Introduction: Osteoarthritis is considered as the most common joint disease. Sulfur mustard (SM) is a toxic compound, which was applied as a chemical warfare agent by Iraq against Iran veterans during 1980-1988. Chemical veterans suffer from chronic implications caused by sulfur mustard that not only adversely affect their quality of life, but also restrict their working abilities and their participation in social activities. This study aims to consider the prevalence of osteoarthritis disorders among Iranian SM-exposed veterans. Methods: In this cross-sectional study, 248 Iranian SM exposed patients were evaluated from 2013 to 2014. Veterans filled a special questionnaire for COPCORD studies and then general and specific rheumatology examinations were applied under the supervision of internists and rheumatologists. The obtained data from 245 filled questionnaires were analyzed by SPSS software and the results were reported as a percentage or mean ±SD. Results: Bone and joint pain (72%), knee joint pain (52.5%), Joint stiffness (49.2%), and shoulder joint pain (45.8%) were the most common type of complications in these patients. Osteoarthritis in at least one joint was the most common type of osteoarthritis in veterans. 69.5% of veterans had osteoarthritis in at least one joint. Knee osteoarthritis was the second most common type of osteoarthritis, which has been found in 58.4% of all veterans. The prevalence of neck osteoarthritis in all veterans was 23.9%. Conclusion: The total prevalence of musculoskeletal disorders among Iranian veterans was significantly higher than the average of society.
Low levels of vitamin D in patients with osteoarthritis (ΟΑ) rather adversely affect the structure and function of articular cartilage. Low levels of vitamin D are also associated with joint pain, limited physical activity, quality of life, as well as decreased muscle strength, primarily in the lower extremities with adverse OA progression. A high percentage of low vitamin D levels was found in patients with OA and joint arthroplasty as well as a less satisfactory postoperative follow-up in patients with low vitamin D levels. The administration of vitamin D supplementation in patients with knee osteoarthritis has been associated with improved articular cartilage architecture, and reduced joint pain, combined with improved functionality and quality of life in patients with OA.
Synovial proliferation is a common intraoperative finding during total knee arthroplasty (TKA) and many studies have proposed synovectomy for the reduction of postoperative pain. We included 180 patients that were split into two groups, one which received a total synovectomy (TS) and the other with partial synovectomy (PS). We measured the amount of intra- and post-operative bleeding as well as perceived pain (using the Visual Analogue Scale) and knee function (using the Knee Society Knee Score) at 4 and 12 weeks. The blood loss during the surgical procedure was 367.77 ± 115.71 mL for TS, while the other group recorded 295.55 ± 106.17 mL (p < 0.05). Regarding postoperative bleeding, the TS group aspirated 533.77 ± 281.65 mL, which was significantly higher than the PS group (404.44 ± 211.55 mL, p < 0.05). No significant differences were recorded between the TS and PS groups regarding pain and knee function at 12 weeks. Total synovectomy demonstrated significantly higher blood loss and lower postoperative hemoglobin levels, even though knee function and pain level did not show improvements. We consider that the decision of performing synovectomy should rely on the clinical indication and, if conditions allow for it, a limited resection should be attempted.
