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Kalinterakis G, Vlastos I, Gianzina E, Mastrantonakis K, Yiannakopoulos CK. Medial patellofemoral ligament reconstruction using an endobutton device: A narrative review. Orthop Rev (Pavia) 2024; 16:94101. [PMID: 38435439 PMCID: PMC10908593 DOI: 10.52965/001c.94101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Since the recognition of MPFL as the primary soft-tissue restraint to lateral displacement of the patella, its reconstruction gained popularity either alone or in combination with other procedures. Today, although there are plenty of techniques described in the literature, there is no consensus regarding which one is better. MPFL reconstruction using an endobutton device has been proved to be a reliable option with satisfying clinical results. Single or dual tunnel can be done depending on surgeon's preference. For safer outcomes more randomized controlled trials should be done while authors should be more meticulous when it comes to surgical technique.
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Affiliation(s)
- Georgios Kalinterakis
- Sports Medicine & Exercise Biology Section National and Kapodistrian University of Athens
| | - Iakovos Vlastos
- Sports Medicine & Exercise Biology Section National and Kapodistrian University of Athens
| | - Elina Gianzina
- Sports Medicine & Exercise Biology Section National and Kapodistrian University of Athens
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Yiannakopoulos C, Gianzina E, Dellis S, Kalinterakis G, Vlastos I, Mastrantonakis K. Interobserver and Intraobserver Variability of Four Suprascapular Notch Classification Systems. Cureus 2024; 16:e54389. [PMID: 38505432 PMCID: PMC10949346 DOI: 10.7759/cureus.54389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Knowledge of the morphology of the suprascapular notch is clinically beneficial in patients with suspected suprascapular nerve compression or palsy. Several classification systems have been proposed for the morphological classification of the suprascapular notch and its several anatomical variations. The purpose of this study was to evaluate the inter- and intraobserver reliability of four different classification systems for suprascapular notch typing analysing shoulder computed tomography (CT) scans. METHODS Shoulder CT scans from 109 subjects (71.5% males) were examined by three raters of various experience levels, one senior, one experienced, and one junior orthopaedic surgeon. The CT scans were evaluated quantitatively and qualitatively and the suprascapular notch was classified according to four classification systems at two separate timepoints, four weeks apart. To determine consistency among the same or different raters, the Kappa statistic was performed and intrarater reliability for each rater between the first and the second evaluation was assessed using Cohen's kappa. Reliability across all raters at each timepoint was assessed using the Fleiss kappa. RESULTS Agreement was almost perfect for all the classification systems and amongst all raters, regardless of their experience level. There were no significant differences between the raters on any of the evaluations. The overall interobserver agreement for all classifications was almost perfect. CONCLUSION The four suprascapular notch classification systems are reliable, and the rater's experience level has no impact on the evaluation.
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Affiliation(s)
- Christos Yiannakopoulos
- Orthopaedics, IASO Hospital, Athens, GRC
- School of Physical Education & Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Elina Gianzina
- School of Physical Education & Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Spilios Dellis
- School of Physical Education & Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Georgios Kalinterakis
- School of Physical Education & Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Iakovos Vlastos
- School of Physical Education & Sport Science, National and Kapodistrian University of Athens, Athens, GRC
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Yiannakopoulos C, Vlastos I, Koutserimpas C, Gianzina E, Dellis S, Kalinterakis G. Comparison of Glenoid Dimensions Between 3D Computed Tomography and 3D Printing. Cureus 2024; 16:e53133. [PMID: 38420064 PMCID: PMC10899810 DOI: 10.7759/cureus.53133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Glenoid dimensions can be measured in vivo with various imaging methods including two-dimensional (2D) and three-dimensional computed tomography (CT) and magnetic resonance imaging scans. Printing of three-dimensional (3D) models of the glenoid using imaging data is feasible and can be used to better understand skeletal trauma and complex skeletal deformations such as glenoid bone loss in patients with shoulder instability. The purpose of this study was to compare measurements of glenoid dimensions on 3D CT scan reconstructed models and 3D printed models of the glenoid. METHODS CT scans from 62 young, male adults acquired for non-trauma-related causes were evaluated. Following volume rendering, a stereolithography model of each scapula was constructed and a 3D model was printed. Additionally, 3D CT models of each glenoid were reconstructed using dedicated software. Measurements of the maximum glenoid height and width were performed on both the 3D printed and the 3D reconstructed models. To assess intra- and interrater reliability, measurements of 15 glenoids were repeated by two observers after three weeks. The measurements of the 3D printed and 3D reconstructed models were compared. RESULTS Inter- and intra-rater reliability was excellent or perfect. Analysis of height and width values demonstrated a strong correlation of 0.91 and 0.89 respectively (p<0.001) for both the 3D printed models and the 3D reconstructed models. There was a strong correlation between the height and width, but no significant difference between the glenoid width and height in both models. There was no statistical significance between height and width when measurements on the two models were examined (p=0.12 and 0.23 respectively). CONCLUSION 3D printed glenoid models can be used to evaluate the glenoid dimensions, width, and height, as they provide similar accuracy with 3D reconstructed models as provided from CT scan data.
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Affiliation(s)
- Christos Yiannakopoulos
- Orthopaedics, IASO General Hospital, Athens, GRC
- School of Physical Education & Sports Science, National & Kapodistrian University of Athens, Athens, GRC
| | - Iakovos Vlastos
- School of Physical Education & Sports Science, National & Kapodistrian University of Athens, Athens, GRC
| | | | - Elina Gianzina
- School of Physical Education & Sports Science, National & Kapodistrian University of Athens, Athens, GRC
| | - Spilios Dellis
- School of Physical Education & Sports Science, National & Kapodistrian University of Athens, Athens, GRC
| | - Georgios Kalinterakis
- School of Physical Education & Sports Science, National & Kapodistrian University of Athens, Athens, GRC
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Kalinterakis G, Vlastos I, Gianzina E, Sachinis NP, Yiannakopoulos CK. Medial patellofemoral ligament reconstruction using patella bone tunnel techniques with or without implants. A systematic review of outcomes and complications. Eur J Orthop Surg Traumatol 2023; 33:3225-3234. [PMID: 37127815 DOI: 10.1007/s00590-023-03559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Τhe main goal of this study was to compare the clinical results, including the complication rates and patient-reported outcomes, in patients who underwent surgery for recurrent patellar dislocation using different patellar tunnel fixation techniques. This study compared Medial Patellofemoral Ligament (MPFL) reconstruction implant free techniques against ones that used implants. METHODS The present systematic review was conducted according to the PRISMA guidelines. The literature search was conducted in January 2023. We included patients who underwent isolated MPFL reconstruction for recurrent patellar instability. Patients with confirmed concomitant or prior ipsilateral knee procedures, multiligament injury, severe patellar dysplasia or less than 6 months of follow-up were excluded. MINORS and MCMS scores were used for the assessment of methodological quality. RESULTS Data from 750 procedures were collected, of which 284 used implants to perform the procedure while in 455 an implant-free technique was used. Patient age at the time of surgery ranged from 11 to 60 years while the follow-up time of the studies ranged between 3 and 108 months. Postoperative Kujala (0.3, p = 0.89) and Lysholm (1.2, p = 0.26) scores were better in the implant-free techniques compared to implant-based. A higher rate of recurrent dislocation (OR 0.51; 95% CI 0.10-2.54, p = 0.4), subluxation (OR 0.20; 95% CI 0.40-0.88, p = 0.019) and stiffness (OR 0.76; 95% CI 0.33-1.72, p = 0.55) was noted in the implant-free techniques, while the implant-based techniques displayed increased incidence of patella fractures (OR 3.12; 95% CI 0.77-12.6, p = 0.09), reoperation (OR 1.69; 95% CI 0.78-3.65, p = 0.17) and infection (OR 2.07; 95% CI 0.46-9.32, p = 0.33). CONCLUSION There was no significant difference between the 2 techniques in terms of patient reported outcomes. Regarding complications, MPFL reconstruction using implants demonstrated significant higher rate of patella fractures while the implant free technique showed a greater risk of subluxation.
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Affiliation(s)
- Georgios Kalinterakis
- School of Physical Education and Sport Science, Sports Medicine and Exercise Biology Section, National and Kapodistrian University of Athens, Athens, Greece.
| | - Iakovos Vlastos
- School of Physical Education and Sport Science, Sports Medicine and Exercise Biology Section, National and Kapodistrian University of Athens, Athens, Greece
| | - Elina Gianzina
- School of Physical Education and Sport Science, Sports Medicine and Exercise Biology Section, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Platon Sachinis
- Department of Orthopaedics, George Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos K Yiannakopoulos
- School of Physical Education and Sport Science, Sports Medicine and Exercise Biology Section, National and Kapodistrian University of Athens, Athens, Greece
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Gianzina E, Kalinterakis G, Delis S, Vlastos I, Platon Sachinis N, Yiannakopoulos CK. Evaluation of gait recovery after total knee arthroplasty using wearable inertial sensors: A systematic review. Knee 2023; 41:190-203. [PMID: 36724578 DOI: 10.1016/j.knee.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/06/2022] [Accepted: 01/04/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE This study aimed to conduct a systematic review of the recent research output to present more evidence of the current clinical applications of wearable sensors to determine the change and the recovery in gait function pre- and post-total knee arthroplasty (TKA). METHODS A systematic search of the PubMed, ScienceDirect, and Scopus databases was conducted in October 2022. Inclusion criteria consisted of applying acceleration wearable sensors for pre- and post-arthroplasty assessment of the gait cycle. Studies reporting gait analysis using wearable sensors in patients with knee osteoarthritis at any time after total or partial knee arthroplasty (KA) were also included. Each included study was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental studies. RESULTS Twelve articles were finally considered. The extracted data included essential characteristics of participants, KA studies and their characteristics, sensor technology characteristics and the clinical protocols, gait parameter changes, and various clinical outcome scores at different follow up times after KA. Postoperative examinations were performed from 5 days to 1 year after KA. Clinical outcome scores and gait variables for all patient groups, with or without postoperative rehabilitation, showed various recovery profiles. A variety of wireless sensor devices for gait analysis were recorded. Also, different types of KA were found in the studies. CONCLUSIONS The study's findings showed that acceleration-based gait analysis has notable clinical use in monitoring patients after KA. This application provides objective information on the functional outcome beyond the use of clinical outcome scores. More extensive prospective studies are required to investigate gait function further with the help of wearable sensors in patients with knee osteoarthritis.
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Affiliation(s)
- Elina Gianzina
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.
| | - Georgios Kalinterakis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Spilios Delis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Iakovos Vlastos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Platon Sachinis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos K Yiannakopoulos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
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Kalinterakis G, Vlastos I, Gianzina E, Karvountzis A, Mastrantonakis K, Yiannakopoulos CK. Giant Cell Tumor of the Patellar Tendon Sheath Mimicking a Meniscal Tear in Athletes.A Report of Two Cases. J Orthop Case Rep 2022; 12:54-59. [PMID: 37013238 PMCID: PMC10066661 DOI: 10.13107/jocr.2022.v12.i11.3414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/21/2022] [Indexed: 02/12/2023] Open
Abstract
Introduction: Giant cell tumors(GCT) are uncommon and benign tumors originating due to proliferation of the tendon synovial sheath. Most commonly are located in the fingers. Involvement of the patellar tendon in the knee is extremely rare. Case Report: We report two cases who presented with moderate swelling located in the anterior surface of the knee, localized anterior knee pain, and painful loss of flexion and catching and locking symptoms. Following detailed imaging evaluation, both cases were treated with open surgical excision and patellar tendon synovectomy. Histological examination revealed the presence of a giant cell tumor of the patellar tendon sheath in both cases. Conclusion: Despite the rarity to GCT, the importance of considering all possible tumors in cases where a soft-tissue tumor is present should be stressed out. Keywords: Giant cell tumor, patellar tendon, nodular synovitis, knee.
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Yiannakopoulos CK, Vlastos I, Theotokatos G, Galanis N. Acromioclavicular joint arthritis is not an indication for routine distal clavicle excision in arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 2021; 29:2090-2095. [PMID: 32556365 DOI: 10.1007/s00167-020-06098-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/10/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate the significance of untreated primary acromioclavicular joint (ACJ) osteoarthritis, encountered during arthroscopic rotator cuff repair (RCR), as a cause of persistent symptomatology and need for revision surgery. METHODS In a cohort of 811 consecutive patients older than 55 years who underwent RCR, the effect of primary ACJ osteoarthritis presence was prospectively examined. A total of 497 patients with mild/moderate and severe ACJ osteoarthritis based on preoperative MRI evaluation were allocated to Group A (n = 185, symptomatic ACJ) and Group B (n = 312, asymptomatic ACJ). Distal clavicle excision was not performed regardless of the presence of pain. The minimum follow-up was 28 months (28-46). The visual analogue scale (VAS) pain scores were assessed for ACJ pain on palpation, the cross body adduction test, the Constant-Murley, and the American Shoulder and Elbow Surgeons (ASES). RESULTS The overall loss to follow-up rate was 3.82% (19 patients: 11 in Group A and eight in Group B). The mean ASES score at the latest follow-up was 91.16 ± 9.3 and 92.37 ± 10.44 in Groups A and B, respectively, and the mean Constant-Murley score was 96.36 ± 5.7 and 95.76 ± 4.6 in Groups A and B, respectively. There was no statistical significance between regarding both scores. Localised ACJ pain on palpation and pain on cross body adduction were diminished in both the symptomatic and asymptomatic group. There were five cases (1%: two in Group A and three in Group B) with persistent ACJ pain who had failed the conservative treatment, and ACJ excision was necessary to alleviate the symptoms. All revision operations were uncomplicated with symptom resolution. CONCLUSION Untreated ACJ osteoarthritis, symptomatic or not, encountered during arthroscopic RCR is associated with a low percentage of failure. Routine distal clavicle excision is not absolutely necessary, even in patients with symptomatic ACJ osteoarthritis. LEVEL OF EVIDENCE II, Prospective cohort study.
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Affiliation(s)
- Christos K Yiannakopoulos
- Metropolitan General Hospital, Athens, Greece. .,School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.
| | - Iakovos Vlastos
- Metropolitan General Hospital, Athens, Greece.,School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Theotokatos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikiforos Galanis
- Orthopaedic Department, Medical School, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
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Yiannakopoulos CK, Vlastos I, Zekis T, Theotokatos G, Rousanoglou E. Quantitative ultrasound densitometry of the calcaneus in acute and chronic anterior cruciate ligament deficiency. JRPMS 2018. [DOI: 10.22540/jrpms-02-118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Georgalas C, Vlastos I, Picavet V, van Drunen C, Garas G, Prokopakis E. Is chronic rhinosinusitis related to allergic rhinitis in adults and children? Applying epidemiological guidelines for causation. Allergy 2014; 69:828-33. [PMID: 24815699 DOI: 10.1111/all.12413] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 01/30/2023]
Abstract
The relationship between allergic rhinitis and chronic rhinosinusitis has been assessed in a number of observational and experimental studies. In this review, we attempt their synthesis and evaluation using the modified Bradford Hill guidelines for causation. Although there is no proof of causation, especially in the pediatric literature, an evaluation of underlying allergies is recommended at least as an initial measure of symptoms relief.
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Affiliation(s)
- C. Georgalas
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - I. Vlastos
- Department of Otorhinolaryngology; University of Crete School of Medicine; Heraklio Crete Greece
| | - V. Picavet
- Department of Otorhinolaryngology; University Hospital Ulm; Ulm Germany
| | - C. van Drunen
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - G. Garas
- Department of Otorhinolaryngology and Head & Neck Surgery; Queens Medical Centre; Nottingham University Hospitals; Nottingham UK
| | - E. Prokopakis
- Department of Otorhinolaryngology; University of Crete School of Medicine; Heraklio Crete Greece
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Gkouskou K, Markaki A, Vasilaki M, Roidis A, Vlastos I. Quality of nutritional information on the Internet in health and disease. Hippokratia 2011; 15:304-307. [PMID: 24391409 PMCID: PMC3876843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Quality assessment of nutritional information on the internet may prove vital prior to providing public guidance on searching relative information. METHODS The most popular web sites on four different topics ("Mediterranean diet", "sports nutrition", "nutrition, dysphagia and children" and "herbs and common cold") were assessed with the use of two validated questionnaires (EQIP and DISCERN). RESULTS Medical categories produced significantly lower total quality scores when compared to "Mediterranean diet" and "sports nutrition" categories. (F=7.189, P<0.001). Commercial web pages had a significantly lower credibility score compared to institutional and other web page types (H=17.987, P<0.001). Ranking order of each web page was related to its total quality score (P=0.04) but not to its credibility (P=0.241). CONCLUSIONS Monitoring the accuracy, comprehensiveness and consistency of health-related information on the internet is an important public health issue since there are popular web pages that are regarded as of high quality but they do not always provide reliable information. Health professionals and especially dieticians should provide consumer training on how to search for and appraise nutritional information from the internet.
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Affiliation(s)
- K Gkouskou
- Department of Nutrition and Dietetics, Technological and Educational Institute, Crete, Greece
- Institute of Molecular Biology and Biotechnology-FORTH, University of Crete, Heraklion, Greece
| | - A Markaki
- Department of Nutrition and Dietetics, Technological and Educational Institute, Crete, Greece
| | - M Vasilaki
- Department of Nutrition and Dietetics, Technological and Educational Institute, Crete, Greece
| | - A Roidis
- Department of Nutrition and Dietetics, Technological and Educational Institute, Crete, Greece
| | - I Vlastos
- Department of Nutrition and Dietetics, Technological and Educational Institute, Crete, Greece
- Deparment of Otolaryngology Head and Neck Surgery, Universtity Hospital of Heraklion, Crete, Greece
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