Tuberculosis (TB) is an ancient disease dated back from ancient Greece time. Once rare in developed countries, now it has re-emerged due to immigration and secondary immunodeficiency. A 27-year-old lady had left knee pain for the past 4 years, went for knee diagnostic arthroscopy procedure, and diagnosed as pigmented villonodular synovitis (PVNS) of the left knee. Despite regular analgesics and physiotherapy, patient symptoms worsen. Two years after the initial treatment, the patient went for a further workout and diagnosed as knee tuberculosis, commenced on anti-TB treatment, the patient still left complicated with a stiff knee and fixed flexion deformity. Identification of knee tuberculosis during the initial phase is crucial as late diagnosis and treatment will leave the patient with debilitating complications.
The growing of mortality and morbidity that are related to orthopaedic cases have contributed to the development and innovation of technology which actively seeks for the best treatment options. In order to achieve the goal, animal models have been used as a bridge from in vitro to the clinical study to provide insights both as a precursor and beneficial to human-based research. Many animal models have been developed to investigate bone regeneration, pathological changes and reparation. Besides, animal models are used more commonly in orthopaedic innovation and development. Through the practical application of the 5Rs (reduction, refinement, replacement, reproducibility and responsibility) principles that correlate with the Islamic ethics in this research, this study aimed to provide an ultimate ethical standard on animal use in orthopaedic research. Besides the texts of the Qur’an and the prophetic narrations (hadith), both Muslim jurists (fuqaha) and ethicists’ relevant opinion on these matters would be unveiled. As from the Islamic viewpoints, the usage of animal is permittable for scientific research purposed within the permissible limits described by the Shari’ah and guided by ethical values derived from the Divine Revelations (al-wahy al-Ilahyi). By practising the guidelines, it is hoped that these ethical guidelines will help to educate the Muslim scholars and researchers to substantive improvements in terms of quality and the ethical standards of animal studies in orthopaedic research.
Total knee arthroplasty represents a major advance in the treatment of
degenerative joint disease. It provides excellent restoration of joint function and pain
relief. The primary indication for total knee arthroplasty is to relieve pain caused by
severe arthritis, with or without significant deformity. This study is to assess
psychological impact pre and post arthroplasty. (Copied from article).
This is a prospective study on infection following fixation of closed fractures done in Hospital Tengku Ampuan Afzan ,Kuantan from May 2003 to May 2005. There were 23 cases in this study. The mean age of patient was 32.9 years (range 15 to 77). Twenty one were males and 2 females. Twenty (87%) infections occurred in the lower limb and only 3(13%) occurred in the upper limbs. Twenty two patients (91%) had plating done for the fracture. Infection following internal fixation is commonly a deep seated (96%) and florid (78%) infection in which 70% occur after the surgical wound has healed. Staphylococcus aureus is the commonest organism isolated in which 43% are Methicillin resistant (MRSA). Overall infection caused by gram negative organisms is more common than gram positive organisms.