Publications
52 results found
Logishetty K, Western L, Morgan R, et al., 2018, Can an Augmented Reality Headset Improve Accuracy of Acetabular Cup Orientation in Simulated THA? A Randomized Trial., Clin Orthop Relat Res
BACKGROUND: Accurate implant orientation reduces wear and increases stability in arthroplasty but is a technically demanding skill. Augmented reality (AR) headsets overlay digital information on top of the real world. We have developed an enhanced AR headset capable of tracking bony anatomy in relation to an implant, but it has not yet been assessed for its suitability as a training tool for implant orientation. QUESTIONS/PURPOSES: (1) In the setting of simulated THA performed by novices, does an AR headset improve the accuracy of acetabular component positioning compared with hands-on training by an expert surgeon? (2) What are trainees' perceptions of the AR headset in terms of realism of the task, acceptability of the technology, and its potential role for surgical training? METHODS: Twenty-four study participants (medical students in their final year of school, who were applying to surgery residency programs, and who had no prior arthroplasty experience) participated in a randomized simulation trial using an AR headset and a simulated THA. Participants were randomized to two groups completing four once-weekly sessions of baseline assessment, training, and reassessment. One group trained using AR (with live holographic orientation feedback) and the other received one-on-one training from a hip arthroplasty surgeon. Demographics and baseline performance in orienting an acetabular implant to six patient-specific values on the phantom pelvis were collected before training and were comparable. The orientation error in degrees between the planned and achieved orientations was measured and was not different between groups with the numbers available (surgeon group mean error ± SD 16° ± 7° versus AR 14° ± 7°; p = 0.22). Participants trained by AR also completed a validated posttraining questionnaire evaluating their experiences. RESULTS: During the four training sessions, participants using AR-guidance had smaller mean (± SD) e
Choudhury A, Lambkin R, Auvinet E, et al., 2018, P 004 - Patellofemoral arthroplasty improves gait in isolated patellofemoral arthritis, a prospective cohort gait analysis study., Gait Posture, Vol: 65 Suppl 1, Pages: 241-242
Riviere C, Iranpoura F, Harris S, et al., 2018, Differences in trochlear parameters between native and prosthetic kinematically or mechanically aligned knees, Revue de Chirurgie Orthopedique et Traumatologique, Vol: 104, Pages: 124-130, ISSN: 1877-0517
Riviere C, Iranpour F, Harris S, et al., 2018, Differences in trochlear parameters between native and prosthetic kinematically or mechanically aligned knees, ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, Vol: 104, Pages: 165-170, ISSN: 1877-0568
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- Citations: 27
Rivière C, Iranpour F, Auvinet E, et al., 2017, Mechanical alignment technique for TKA: Are there intrinsic technical limitations?, Revue de Chirurgie Orthopedique et Traumatologique, Vol: 103, Pages: 762-772, ISSN: 1877-0517
Rivière C, Iranpour F, Harris S, et al., 2017, The kinematic alignment technique for TKA reliably aligns the femoral component with the cylindrical axis, Revue de Chirurgie Orthopedique et Traumatologique, Vol: 103, Pages: 773-777, ISSN: 1877-0517
Riviere C, Iranpour F, Harris S, et al., 2017, The kinematic alignment technique for TKA reliably aligns the femoral component with the cylindrical axis, ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, Vol: 103, Pages: 1069-1073, ISSN: 1877-0568
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- Citations: 23
Riviere C, Iranpour F, Auvinet E, et al., 2017, Alignment options for total knee arthroplasty: A systematic review, ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, Vol: 103, Pages: 1047-1056, ISSN: 1877-0568
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- Citations: 141
Rivière C, FarhadIranpour, Auvinet E, et al., 2017, Mechanical Alignment Technique For TKA: Are there Intrinsic Technical Limitations?, Orthopaedics and Traumatology: Surgery and Research, ISSN: 1877-0568
BACKGROUND: Mechanically aligned (MA) total knee arthroplasty (TKA) is affected by disappointing functional outcomes in spite of the recent improvements in surgical precision and implant designs. This might suggest the existence of intrinsic technical limitations. Our study aims to compare the prosthetic and native trochlear articular surfaces and to estimate the extent of collateral ligament imbalance which is technically un-correctable by collateral ligament release when TKA implants are mechanically aligned. STUDY HYPOTHESIS: conventional MA technique generates a high rate of prosthetic overstuffing of the distal groove, distal lateral trochlear facet and distal lateral femoral condyle (Hypothesis 1), and technically un-correctable collateral ligament imbalance (hypothesis 2)? Disregarding the distal femoral joint line obliquity (DFJLO) when performing femoral cuts explainsdistal lateral femoral prosthetic stuffing and un-correctable imbalance (hypothesis 3)? METHODS: Twenty patients underwent a conventional MA TKA. Pre-operative MRI-based 3D knee models were generated and MA TKA was simulated. Native and prosthetic trochlear articular surfaces were compared using in-house analysis software.Following the automatic determination by the planning software of the size of the extension and flexion gaps, an algorithm was applied to balance the gaps and the frequency and amplitude of technically un-correctable knee imbalance wereestimated. RESULTS: The conventional MA technique generateda significant slight distal lateral femoral prosthetic overstuffing (mean 0.6mm, 0.8mm, 1.25 mmfor the most distal lateral facet point, groove, and at the most distal point of lateral femoral condyle, respectively) and a high rate of type 1 and 2 un-corretable knee imbalance (30% and 40%, respectively). The incidence of distal lateral prosthetic overstuffing (trochlea and condyle) and un-correctable knee imbalance were strongly to very strongly correlated with the DFJLO (r=0.53 to 0.89).
Aframian A, Auvinet E, Iranpour F, et al., 2017, O95: An instrumented treadmill shows excellent reliability and repeatability at a range of speeds to maximal walking speedover a range of inclines and declines, Gait and Posture, Vol: 57, ISSN: 0966-6362
Iranpour F, Merican AM, Teo SH, et al., 2017, Femoral articular geometry and patellofemoral stability, KNEE, Vol: 24, Pages: 555-563, ISSN: 0968-0160
Background:Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry.Methods:Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175 N and 30 N, respectively. The force required to displace the patella 10 mm laterally and medially at 0°, 20°, 30°, 60° and 90° knee flexion was measured. Patellofemoral contact points at these knee flexion angles were marked. The trochlea cartilage geometry at these flexion angles was visualized by Computed Tomography imaging of the femora in air with no overlying tissue. The sulcus, medial and lateral facet angles were measured. The facet angles were measured relative to the posterior condylar datum.Results:The lateral facet slope decreased progressively with flexion from 23° ± 3° (mean ± S.D.) at 0° to 17 ± 5° at 90°. While the medial facet angle increased progressively from 8° ± 8° to 36° ± 9° between 0° and 90°. Patellar lateral stability varied from 96 ± 22 N at 0°, to 77 ± 23 N at 20°, then to 101 ± 27 N at 90° knee flexion. Medial stability varied from 74 ± 20 N at 0° to 170 ± 21 N at 90°. There were significant correlations between the sulcus angle and the medial facet angle with medial stability (r = 0.78, p < 0.0001).Conclusions:These results provide objective evidence relating the changes of femoral profile geometry with knee flexion to patellofemoral stability.
Nazruzov T, Van Der Straeten C, Iranpour Boroujeni F, et al., 2017, REGISTRATION OF PRE- AND POST-OPERATIVE CT DATA USING ICP FOR PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY (TKA), Bone & Joint Journal, ISSN: 2049-4394
Merican AM, Iranpour F, Amis AA, 2016, Iliotibial band tension reduces patellar lateral stability, J Orthop Res
Iranpour F, Aframian A, Cobb JP, 2016, The patellofemoral joint, Joint Preservation in the Adult Knee, Pages: 43-53, ISBN: 9783319418070
The patellofemoral joint has traditionally been poorly understood and interventions for patellofemoral joint problems have generally been less successful than those employed for the tibiofemoral joint. Pathologies affecting the patellofemoral joint in the adult can be largely divided into three groups: instability, osteochondral defects and osteoarthritis. These three conditions share a number of aetiological factors and all represent disorders of the normal mechanics of the patellofemoral articulation. As such, understanding the normal and abnormal anatomy and kinematics of the joint are vital to clinicians treating patellofemoral disorders. Treating the symptoms of these conditions without addressing the underlying disorder of kinematics will be likely to fail. In this chapter, the normal and abnormal anatomy and physiology of the joint are discussed as are the clinical features and treatments for the three commonly encountered pathologies of the patellofemoral joint.
Aframian A, Boughton OR, Auvinet E, et al., 2015, Patellofemoral pain is a symptom, not a diagnosis, British Medical Journal, Vol: 351, ISSN: 1468-5833
Iranpour F, 2015, 9 Importance of the Patellofemoral Joint for Total Knee Replacement, The Unhappy Total Knee Replacement, Publisher: Springer International Publishing, Pages: 105-113, ISBN: 9783319080987
Dandachli W, Najefi A, Iranpour F, et al., 2012, Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography, SKELETAL RADIOLOGY, Vol: 41, Pages: 1295-1300, ISSN: 0364-2348
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- Citations: 20
Ghosh KM, Merican AM, Iranpour F, et al., 2012, Length-change patterns of the collateral ligaments after total knee arthroplasty, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 20, Pages: 1349-1356, ISSN: 0942-2056
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- Citations: 34
Hirschmann MT, Konala P, Iranpour F, et al., 2011, Paper # 8: Clinical Value of Spect/Ct for Evaluation of Patients with Pain Following Total Knee Arthroplasty: A New Dimension of Diagnostics, Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol: 27, Pages: e74-e74, ISSN: 0749-8063
Iranpour F, Merican AM, Amis AA, et al., 2011, Paper # 100: Winner of the Patellofemoral Research Excellence Award The Geometry and Function of the Patellofemoral Joint, Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol: 27, Pages: e134-e134, ISSN: 0749-8063
Merican AM, Ghosh KM, Iranpour F, et al., 2011, The effect of femoral component rotation on the kinematics of the tibiofemoral and patellofemoral joints after total knee arthroplasty, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 19, Pages: 1479-1487, ISSN: 0942-2056
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- Citations: 77
Hirschmann MT, Konala P, Iranpour F, et al., 2011, The position and orientation of total knee components: a comparison of conventional radiographs, transverse 2D-CT slices and 3D-CT, Publisher: E M H SWISS MEDICAL PUBLISHERS LTD, Pages: 17S-17S, ISSN: 1424-7860
Hirschmann MT, Konala P, Amsler F, et al., 2011, The position and orientation of total knee replacement components A COMPARISON OF CONVENTIONAL RADIOGRAPHS, TRANSVERSE 2D-CT SLICES AND 3D-CT RECONSTRUCTION, JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, Vol: 93B, Pages: 629-633, ISSN: 0301-620X
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- Citations: 149
Hirschmann MT, Davda K, Iranpour F, et al., 2011, Combined single photon emission computerised tomography and conventional computerised tomography (SPECT/CT) in patellofemoral disorders: a clinical review, INTERNATIONAL ORTHOPAEDICS, Vol: 35, Pages: 675-680, ISSN: 0341-2695
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- Citations: 26
Konala P, Schaefer TK, Iranpour F, et al., 2011, An unusual case of persistent groin pain after total hip arthroplasty: a case report., Journal of Medical Case Reports, Vol: 5, ISSN: 1752-1947
INTRODUCTION: Arthroplasty is a well-established routine elective surgical procedure in orthopaedics. To a great extent, diagnosis, treatment and post-operative rehabilitation in these patients is standardised. In a busy clinic, surgeons from time to time tend to focus their attention on common causes of joint pain, but it may lead them to overlook sinister but less common pathologies. Here we report a case of a patient with groin pain due to pre-operatively undetected pelvic metastases from a pyeloureteral carcinoma who underwent total hip arthroplasty. There are several case reports which deal with primary or secondary tumours which were either discovered at the time of replacement surgery or developed at the site of prosthesis years after total hip or knee replacement. To the best of our knowledge, this is the first case report in which a metastatic cancer was missed pre-operatively and intra-operatively both by the radiologist and by the orthopaedic surgeon and should be reported so that surgeons are reminded to be careful when dealing with seemingly routine cases. CASE PRESENTATION: A 79-year-old Caucasian woman presented to the arthroplasty clinic with groin pain. Initial radiographs showed subtle bilateral abnormalities in the pelvis. Neither the radiologist nor the orthopaedic surgeon recognized it. A diagnosis of osteoarthritis of the hip was established, and she underwent total hip arthroplasty. Despite initial improvement, the patient came back with worsening hip pain three months later. Further radiological examination revealed multiple metastatic lesions throughout the pelvis due to a pyeloureteral carcinoma. CONCLUSIONS: This case report emphasizes the importance of meticulous, unbiased pre-operative assessment of patients and their radiographs, even in so-called routine clinical cases. Often subtle radiological changes are classed as normal, especially if they are bilateral. Further radiological imaging should be recommended in all cases where unexpla
Hirschmann MT, Konala P, Iranpour F, et al., 2011, Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty-a new dimension of diagnostics?, BMC MUSCULOSKELETAL DISORDERS, Vol: 12
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- Citations: 72
Konala P, Iranpour F, Kerner A, et al., 2010, Clinical benefit of SPECT/CT for follow-up of surgical treatment of osteochondritis dissecans, ANNALS OF NUCLEAR MEDICINE, Vol: 24, Pages: 621-624, ISSN: 0914-7187
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- Citations: 15
Ghosh KM, Merican AM, Iranpour F, et al., 2010, The Effect of Femoral Component Rotation on the Extensor Retinaculum of the Knee, JOURNAL OF ORTHOPAEDIC RESEARCH, Vol: 28, Pages: 1136-1141, ISSN: 0736-0266
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- Citations: 20
Cobb J, Logishetty K, Davda K, et al., 2010, Cams and Pincer Impingement Are Distinct, Not Mixed The Acetabular Pathomorphology of Femoroacetabular Impingement, CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, Vol: 468, Pages: 2143-2151, ISSN: 0009-921X
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- Citations: 62
Hirschmann MT, Iranpour F, Konala P, et al., 2010, A novel standardized algorithm for evaluating patients with painful total knee arthroplasty using combined single photon emission tomography and conventional computerized tomography, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 18, Pages: 939-944, ISSN: 0942-2056
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- Citations: 70
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