the average maximum flexion was 141.6° for the normal group and 140.2° for the TKA group. The normal group’s maximum and minimum knee angles (flexion, abduction, external rotation) were reported and, with the exception of maximum extension, were not significantly different from the TKA group, despite short postoperative times. Keywords: total knee arthroplasty, knee kinematics, high-flexion activities.

Primary Repair of latrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique

Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique

Alisina Shahi, MD a, Timothy L. Tan, MD b, Samih Tarabichi, MD a, Ahmed Maher, MD a, Craig Della Valle, MD c, Usama Hassan Saleh, MD

abstract

Intraoperative injury to the medial collateral ligament (MCL) is a rare but important complication of total knee arthroplasty (TKA). While described treatment methods are mainly primary repair and revision with a more constrained implant, a few studies have investigated the outcomes of primary repair without constrained implants. A retrospective study was performed to evaluate the prevalence of iatrogenic injury to the MCL during primary TKA and determine the clinical outcomes of MCL repair augmented with synthetic material without the use of a constrained device. The incidence of intraoperative tear of the MCL was 0.43% (15/3432). No patient demonstrated instability during the follow-up period. Primary repair of iatrogenic MCL injury without the use of constrained im- plants appears to be a potential alternative that warrants further investigation.

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Special Considerations in Asian Knee Arthroplasty

Special Considerations in Asian Knee Arthroplasty

Hamid Reza Seyyed Hosseinzadeh, Samih Tarabichi, Ali Sina Shahi, Mehrnoush Hassas Yeganeh
Usama Hassan Saleh, Gholam Reza Kazemian and Aidin Masoudi

Human body is a unique correlation between anatomy and physiology. It is mandatory to have adequate knowledge on this issue former to perform any kind of surgery. As in all parts of human body, there are several variations in human knee concerning middle-eastern and Asian ethnicity, which should be considered for performing total knee arthroplasty among these races. These differences involve both in anatomical and physiological features, causing variations in a wide spectrum from metabolic syndromes to morphology of knee components.

During total knee replacement, the accurate bone cutting, adequate balancing of the soft tis‐ sues and proper coverage of the resected surface were important factors for achieving a suc‐ cessful outcome. In recent years, many studies have identified shape differences in the knee within the Caucasian population. Total knee replacement is a precise procedure, requiring accurate soft tissue balancing and resection of bone thickness equal to the thickness of the implanted prosthetic component. Proper bone cuts for rotational alignment of the femur and tibia in the axial plane represents the key for a balanced flexion gap and proper patella tracking. Both represent important parameters for high flexion. [1] A properly shaped pros‐ thesis can provide the best coverage and avoid soft tissue impingement. Thus, it becomes important to obtain the anthropometric data to achieve the best stability and longevity for implant. Total knee prostheses based on the accurately morphologic data of knee, gender morphologic difference, and the morphologic correlations between tibia and femur may be expected to give better results.

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Special Considerations in Asian Knee Arthroplasty searchgate

Special Considerations in Asian Knee

Arthroplasty

 Introduction

Human body is a unique correlation between anatomy and physiology. It is mandatory to have adequate knowledge on this issue former to perform any kind of surgery. As in all parts of human body, there are several variations in human knee concerning middle-eastern and Asian ethnicity, which should be considered for performing total knee arthroplasty among these races. These differences involve both in anatomical and physiological features, causing variations in a wide spectrum from metabolic syndromes to morphology of knee components

During total knee replacement, the accurate bone cutting, adequate balancing of the soft tis‐ sues and proper coverage of the resected surface were important factors for achieving a suc‐ cessful outcome. In recent years, many studies have identified shape differences in the knee within the Caucasian population. Total knee replacement is a precise procedure, requiring accurate soft tissue balancing and resection of bone thickness equal to the thickness of the implanted prosthetic component. Proper bone cuts for rotational alignment of the femur and tibia in the axial plane represents the key for a balanced flexion gap and proper patella tracking. Both represent important parameters for high flexion. [1] A properly shaped pros‐ thesis can provide the best coverage and avoid soft tissue impingement. Thus, it becomes important to obtain the anthropometric data to achieve the best stability and longevity for implant. Total knee prostheses based on the accurately morphologic data of knee, gender morphologic difference, and the morphologic correlations between tibia and femur may be expected to give better results

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Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique

Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique

Alisina Shahi, MD a, Timothy L. Tan, MD b, Samih Tarabichi, MD a, Ahmed Maher, MD a, Craig Della Valle, MD c, Usama Hassan Saleh, MD a

Intraoperative injury to the medial collateral ligament (MCL) is a rare but important complication of total knee arthroplasty (TKA). While described treatment methods are mainly primary repair and revision with a more constrained implant, a few studies have investigated the outcomes of primary repair without constrained implants. A retrospective study was performed to evaluate the prevalence of iatrogenic injury to the MCL during primary TKA and determine the clinical outcomes of MCL repair augmented with synthetic material without the use of a constrained device. The incidence of intraoperative tear of the MCL was 0.43% (15/3432). No patient demonstrated instability during the follow-up period. Primary repair of iatrogenic MCL injury without the use of constrained im- plants appears to be a potential alternative that warrants further investigation.

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THINGS YOU SHOULD KNOW ABOUT ASIAN KNEE BEEORE DOING. TQIALKNEEREPLACEMENT

Medical literatures has documented some unique features of the Asian knee. These features need to be addressed when performing TKA on Asians. The senior writer of this paper has performed over 3,000 TKA on Americans and over 5000 TKA on Asians. This enabled us to document specific anatomical, systemic, functional and revision surgery features. The objective of this exhibit is to introduce surgeons to these features and recommend specific modifications for each feature to improve clinical outcome.

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Tranexamic Acid to Reduce Blood Loss After Bilateral Total Knee Arthroplasty

Tranexamic Acid to Reduce Blood Loss After Bilateral Total Knee Arthroplasty

A Prospective, Randomized Double Blind Study Robin G. MacGillivray, FCA(SA),* Samih B. Tarabichi, MD,y

Marwan F. Hawari, MD,y and Nayzak T. Raoof, FRCA*

Abstract

The effects of 2-dosage regimens of tranexamic acid (10 mg/kg and 15 mg/kg) on blood loss and transfusion requirement were compared to saline placebo in 60 patients undergoing concurrent bilateral total knee arthroplasty, with additional reinfusion autotransfu- sion from intraarticular drains. Mean blood loss was 462 mL in 15 mL/kg group, 678 mL in 10 mg/kg group, and 918 mL in controls (P b .01 vs 15 mg/kg). Blood available for autotransfusion was greatest in controls and least in 15 mg/kg group. Combined autologous and allogenic transfusion volumes were similar in the treatment groups and significantly less than controls (P b .01). With use of an autologous reinfusion strategy, the lower dose is sufficient to lead to a lesser allogenic transfusion requirement. Keywords: bilateral total knee arthroplasty, blood loss, transfusion, tranexamic acid.

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أرحب بكم في موقعنا وأعبر عن امتناني لإبداء اهتمامكم بمركزنا. نحن فريق ديناميكي من المتخصصين في الرعاية الصحية الذين يلتزمون بتوفير أعلى مستويات الجودة من الرعاية في المنطقة
تأسس المركز عام 2000 ويعتبر من المراكز المتميزة القليلة المتخصصة بعلاج المفاصل وإصابات العظام.
نسعى جاهدين لتوفير أفضل رعاية لجميع مرضانا.
مع وجود مركز للعلاج الطبيعي وإعادة التأهيل مجهز بأحدث الأجهزة الطبية ومدعوم بأفضل الطواقم الطبية المدربة بشكل كبير في هذا المجال.
نحرص باستمرار في مركزنا على التعليم المستمر, كي نستفيد من الخبرات العالمية ونبقى على إطلاع على أفضل الطرق العالمية لتقديم الأفضل لمرضانا.

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