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Cancer is a leading cause of death worldwide and around 10 million deaths in 2020 were related to cancer. There are a number of therapeutic modalities for cancer such as chemotherapy, radiotherapy and surgery. However, tumor cells have capacity of developing resistance to chemotherapy and radiotherapy. Genetic mutations participate in development and progression of cancer. The current review focuses on the role of SOX2 transcription factor in cancer. SOX2 has capacity of increasing growth and metastasis of cancer cells. It functions as double-edged sword and has ability of suppressing tumor progression. Increasing evidence reveals that SOX2 is involved in triggering resistance to chemotherapy and radiotherapy. SOX2 promotes stemness of tumor cells and increases the number of cancer stem cells. SOX2 overexpression occurs in the tumor cells and tissues to ensure their proliferation and metastasis …

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Acetabular revision arthroplasty with major bone loss is one of the most difficult operations in hip arthroplasty, The graft augmentation prosthesis (GAP) has been designed particularly as an implant for revision acetabular reconstruction. We evaluated the use of GAP II acetabular cage in revision of acetabulum in total hip arthroplasty. From 2009 to 2014, we performed revision total hip arthroplasty in patients with acetabular defects by cage (GAP II) in patients referred to Milad and Erfan Hospitals, Tehran, Iran. We included all patients in class 3a and 3b of Paprosky bone loss classification and type III bone loss according to the system of the American Academy of Orthopedic Surgeons. We used SPSS software Ver 19 and descriptive tests, Chi square and independent t-test were used for analysis. There were 221 men (71.99%) and 86 women (28.01%) with an average age of 51.3±21.7 years (range, 35–86 years …

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Cancer is the manifestation of changes and mutations in genetic and epigenetic levels. Non-coding RNAs (ncRNAs) are commonly dysregulated in disease pathogenesis, and their role in cancer has been well-documented. The ncRNAs regulate various molecular pathways and mechanisms in cancer that can lead to induction/inhibition of carcinogenesis. Autophagy is a molecular “self-digestion” mechanism its function can be pro-survival or pro-death in tumor cells. The aim of the present review is to evaluate the role of ncRNAs in regulating autophagy in gastrointestinal tumors. The role of the ncRNA/autophagy axis in affecting the progression of gastric, liver, colorectal, pancreatic, esophageal, and gallbladder cancers is investigated. Both ncRNAs and autophagy mechanisms can function as oncogenic or onco-suppressor and this interaction can determine the growth, invasion, and therapy response of …

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The field of non-coding RNA (ncRNA) has made significant progress in understanding the pathogenesis of diseases and has broadened our knowledge towards their targeting, especially in cancer therapy. ncRNAs are a large family of RNAs with microRNAs (miRNAs) being one kind of endogenous RNA which lack encoded proteins. By now, miRNAs have been well-coined in pathogenesis and development of cancer. The current review focuses on the role of miR-21 in cancers and its association with tumor progression. miR-21 has both oncogenic and onco-suppressor functions and most of the experiments are in agreement with the tumor-promoting function of this miRNA. miR-21 primarily decreases PTEN expression to induce PI3K/Akt signaling in cancer progression. Overexpression of miR-21 inhibits apoptosis and is vital for inducing pro-survival autophagy. miR-21 is vital for metabolic reprogramming and …

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Cancer progression results from activation of various signaling networks. Among these, PI3K/Akt signaling contributes to proliferation, invasion, and inhibition of apoptosis. Hepatocellular carcinoma (HCC) is a primary liver cancer with high incidence rate, especially in regions with high prevalence of viral hepatitis infection. Autoimmune disorders, diabetes mellitus, obesity, alcohol consumption, and inflammation can also lead to initiation and development of HCC. The treatment of HCC depends on the identification of oncogenic factors that lead tumor cells to develop resistance to therapy. The present review article focuses on the role of PI3K/Akt signaling in HCC progression. Activation of PI3K/Akt signaling promotes glucose uptake, favors glycolysis and increases tumor cell proliferation. It inhibits apoptosis and pro-death autophagy while promoting HCC cell survival. PI3K/Akt stimulates epithelial-to-mesenchymal …

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Urological cancers have obtained much attention in recent years due to their mortality and morbidity. The most common and malignant tumor of urological cancers is prostate cancer that imposes high socioeconomic costs on public life and androgen-deprivation therapy, surgery, and combination of chemotherapy and radiotherapy are employed in its treatment. PI3K/Akt signaling is an oncogenic pathway responsible for migration, proliferation and drug resistance in various cancers. In the present review, the role of PI3K/Akt signaling in prostate cancer progression is highlighted. The activation of PI3K/Akt signaling occurs in prostate cancer, while PTEN as inhibitor of PI3K/Akt shows down-regulation. Stimulation of PI3K/Akt signaling promotes survival of prostate tumor cells and prevents apoptosis. The cell cycle progression and proliferation rate of prostate tumor cells increase by PI3K/Akt signaling induction. PI3K …

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Epithelial-to-mesenchymal transition (EMT) is a process that involves the transformation of polarized epithelial cells to attain a mesenchymal phenotype that presents an elevated migratory potential, invasiveness, and antiapoptotic properties. Many studies have demonstrated that EMT is a prominent event that is associated with embryogenesis, tumor progression, metastasis, and therapeutic resistance. The EMT process is driven by key transcription factors (such as Snail, Twist, ZEB, and TGF-β) and several long non-coding RNAs (lncRNAs) in many non-pathological as well as pathological conditions. In the present report, we have comprehensively discussed the oncogenic and tumor suppressor role of lncRNAs and their mechanism of action in the regulation of the EMT process in various cancers such as brain tumors, gastrointestinal tumors, and gynecological and urological tumors. We have also elaborated on …

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One of the malignant tumors in women that has involved both developed and developing countries is breast cancer. Similar to other types of tumors, breast cancer cells demonstrate high metastatic nature. Besides, breast tumor cells have ability of developing drug resistance. EMT is the related mechanism to cancer metastasis and focus of current manuscript is highlighting function of EMT in breast tumor malignancy and drug resistance. Breast tumor cells increase their migration by EMT induction During EMT, N-cadherin and vimentin levels increase, and E-cadherin levels decrease to mediate EMT-induced breast tumor invasion. Different kinds of anti-cancer agents such as tamoxifen, cisplatin and paclitaxel that EMT induction mediates chemoresistance feature of breast tumor cells. Furthermore, EMT induction correlates with radio-resistance in breast tumor. Clinical aspect is reversing EMT in preventing …

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Urological cancers are considered as life-threatening diseases around the world. Bladder cancer is one of the most malignant urological tumors with high mortality and morbidity. Bladder cancer is a heterogenous disease and genetic alterations have shown to be key players in regulating its progression. Although conventional therapies are somewhat beneficial in improving prognosis and survival, bladder cancer patients suffer from recurrence. MicroRNAs (miRNAs) are endogenous short RNA molecules that do not encode proteins and show dysregulated expression in human cancers. miRNAs are regulators of vital biological processes in cells such as proliferation, migration, differentiation and apoptosis. Dysregulation of miRNAs is observed in bladder cancer and they are used as biomarkers for diagnosis and prognosis of patients. LncRNAs and circRNAs are modulators of bladder cancer progression via …

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RNA molecules lacking capacity in protein translation, are known as non-coding RNAs (ncRNAs). Growth, differentiation and migration are influenced by ncRNAs in cells. The abnormal expression of ncRNAs contributes to development of diseases, especially cancer. On the other hand, EMT is a vital mechanism for cancer invasion and diffusion in body. In this manuscript, role of ncRNAs in EMT regulation and subsequent effect on cancer progression is investigated. The miRNAs regulate EMT by affecting signaling pathways including PI3K/Akt and PTEN to modulate cancer metastasis. Furthermore, miRNA and EMT interaction has close association with drug sensitivity of tumor cells. LncRNAs can affect EMT via targeting ZEB1/2, Twist and Snail among others and similarly, based on the impact on EMT, sensitivity of cancer cells to therapy increases or decreases. CircRNAs regulate both drug sensitivity and …

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Cancer is a challenging to treat disease with a high mortality rate worldwide, nevertheless advances in science has led to a decrease in the number of death cases caused by cancer. Aberrant expression of genes occurs during tumorigenesis therefore targeting the signaling pathways that regulate these genes' expression is of importance in cancer therapy. Notch is one of the signaling pathways having interactions with other vital cell signaling molecules responsible for cellular functions such as proliferation, apoptosis, invasion, metastasis, epithelial-to-mesenchymal transition (EMT), angiogenesis, and immune evasion. Furthermore, the Notch pathway is involved in response to chemo- and radiotherapy. Thus, targeting the Notch signaling pathway in cancer therapy can be beneficial for overcoming the therapeutic gaps. Non-coding RNAs (ncRNAs) are a class of RNAs that include short ncRNAs (such as micro …

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Initiation and development of cancer depend on multiple factors that mutations in genes and epigenetic level can be considered as important drivers. Epigenetic factors include a large family of members and understanding their function in cancer has been a hot topic. LncRNAs are RNA molecules with no capacity in synthesis of proteins, and they have regulatory functions in cells. LncRNAs are localized in nucleus and cytoplasm, and their abnormal expression is related to development of tumor. This manuscript emphasizes on the role of lncRNA H19 in various cancers and its association with tumor hallmarks. The function of lncRNA H19 in most tumors is oncogenic and therefore, tumor cells increase its expression for promoting their progression. LncRNA H19 contributes to enhancing growth and cell cycle of cancers and by EMT induction, it is able to elevate metastasis rate. Silencing H19 induces apoptotic cell …

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Urological cancers include bladder, prostate and renal cancers that can cause death in males and females. Patients with urological cancers are mainly diagnosed at an advanced disease stage when they also develop resistance to therapy or poor response. The use of natural products in the treatment of urological cancers has shown a significant increase. Curcumin has been widely used in cancer treatment due to its ability to trigger cell death and suppress metastasis. The beneficial effects of curcumin in the treatment of urological cancers is the focus of current review. Curcumin can induce apoptosis in the three types of urological cancers limiting their proliferative potential. Furthermore, curcumin can suppress invasion of urological cancers through EMT inhibition. Notably, curcumin decreases the expression of MMPs, therefore interfering with urological cancer metastasis. When used in combination with …

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Epigenetic factors are critical regulators of biological and pathological mechanisms and they could interact with different molecular pathways. Targeting epigenetic factors has been an idea approach in disease therapy, especially cancer. Accumulating evidence has highlighted function of long non-coding RNAs (lncRNAs) as epigenetic factors in cancer initiation and development and has focused on their association with downstream targets. microRNAs (miRNAs) are the most well-known targets of lncRNAs and present review focuses on lncRNA-miRNA axis in malignancy and therapy resistance of tumors. LncRNA-miRNA regulates cell death mechanisms such as apoptosis and autophagy in cancers. This axis affects tumor metastasis via regulating EMT and MMPs. Besides, lncRNA-miRNA axis determines sensitivity of tumor cells to chemotherapy, radiotherapy and immunotherapy. Based on the studies, lncRNAs …

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Epithelial-to-mesenchymal transition (EMT) mechanism is responsible for metastasis of tumor cells and their spread to various organs and tissues of body, providing undesirable prognosis. In addition to migration, EMT increases stemness and mediates therapy resistance. Hence, pathways involved in EMT regulation should be highlighted. STAT3 is an oncogenic pathway that can elevate growth rate and migratory ability of cancer cells and induce drug resistance. The inhibition of STAT3 signaling impairs cancer progression and promotes chemotherapy-mediated cell death. Present review focuses on STAT3 and EMT interaction in modulating cancer migration. First of all, STAT3 is an upstream mediator of EMT and is able to induce EMT-mediated metastasis in brain tumors, thoracic cancers and gastrointestinal cancers. Therefore, STAT3 inhibition significantly suppresses cancer metastasis and improves prognosis …

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Among the different kinds of tumors threatening human life, lung cancer is one that is commonly observed in both males and females. The aggressive behavior of lung cancer and interactions occurring in tumor microenvironment enhances the malignancy of this tumor. The lung tumor cells have demonstrated capacity in developing chemo- and radio-resistance. LncRNAs are a category of non-coding RNAs that do not encode proteins, but their aberrant expression is responsible for tumor development, especially lung cancer. In the present review, we focus on both lncRNAs and exosomal lncRNAs in lung cancer, and their ability in regulating proliferation and metastasis. Cell cycle progression and molecular mechanisms related to lung cancer metastasis such as EMT and MMPs are regulated by lncRNAs. LncRNAs interact with miRNAs, STAT, Wnt, EZH2, PTEN and PI3K/Akt signaling pathways to affect progression …

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Bacterial infections are the leading cause of failure in surgeries based on orthopedic implants. One of the promising methods to suppress bacterial infection, given the high efficiency of antibiotic administration, is to use Titania Nanotubes (Titania-NTs) loaded with antibiotics. Titania-NTs obtained by the electrochemical anodizing process have presented a modern approach in drug delivery applications. However, it is complicated to control the drug release process from drug delivery systems. This study investigates the controlled release of Vancomycin (V) from Titania-NTs surfaces enriched by drugs via physical absorption. Titania-NTs loaded with Vancomycin were coated by Silk Fibroin Nanofibers (SF-NFs). The results showed that the drug delivery was controlled through a coated layer of nanofibers. Moreover, Vancomycin inhibits bacterial development due to its antibacterial property. This is a feasible method …

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As a member of JAK family of non-receptor tyrosine kinases, TYK2 has a crucial role in regulation of immune responses. This protein has a crucial role in constant expression of IFNAR1 on surface of cells and initiation of type I IFN signaling. In the current study, we measured expression of IFNAR1 and TYK2 levels in venous blood samples of COVID-19 patients and matched controls. TYK2 was significantly down-regulated in male patients compared with male controls (RME = 0.34, P value = 0.03). Though, levels of TYK2 were not different between female cases and female controls, or between ICU-admitted and non-ICU-admitted cases. Expression of IFNAR1 was not different either between COVID-19 cases and controls or between patients required ICU admission and non-ICU-admitted cases. However, none of these transcripts can properly diffrentiate COVID-19 cases from controls or separate patients based on …

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The macrophages are abundantly found in TME and their M2 polarization is in favor of tumor malignancy. On the other hand, non-coding RNAs (ncRNAs) can modulate macrophage polarization in TME to affect cancer progression. The miRNAs can dually induce/suppress M2 polarization of macrophages and by affecting various molecular pathways, they modulate tumor progression and therapy response. The lncRNAs can affect miRNAs via sponging and other molecular pathways to modulate macrophage polarization. A few experiments have also examined role of circRNAs in targeting signaling networks and affecting macrophages. The therapeutic targeting of these ncRNAs can mediate TME remodeling and affect macrophage polarization. Furthermore, exosomal ncRNAs derived from tumor cells or macrophages can modulate polarization and TME remodeling. Suppressing biogenesis and secretion of …

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Total hip arthroplasty first occurred in Germany in 1891. The literature endeavor was to facilitate surgical techniques and innovations to improve the devices for a better operation outcome that provides a better lifestyle for the patients who had undergone total hip arthroplasty [1, 2]. Recently, surgeons have faced different instruments and devices in hip arthroplasties orthopedics. Zimmer Biomet products as one of the popular brands in orthopedic procedures help in achieving good results; however, there are at least 3 failure report documents at the moment [3, 4, 5]. The femoral stem fractures in Zimmer modular revision (ZMR) hip system have been designed for revision hip surgery. The femoral component of the ZMR contains 3 modular components: the stem, the body, and the femoral head. The stem and the body are available in several lengths and sizes which provide a good variety and surgical flexibility [3, 4, 5, 6]. It is designed to have proximal support for the implant in femoral revision hip surgery. If such support is not obtained, the risk of fatigue fracture of the stem increases.

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Diabetes mellitus (DM) is considered as a main challenge in both developing and developed countries, as lifestyle has changed and its management seems to be vital. Type I and type II diabetes are the main kinds and they result in hyperglycemia in patients and related complications. The gene expression alteration can lead to development of DM and related complications. The AMP-activated protein kinase (AMPK) is an energy sensor with aberrant expression in various diseases including cancer, cardiovascular diseases and DM. The present review focuses on understanding AMPK role in DM. Inducing AMPK signaling promotes glucose in DM that is of importance for ameliorating hyperglycemia. Further investigation reveals the role of AMPK signaling in enhancing insulin sensitivity for treatment of diabetic patients. Furthermore, AMPK upregulation inhibits stress and cell death in β cells that is of importance for …

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Self-renewal and differentiation into diverse cells are two main characteristics of stem cells. These cells have important roles in development and homeostasis of different tissues and are supposed to facilitate tissue regeneration. Function of stem cells is regulated by dynamic interactions between external signaling, epigenetic factors, and molecules that regulate expression of genes. Among the highly appreciated regulators of function of stem cells are long non-coding RNAs (lncRNAs) and microRNAs (miRNAs). Impact of miR-342-5p, miR-145, miR-1297, miR-204-5p, miR-132, miR-128-3p, hsa-miR-302, miR-26b-5p and miR-10a are among miRNAs that regulate function of stem cells. Among lncRNAs, AK141205, ANCR, MEG3, Pnky, H19, TINCR, HULC, EPB41L4A-AS1 and SNHG7 have important roles in the regulation of stem cells. In the current paper, we aimed at reviewing the importance of miRNAs and …

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Osteoarthritis (OS) is the most frequent degenerative condition in the joints, disabling many adults. Several abnormalities in the articular cartilage, subchondral bone, synovial tissue, and meniscus have been detected in the course of OA. Destruction of articular cartilage, the formation of osteophytes, subchondral sclerosis, and hyperplasia of synovial tissue are hallmarks of OA. More recently, several investigations have underscored the regulatory roles of non-coding RNAs (ncRNAs) in OA development. Different classes of non-coding RNAs, including long ncRNAs (lncRNAs), microRNAs (miRNAs), and circular RNAs (circRNAs), have been reported to affect the development of OA. The expression level of these transcripts has also been used as diagnostic tools in OA. In the present article, we aimed at reporting the role of these transcripts in this process. We need to give a specific angle on the pathology to provide meaningful thoughts on it.

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Today, Total Hip Replacement has become one of the most common orthopedic surgeries such that it provides better life conditions for patients suffering from complex and painful lesions. Considering the ever increasing growth of such surgeries, it is necessary to introduce new challenges and threats of this context. Wear and corrosion in design variables and stem production related to hip replacement surgery has always been debated. This paper tries to describe the scientific knowledge of problems in wear and corrosion of stem's neck cone region because neglecting this issue may cause a disaster. Following different shear forces in the area shared between prosthetic head and cone region of the prosthetic stem, corrosion caused by friction and wearing in the surface shared between these two which is referred to as Taperosis, creates metal ions and very small particles released from metal surface on poly …

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Bacterial infection, wide inflammation, and osteoporosis are the most common factors in the failure of orthopedic implants. The present study aims to design an orthopedic implant based on Titania nanotubes (TiO2-NTs) which not only have a high biocompatibility but also are characterized by anti-bacterial property. In order to improve the osseointegration of the TiO2-NTs structures (110–120 nm in diameter, 40 μm in length), they were used to coat the Titania implant by electrochemical anodizing. Vancomycin, which is soluble in water, was loaded as a main clinical drug to control intensive infections caused by positive gram bacteria. For the first time, Silk Fibroin (SF) Nanofibers coating was used to control drug release by the implementation of electrospinning on the TiO2-NTs surface. In order to investigate the anti-bacterial activities, S. aureus bacterium culture test was used. The cell culture of MG63 was …

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Background:
Despite several studies, controversy has prevailed over the rate of complications following 1-stage and 2-stage bilateral total hip arthroplasty (THA). In the current study, we compare the complications and functional outcomes of 1-stage and 2-stage procedures.
Methods:
One hundred and eighty patients (ASA class I or II) with bilateral hip osteoarthritis were assigned randomly to two equal groups. The two groups were matched in terms of age and sex. All of the surgeries were performed via the Hardinge approach using uncemented implants. In 2-stage procedures, surgeries were performed with a 6-month to 1-year interval. All patients were evaluated 1 year postoperatively.

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Background
Fractures of the acetabulum are challenging and very difficult to treat, and even after fixation, they can lead to posttraumatic arthritis. Total hip arthroplasty (THA) has been the most common surgery performed for the complications of posttraumatic arthritis in this group of patients.
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Aim
In this article, it is aimed to assess the functional results and complications of the conversion to THA for posttraumatic arthritis after acetabular fracture.​​​​​​​

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During April 2009 to October 2015, 203 patients (203 hips) underwent total hip arthroplasty through the direct lateral approach, as salvage of failed intertrochanteric fracture management by dynamic hip screw (DHS). The restoration process was done by a direct lateral approach (Hardinge) in all hips. The operation details, such as duration, blood transfusion volume, blood loss, and duration of hospital stay, were recorded. Modified Harris hip score (MHHS) was applied for assessment of clinical outcome before and after the operation, and during the follow-up.

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Total hip arthroplasty is one of the best treatments for restoring function and activity in young patients with advanced joint diseases. One-Stage Bilateral Total Hip Arthroplasty (BTHA) offers many advantages, which are important to younger patients and diminished costs and time in comparison with sequential THA. There is currently much concern about the safety of this procedure. The current study was designed to provide more information regarding THA in patients aged 30 years old or younger. Between April 2010 and September 2015, arthroplasty procedures were performed on 180 patients at the surgical centers of Erfan and Milad, Tehran, Iran. The patients that were entered in the study included those with bilateral hip involvement of Avascular Necrosis (AVN), Rheumatoid Arthritis (RA), Juvenile Rheumatoid Arthritis (JRA), Slipped Capital Femoral Epiphysis (SCFE), and Developmental Dysplasia of the Hip …

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Introduction: Klebsiella pneumoniae is one of the most frequent infection organism following orthopedic surgeries and specifically total hip arthroplasty. Recently, attitude toward herbal medicine is being popular both in people and health care systems. Ruta graveolens is a traditional herbal remedy Iranian medicine and some other countries with a wide spectrum of therapeutic utilities. Our purpose was to determine the effects of this medicinal plant on

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Most adverse events following total hip arthroplasty (THA) are uncommon and preventable or treated easily as expected. Adverse effects related to any major surgical procedure, including anesthesia, performing with other medical problems, drugs, and allergic reactions, might also occur. Potential cardiovascular complications are known to occur during or following THA and will be reviewed here. Complications can be categorized as myocardial infarction, cardiac arrest, thromboembolism, and so on. Special considerations in cardiovascular procedures are also reviewed in this paper.

Interventions:
Concurrent total hip replacement and total knee arthroplasty were performed for patient.
Outcomes:
After more than a 2-year follow-up time, the patient showed excellent clinical function and remained satisfied with the surgical outcome. Multiple simultaneous total joint arthroplasty (TJA) is reviewed in this article.
Lessons:
Joint arthroplasty surgeries can be performed in a simultaneous procedure to shorten disability and rehabilitation time with one anesthesia.​​​​​​​

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Results: Our findings showed that expression of MiR-182 was clearly lower in osteosarcoma bone tissue (mean±SD: 2.84±. 07) compared with noncancerous bone tissues (6.23±1.72, p= 0.004). On the other hand, lower expression of MiR-183 was seen in osteosarcoma bone tissue (1.43±0.59) when compared with normal tissues (4.36±2.47, p= 0.036). Decreased expression of MiR-182 was clearly correlated with advanced clinical stage (p= 0.001), metastasis or recurrence (p= 0.024), and large tumor size (p= 0.032). Decreased expression of MiR-183 was associated with advanced TNM stage (p= 0.004), and metastasis or recurrence (p= 0.002). A multivariate Cox proportional hazards model revealed that low expression of MiR-182 and MiR-183 (p= 0.02; p= 0.016), TNM stage (p= 0.04), and metastasis or recurrence (p= 0.03) were significantly associated with poor survival as independent prognostic factors …

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Results: PLA2G16 expression was upregulated in osteosarcoma tissues when compared with adjacent normal bone tissues, and the difference was statistically significant (4.78±0.70 vs. 1.31±0.65; p< 0.05). Our data indicated that high expression of PLA2G16 was significantly related to advanced TNM stage and metastasis or recurrence (p< 0.05). The expression level of CDH11 was lower in osteosarcoma tissues (median relative expression level±SD: 6.29±1.43) than adjacent normal bone tissues (mean±SD: 13.72±3.08, p< 0.05). Our findings demonstrated that decreased expression of CDH11 was strongly linked to advanced TNM stage, and metastasis or recurrence (p< 0.05). Log-rank analysis showed that patients with high expression of PLA2G16 have shorter overall survival than those with low expression. Moreover, shorter overall survival was significantly correlated with decreased expression of CDH11 …

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Purpose of this study was to evaluate the outcomes of patients underwent hemiarthroplasty for proximal femoral fracture converted to total hip arthroplasty (THA).

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Osteochondroma or hereditary multiple exostoses is the most common benign bone tumor and is usually found in young patients. Osteochondromata of the proximal femur or hip have been reported in 30% to 90% of patients with hereditary multiple exostoses. This article presents a 25-year-old-male referred to our orthopedic clinic with a complaint of pain in both groins for the last four years which has deteriorated in the past 6 months by limitation of range of motion. Radiographic findings were consistent with huge hip osteochondroma and a histopathological report confirmed the diagnosis. This was a case of a huge bilateral osteochondroma of the hip originating from the posterior of the hips to the neck of the femur and hip joints and part of proximal of femur, that underwent one-stage surgical excision of the tumor with posterior approach and tumor resection. As we know, this case of bilateral huge hip …

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Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age …

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Introduction
Failure of intertrochanteric fracture fixation often occurs in patients, who have poor bone quality, severe osteoporosis, or unstable fracture patterns. Hip arthroplasty is a good replacement procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure. The purpose of this study is to evaluate the outcomes of total hip arthroplasty (THA) as the replacement for failed fixation of intertrochanteric fractures of the femur.
Patients and Methods
203 patients of failed intertrochanteric fractures between April 2009 and October 2014 were included in the study. All of them underwent total hip arthroplasty through direct lateral approach. 150 patients were male (73.8%) and 53 patients (26.1%) were female and the mean of age was 59.02±10.34 years old (range: 56–90 years). The indications of the failure were nail cut out …​​​​​​​

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Background:
Although forefoot fractures are of the most common orthopedic injuries, there are limited studies regarding the outcomes of nonoperative treatment of these fractures. In the current randomized clinical trial, for the first time, we evaluated the outcomes of nonoperative treatment of metatarsal bone fractures using off-loading shoes compared with casting.
Methods:
In this study, there were 60 patients with metatarsal fractures without indications for surgical management who were assigned to the two equal groups: casting (group C) and off-loading shoe (group OS). The rate of fracture union was investigated. Also, the pain severity and patient satisfaction were measured based on visual analogue scale (VAS). Patients were followed for six months. In the last examination, American foot and ankle score (AOFAS) was completed. Finally, the outcomes were compared between two groups.​​​​​​​

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Background
Total joint replacement surgery is associated with large amounts of blood loss and significant rates of transfusions. Postoperative bleeding is one of the most important problems after major orthopedic surgeries including revision Total Hip Arthroplasty (THA). It has been demonstrate that Tranexamic acid is a useful agent to control the volume of blood loss. However, the more effective route of TXA administration remained controversial.
Methods
In current study, we compared the effects of local and intravenous(IV) administration of TXA on need to blood transfusion and hemoglobin drop. We randomized 80 patients undergoing revision THA into two groups: local group and IV group. In group IV 40 patients was administrated TXA 4 g alone systemically and in local group 40 patients the joint was irrigated with 4 g of TXA plus 0.33mg DEP (1:200,000).
Results
The level of Hb was measured before and after …

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In this study, we investigated the expression levels of Dickkopf‐1 (DKK‐1) and programmed cell death 5 (PDCD5) by using quantitative real‐time PCR and immunohistochemistry in patients with chondrosarcoma. The DKK‐1 mRNA levels were significantly higher in chondrosarcoma when compared with the corresponding nontumor tissues (mean ± SD: 4.23 ± 1.54; 1.54 ± 0.87; P = 0.001). PDCD5 mRNA levels were remarkably deceased in tumor tissues when compared with corresponding nontumor tissues (mean ± SD: 1.94 ± 0.73; 5.42 ± 1.73; P = 0.001). The high and moderate DKK‐1 expressions were observed for 60% of chondrosarcoma samples in comparison with 27.5% of corresponding nontumor tissues (P  = 0.001). Moreover, low expression of PDCD5 was found in 67.5% of the tumor tissues when compared with the nontumor tissues (32.5%; P = 0.002). The results of this study …

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Introduction
Total hip arthroplasty (THA) is one of the most common orthopedic surgeries. The procedure is sophisticated and in addition to several factors affecting the outcomes such as patient's status, surgeon's expertise and implant type, using appropriate surgical tools is necessary. Acetabular component implantation necessitates the surgeon to ream the acetabular fossa which is time consuming and devastating. Utilizing currently-used reamers (figure 1), the size of the tool must be changed repeatedly for 5–20 times within a surgery. In every stage, the size of the reamer is increased up to 1–2 mm. This tiring process takes 15–30 minutes and is associated with some injuries to the soft tissue. Furthermore, the risk of mistakes is considerable.
Objectives
Designing a new system which overcomes the limitations and defects with previous systems
Methods
Regarding the defects of currently used reaming tools, we …​​​​​​​

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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.

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Background: Although forefoot fractures are of the most common orthopedic injuries, there are limited studies regarding the outcomes of nonoperative treatment of these fractures. In the current randomized clinical trial, for the first time, we evaluated the outcomes of nonoperative treatment of metatarsal bone fractures using off-loading shoes compared with those of casting. Methods: In this study, there were 60 patients with metatarsal fractures without indications of surgical management who were assigned to the two equal groups: casting (group C) and off-loading shoe (group OS). The rate of fracture union was investigated. Also, the pain severity and patient satisfaction were measured based on visual analogue scale (VAS). Patients were followed for six months. In the last examination, American foot and ankle score (AOFAS) was completed. Finally, the outcomes were compared between two groups.

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Background: Post traumatic arthritis is common in young patients. It should be treated by normal joint biomechanics to not developing. Total hip arthroplasty (THA) after this disorder is a challenge for orthopedics. Objectives: The aim of this study was to assess the short term outcomes of THA following acetabular fracture. Patients and Methods: 85 patients with post-traumatic arthritis after acetabular fractures were treated by THA in Milad and Erfan hospitals, Tehran, Iran during 5-year. Short-term outcomes of subjects were evaluated. 73/85 were male and the mean age of participants was 49 years (18-69 years). Prospective functional outcome and complications of THA was recorded in follow up of patients for a period of 5.21 ą 0.38 years. Results: There was no dislocation, DVT or PTE and only 4 cases with preoperative sciatic nerve injury detected. Two cases (2.35%) underwent re-operation. Our analysis of results showed that Modified Hip Harris Score (MHHS) improved from 43.64 ą4. 42 preoperatively to 93.26 ą3. 28 postoperatively (P< 0.0001). Five-years survival was 95% with all variables considered.

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Polyethylene failure is a rare complication of ceramic-on-polyethylene total hip arthroplasty due to characteristics of ceramic. Complications associated with ceramic-on-polyethylene articulations have been studied extensively, however, only few reports have described its catastrophic wear and concurrent pseudotumor formation. The etiology of this biological reaction and concurrency of pseudotumor formation with metallosis remain unclear. We report two cases of wear of the acetabular liner in a ceramic-on-polyethylene prosthesis due to total hip arthroplasty (THA) long time ago. They came back to the clinic with the history of worsening hip pain and abnormal radiological and clinical findings. Then they underwent surgery and metallosis and pseudotumors were detected and revisions were performed for them. It is necessary to evaluate patients underwent THA complaining of hip pain for component wear and be checked the cup appear well fixing and fairly oriented on follow-up radiographies. Close follow ups can prevent accelerated polyethylene wear in ceramic-on-polyethylene coupling THA.

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Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) offers many benefits. However, there are concerns about the safety of the procedure and higher complications. We aimed to evaluate the complications and outcomes of one-stage BTHA with Hardinge approach for femoral head avascular necrosis patients. A total of 60 patients from April 2009 and May 2013, were underwent one-stage bilateral total hip arthroplasty (BTHA) in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with femoral head avascular necrosis (AVN) performed. We evaluated all patients clinically and radiologically with serial follow-ups …

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This article describes a case of a fracture of an alumina-bearing couple delta ceramic liner without trauma history that was treated with ceramic-on-polyethylene revision total hip arthroplasty. A 57-year-old man was admitted to the hip ward because of an alumina-bearing couple delta ceramic liner fracture. He underwent hip replacement by anterior approach 18 months previously in the same center because of left hip primary osteoarthritis. He received a 54×36-mm modular press-fit cup ceramic alumina-bearing couple delta insert. Probable causes of such fractures are manufacture production failure and edge loading based on cup inclination, but in our …

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Objective
This prospective investigation is designed to determine the prognostic factors associated with the response to conservative therapy of subacromial impingement syndrome.
Materials and Methods
We treated 102 patients with subacromial impingement syndrome, diagnosed by physical examination and a subacromial lidocaine injection test, with a standardized conservative protocol. We followed the patients for a period of 12 months. Outcome was evaluated with Constant score and effects of 8 variables: Age, sex, pretreatment symptom duration, dominant shoulder, initial Constant score, active range of motion, acromion morphology, and acromial spur on patient outcomes were evaluated with univariate and multivariate analyses.
Results
Among 89 patients (44 men; mean age, 56.4 years) who finished the study, the mean difference between initial and final scores was 15.9 (95% confidence interval [CI]: 13.9 …

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Urological cancers are among the most common malignancies around the world. In particular, bladder cancer severely threatens human health due to its aggressive and heterogenous nature. Various therapeutic modalities have been considered for the treatment of bladder cancer although its prognosis remains unfavorable. It is perceived that treatment of bladder cancer depends on an interdisciplinary approach combining biology and engineering. The nanotechnological approaches have been introduced in the treatment of various cancers, especially bladder cancer. The current review aims to emphasize and highlight possible applications of nanomedicine in eradication of bladder tumor. Nanoparticles can improve efficacy of drugs in bladder cancer therapy through elevating their bioavailability. The potential of genetic tools such as siRNA and miRNA in gene expression regulation can be boosted using …