MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext The PUTRA press-fit system as an alternative femoral fixation technique for posterior cruciate ligament reconstruction – a technical note and outcome evaluation

Nasir Mohd Nizlan, Paisal Hussin, Raymond Yeak Dieu Kiat

Malaysian Journal of Medicine and Health Sciences, 2019;15(3):148-152.
MyJurnal

We describe our technique of single-bundle PCL reconstruction using a bony femoral press-fit system. 9 patients un- derwent PCL reconstruction using our pressfit system. The surgical procedure is described in detail. Post-operatively, 5 patients were available for assessment and review. Four patients gave a final Lysholm score of 92 – 100%. Three patients gave a Hospital for Special Surgery (HSS) score of excellent, one fair and one poor. Two patients gave a re- duced Tegner activity score post-operatively while the other three gave a similar score post-operatively. Assessment using KT-1000 revealed four patients with a side-to-side difference of less than 3 mm (average side-to-side difference,1.87 mm), while one patient exhibited a side-to-side difference of 5.8 mm. We believe that our technique enhances tunnel healing through usage of a bone-plug fixation and provides a cheap alternative for graft fixation on the femoral side in PCL reconstruction.
Fulltext Degenerative osteophyte causing acute locked knee in a young man: a case report

Nur Ayuni Khirul Ashar, Paisal Hussin, Mohd Nizlan Mohd Nasir, Maliza Mawardi

Malaysian Journal of Medicine and Health Sciences, 2019;15(3):161-163.
MyJurnal

Acute locked knee is usually caused by mechanical blockage. We report an unusual case of a locked knee due to tibial osteophyte in a young man following a sport injury. To the best of our knowledge, there has been no previous report describing the same etiology. This case report emphasizes the need for thorough history taking and careful assessment to aid us in the diagnosis. The findings made by arthroscopy confirmed our diagnosis.
Fulltext Arthroscopic mumford procedure utilizing the anteromedial and neviaser portals – a pilot cadaveric study on neurovascular structures at risk

Nasir Mohd Nizlan, Azfar Rizal Ahmad, Hisham Abdul Rashid, Paisal Hussin, Che Hamzah Fahrudin, Abdullah Arifaizad, et al.

Malaysian Journal of Medicine and Health Sciences, 2016;12(2):16-20.
MyJurnal

Introduction: Degenerative disorder involving the acromioclavicular
joint (ACJ) is quite common especially in the elderly.
One of the surgical modalities of treatment of this disorder is the
Mumford Procedure. Arthroscopic approach is preferred due to
its reduced morbidity and faster post-operative recovery. One
method utilizes the anteromedial and Neviaser portals, which
allow direct and better visualization of the ACJ from the
subacromial space. However, the dangers that may arise from
incision and insertion of instruments through these portals are
not fully understood. This cadaveric study was carried out to
investigate the dangers that can arise from utilization of these
portals and which structures are at risk during this procedure.
Methods: Arthroscopic Mumford procedures were performed
on 5 cadaver shoulders by a single surgeon utilizing the
anteromedial and Neviaser portals. After marking each portals
with methylene blue, dissection of nearby structures were
carried out immediately after each procedure was completed.
Important structures (subclavian artery as well as brachial plexus
and its branches) were identified and the nearest measurements
were made from each portal edges to these structures. Results:
The anteromedial portal was noted to be closest to the
suprascapular nerve (SSN) at 2.91 cm, while the Neviaser portal
was noted to be closest also to the SSN at 1.60 cm. The
suprascapular nerve was the structure most at risk during the
Mumford procedure. The anteromedial portal was noted to be
the most risky portal to utilize compared to the Neviaser portal.
Conclusion: Extra precaution needs to be given to the
anteromedial portal while performing an arthroscopic distal
clavicle resection in view of the risk of injuring the
suprascapular nerve of the affected limb.
Fulltext A qualitative and quantitative investigation of the coracoid process of human scapula

Manal Fathi, Ezamin, A.R., Cheah, Pike See, Nizlan, Nasir M., Paisal Hussin, Rozi Mahmud, et al.

Malaysian Journal of Microscopy, 2016;12(1):40-47.
MyJurnal

Coracoid process (CP) bone quality and quantity are two important variables in many successful shoulder surgeries. The goal of this study was to determine the Bone Mineral Density (BMD) and morphometry of CP in Malaysian population using a non-invasive imaging data. Sixty-six (66) shoulders’ computed tomographic (CT) examinations of 132 potential sites were selected. BMD and morphometry of CP was evaluated using e-film. The present study found that there are significant (P
Fulltext Popliteal artery to tibial plateau distance at the knee level: a radiological study to assess injury risks in osteoarthritic knees using dual source dual energy CT scan

Ezamin, A.R., Hasyma, A.H., Suppiah, S., Suraini, M.S., Arifaizad, A., Paisal, Hussin, et al.

Pertanika Journal of Science & Technology, 2017;25(1):371-378.
MyJurnal

Popliteal artery injury is the most disastrous intraoperative complication during total knee replacement. This study aims to determine the mean distance between the popliteal artery (PA) and the tibial plateau in normal and osteoarthritic patients who underwent Dual Energy CT Angiography (CTA) of the lower limb.
Materials and Methods: All CTA lower limb examinations from January 2013 to October 2014 were retrospectively reviewed. The distance between the PA the tibial plateau distance and the thickness of popliteus muscle were electronically measured. We used modified Kellgren and Lawrence’s Classification to grade the osteoarthritis in patients who underwent CT examinations regardless of symptoms.
Results: There were a total of 126 patients who underwent CTA (93 males and 33 females). 54 of them were Malays, 47 Indians, and 24 Chinese. The mean age of patients was 58 years (range 16 to 92). The mean PA-totibial plateau distance was 9.9 mm for the right lower limb (range 2.5 mm to 17.2 mm) and 10.24 mm for the left (range 5.5 mm to 15.4 mm). There were no significant correlations between PA-to-tibial plateau distance with osteoarthritis grade, age, gender, and racial origin (P > 0.05); however, there was a positive
correlation between PA-to-tibial plateau distances with popliteus muscle thickness (P = 0.000).
Conclusion: Osteoarthritic condition in the knee does not reduce the popliteal artery to the tibial plateau distance. Hence, a higher osteoarthritic grade does not impose additional risks with regards to popliteal artery to tibial plateau distance, with relatively similar arterial injury risks compared to normal knees.
Feasibility of Percutaneous Posterolateral Spinal Fusion With Recombinant Bone Morphogenetic Protein-2 (rhBMP-2): A Comparison With Standard Methods Using an Animal Model Study

Chan CY, Kwan MK, Saw LB, Paisal H

Clin Spine Surg, 2017 03;30(2):E138-E147.
PMID: 28207623 DOI: 10.1097/BSD.0b013e3182aa6860

BACKGROUND CONTEXT: The clinical application of recombinant bone morphogenetic protein in spinal surgery has been shown to be safe and effective. However, its use in minimally invasive spine surgery has been limited to anterior interbody fusion procedures. To date, no study has evaluated the feasibility of percutaneous posterolateral fusion in the spine utilizing recombinant bone morphogenetic protein-2 (rhBMP-2).
PURPOSE: To evaluate the feasibility of percutaneous posterolateral fusion in the spine utilizing rhBMP-2.
STUDY DESIGN: Animal study.
METHODS: This is an animal research model involving 32 New Zealand white rabbits stratified into 4 study groups: control, autogenous iliac crest bone graft (ICBG), demineralized bone matrix (DBM), and rhBMP-2 groups, with 8 study subjects per group. The rhBMP-2 group was subdivided into the open technique (right side) and the percutaneous technique groups (left side). Fusion was graded at 6 weeks and 3 months after plain radiography, computed tomography, and clinical assessment with the following grading system: grade A, no bone formation; grade B, non-bridging bone formation; grade C, fusion; and grade D, fusion with ectopic bone formation.
RESULTS: No fusion was noted in the placebo and the DBM groups. However, in the DBM group, bone formation occurred in 37.5% of the subjects. The rhBMP-2 group had a higher fusion rate compared with the ICBG group at 6 weeks and 3 months. The fusion rate for the ICBG, the rhBMP-2 (open), and the rhBMP-2 (percutaneous) groups were 37.5%, 87.5%, and 50.0% at 6 weeks and 50.0%, 100.0%, and 62.5% at 3 months, respectively. Ectopic bone formation occurred in 12.5% of the cases in the rhBMP-2 (percutaneous) group and in 25.0% of the cases in the rhBMP-2 (open) group.
CONCLUSIONS: Usage of rhBMP-2 is feasible for percutaneous posterolateral fusion of the lumbar spine in this animal model. However, a more precise delivery system might improve the fusion rate when the percutaneous technique is used. A significant rate of ectopic bone formation occurred when rhBMP-2 was used.