1
|
Kolovos S, Sioutis S, Papakonstantinou ME, Serenidis D, Altsitzioglou P, Karampikas V, Chlapoutakis K, Mitsiokapa E, Katsanos S, Mastrokalos D, Koulalis D, Papagelopoulos PJ, Mavrogenis AF. Ultrasonographic screening for developmental dysplasia of the hip: the Graf method revisited. Eur J Orthop Surg Traumatol 2024; 34:723-734. [PMID: 37884843 DOI: 10.1007/s00590-023-03767-9] [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: 07/07/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
Until the 1980s, the diagnosis of developmental dysplasia of the hip (DDH) was based on clinical examination and radiographic imaging. In 1980, Reinhard Graf developed his own ultrasonographic method for the examination of the infant hip joint. Graf's method evaluates the osseous and cartilaginous coverage of the femoral head by the acetabulum in the infantile hip joint by measuring the angles α and β. The validity of Graf method is that with these measurements the hip joint is further classified by Graf classification into types I to IV that guide treatment. Currently, Graf method is considered the gold standard examination for the diagnosis of DDH in many European countries. This review article aims to discuss the incidence, risk factors and pathophysiology of DDH, and to emphasize on the Graf method for the evaluation, classification, prevention and further management of this entity.
Collapse
Affiliation(s)
- Stylianos Kolovos
- Department of Orthopaedics, General Hospital of Larisa, Larisa, Greece
| | - Spyridon Sioutis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria-Eleni Papakonstantinou
- Third Department of Paediatrics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Serenidis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Pavlos Altsitzioglou
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasileios Karampikas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Evanthia Mitsiokapa
- Department of Physical and Rehabilitation Medicine, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | - Spyridon Katsanos
- Department of Emergency Medicine and Cardiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Mastrokalos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| |
Collapse
|
2
|
Sioutis S, Zikopoulos A, Karampikas V, Mitsiokapa E, Tsatsaragkou A, Katsanos S, Mastrokalos D, Koulalis D, Mavrogenis AF. Hip Fractures in Patients with Dementia: An Emerging Orthopedic Concern. J Long Term Eff Med Implants 2024; 34:85-93. [PMID: 37938210 DOI: 10.1615/jlongtermeffmedimplants.2023046658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Hip fractures are a very common injury in the elderly population associated with an increased mortality rate. Currently, more and more elderly patients are diagnosed with dementia. Demented patients are more prone to falls and hip fractures compared to the general population because of conditions related to their disease such as instability, osteoporosis, poor muscle control and weakness. The coexistence of dementia and hip fractures is a difficult situation for both the patients and the treating physicians because of postoperative complications in this frail subgroup of patients and their inability to stand up and walk. To enhance the literature, we reviewed published studies of hip fracture patients suffering from dementia to discuss why they have more frequent hip fractures, to review their associated in-hospital complications, and to emphasize on their postoperative management to be able to reach the pre-injury activity level and optimal quality of life.
Collapse
Affiliation(s)
- Spyridon Sioutis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, University Medical School, Athens, Greece
| | - Alexandros Zikopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Karampikas
- First Department of Orthopedics, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece
| | - Evanthia Mitsiokapa
- Department of Physical and Rehabilitation Medicine, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | | | - Spyridon Katsanos
- Department of Emergency Medicine and Cardiology, National and Kapodistrian University of Athens
| | - Dimitrios Mastrokalos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
| |
Collapse
|
3
|
Mavrogenis AF, Karampikas V, Zikopoulos A, Sioutis S, Mastrokalos D, Koulalis D, Scarlat MM, Hernigou P. Orthobiologics: a review. Int Orthop 2023:10.1007/s00264-023-05803-z. [PMID: 37071148 DOI: 10.1007/s00264-023-05803-z] [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] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/30/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE The use of biologic materials in orthopaedics (orthobiologics) has gained significant attention over the past years. To enhance the body of the related literature, this review article is aimed at summarizing these novel biologic therapies in orthopaedics and at discussing their multiple clinical implementations and outcomes. METHODS This review of the literature presents the methods, clinical applications, impact, cost-effectiveness, and outcomes, as well as the current indications and future perspectives of orthobiologics, namely, platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, growth factors, and tissue engineering. RESULTS Currently available studies have used variable methods of research including biologic materials as well as patient populations and outcome measurements, therefore making comparison of studies difficult. Key features for the study and use of orthobiologics include minimal invasiveness, great healing potential, and reasonable cost as a nonoperative treatment option. Their clinical applications have been described for common orthopaedic pathologies such as osteoarthritis, articular cartilage defects, bone defects and fracture nonunions, ligament injuries, and tendinopathies. CONCLUSIONS Orthobiologics-based therapies have shown noticeable clinical results at the short- and mid-term. It is crucial that these therapies remain effective and stable in the long term. The optimal design for a successful scaffold remains to be further determined.
Collapse
Affiliation(s)
- Andreas F Mavrogenis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - Vasileios Karampikas
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexandros Zikopoulos
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Spyridon Sioutis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Mastrokalos
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | | |
Collapse
|
4
|
Georgoulis J, Mavrogenis A, Gkiatas I, Chatzipapas C, Koulalis D, Mastrokalos D, Hantes M, Georgoulis A. Higher infection rate after ACL reconstruction with hamstrings tendon autografts compared to bone patellar bone tendon autografts: a review. J Long Term Eff Med Implants 2022; 32:9-13. [DOI: 10.1615/jlongtermeffmedimplants.2022041978] [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: 01/11/2023]
|
5
|
Koulalis D, Bekos A, Tsantes AG, Mastrokalos D, Papagelopoulos PJ, Mavrogenis AF. Osteomyelitis of the femur effectively treated with medulloscopy debridement: a case report. Eur J Orthop Surg Traumatol 2020; 31:797-801. [PMID: 33159564 DOI: 10.1007/s00590-020-02813-0] [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: 07/29/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medulloscopy refers to the visualization of the intramedullary canal with an arthroscope, providing access to the infection site without the need for an extensive approach therefore not compromising the surrounding soft tissue. It provides information regarding the extent of the infected endosteal surface of bone, and it allows a thorough debridement of the intramedullary canal in a controlled manner. Therefore, it can be used as an adjunct to traditional open surgical techniques, to perhaps help to visualize hard to see intramedullary areas. MATERIALS AND METHODS This article reports a patient with chronic osteomyelitis of the distal metaphysis of the femur that was treated successfully with intramedullary debridement through medulloscopy. The sinus tract reaching down to the femoral bone and communicating with the intramedullary canal was excised, and a cortical window was formed through which the arthroscope was inserted and thorough irrigation of the intramedullary canal and excision of necrotic and infected bone was done. A second medulloscopy through the same approach was necessary 3 months later because of persistent infection. RE: SULTS: At 3-year follow-up, the patient was well without any clinical or radiographic evidence of recurrent infection. CONCLUSION Medulloscopy can be very useful in localized osteomyelitis as an adjunct to traditional surgical techniques; it helps to visualize hard to see intramedullary areas and adequately addresses the infection, while the damage to surrounding soft-tissue is limited.
Collapse
Affiliation(s)
- Dimitrios Koulalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece.
| | - Achilles Bekos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece
| | - Andreas G Tsantes
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece
| | - Dimitrios Mastrokalos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 15562, Athens, Greece
| |
Collapse
|
6
|
Apostolopoulos AP, Chronopoulos E, Michos IV, Mastrokalos D, Darras N, Nikolaou VS. Kinematic and Kinetic Waveform Changes of the Knee Joint Following a Mobile Bearing Total Knee Arthroplasty-Gait Analysis and Single Step Ascent. J Knee Surg 2020; 33:978-986. [PMID: 31127599 DOI: 10.1055/s-0039-1688963] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The objective of this study is to analyze the kinetic and kinematic changes of the osteoarthritic knee after a mobile bearing total knee arthroplasty. Kinematic and kinetic gait analysis of level walking was performed in 15 patients (eight female and seven male) with knee ostoarthritis. All patients were free of any neurological diseases that could affect their normal gait. Mean age was 68.6 ± 5.2 years, mean height 159.8 ± 6.9 cm, and mean weight was 78.5 ± 10.1 kg. Full body gait analysis was performed using the BioKin three-dimensional (3D) motion analysis system preoperatively and 9 months after total knee arthroplasty. A single-step ascending kinetic analysis and a plantar pressure distribution analysis were also performed in all patients. An increased average cadence (mean 99.39 step/min preoperatively and 104.64 step/min postoperatively; p = 0.152), step length (0.44 m preoperatively and 0.52 m postoperatively; p < 0.001), stride length (0.89 m preoperatively and 1.0 m postoperatively; p < 0.007), and walking velocity (0.73 m/sec preoperatively and 0.90 m/sec postoperatively; p = 0.005) were noted postoperatively and postoperatively. A decrease in the stance duration percentage and the knee adduction moment was also reported postoperatively. All patients showed a significant improvement of knee kinetics and kinematics after a mobile bearing total knee arthroplasty. Statistically significant differences were found in the step length, stride length, and walk velocity postoperatively. The knee adduction moment was also significantly reduced. Further research is warranted to determine the clinical relevance of these findings. This study is a prospective comparative one and reflects level II evidence.
Collapse
Affiliation(s)
- A P Apostolopoulos
- 4th Orthopaedic Department, Ascleipion Voulas General Hospital, Athens, Greece.,Trauma and Orthopaedic Department, Ealing Hospital, Imperial College Healltcare NHS Trust, London, United Kingdom
| | - E Chronopoulos
- 2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - I V Michos
- 4th Orthopaedic Department, Ascleipion Voulas General Hospital, Athens, Greece
| | - D Mastrokalos
- 1st Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - N Darras
- Gait and Motion Analysis Center, ELEPAP-Rehabilitation for the Disabled, Athens, Greece
| | - V S Nikolaou
- 2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
7
|
Petroudi D, Tsagkaris I, Mastrokalos D, Papagelopoulos P, Kontogeorgakos V. Can Initial Hematocrit Predict Blood Transfusions, Hospital Cost, and Mortality in Polytrauma Patients? J Long Term Eff Med Implants 2020; 30:83-86. [PMID: 33426845 DOI: 10.1615/jlongtermeffmedimplants.2020035548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Knowing the initial hematocrit of a polytrauma patient can assist his trauma management. This paper describes a four-year study of 88 polytrauma patients. Fifty-nine were transfused, and eight were women (13.5%). The mean cost of the first hospitalization of patients who were transfused was 14,503 €; the mean cost of patients who were not transfused was 5,718 €. HCT did not correlate with ICU stay; nor did days of hospitalization. The mean HCT of those who died was not much different from that of survivors (33.23 with standard deviation [SD] 7.43 versus 32.37 with SD 5.89). This study showed that initial HCT does not correlate with days of hospitalization or days in ICU, but that transfusion can predict higher total cost.
Collapse
Affiliation(s)
- Dimitra Petroudi
- Registered Nurse, Attikon University Hospital of Athens, Athens, Greece
| | - I Tsagkaris
- National and Kapodistrian University of Athens, Department of Critical Care, Athens, Greece
| | - Dimitrios Mastrokalos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| | - P Papagelopoulos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| | - V Kontogeorgakos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| |
Collapse
|
8
|
Petroudi D, Tsagkaris I, Mastrokalos D, Galanopoulos I, Galanis P, Papagelopoulos P, Kontogeorgakos V. Polytrauma: Treatment, Cost, and Associated Factors. J Long Term Eff Med Implants 2019; 29:311-316. [PMID: 32749136 DOI: 10.1615/jlongtermeffmedimplants.2020034807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Trauma is a multifactor problem with economic, social, and political burdens. In this article, we estimate its economic extension. This 3-yr study includes 69 patients above 14 yr of age, who experienced multiple traumatic injuries. We review their economic impact on the National Health System of Greece. Mean patient age is 38.91 yr, and most are male (85.5%), nonsmoking (69.6%), and without open fractures (78.3%). As a result of their injuries, most patients (76.8%) stayed in the intensive care unit (ICU), underwent surgery (76.8%), were transfused (68.1%), and became infected (63.8%). Mean cost was 16,365.65€, median cost 10,399.07€, minimum value 554.17€, and maximum value 89,243.52€. Of the 69 patients, 12 died. The number of polytrauma patients is relatively small compared to the total amount of patients in hospital care, but their impact on health services is very high. Patients admitted to the ICU are at great risk of infection, which can almost triple financial cost and increase hospital stay.
Collapse
Affiliation(s)
| | - I Tsagkaris
- National and Kapodistrian University of Athens, Department of Critical Care, Athens, Greece
| | - Dimitrios Mastrokalos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| | - I Galanopoulos
- Orthopaedic Surgeon, Thriasio General Hospital of Athens, Athens, Greece
| | - P Galanis
- RN, PhD, National & Kapodistrian University of Athens, Department of Public Health, Athens, Greece
| | - P Papagelopoulos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| | - V Kontogeorgakos
- National & Kapodistrian University of Athens, Department of Orthopaedic Surgery, Athens, Greece
| |
Collapse
|
9
|
Brilakis EV, Kaselouris E, Markatos K, Mastrokalos D, Provatidis C, Efstathopoulos N, Chronopoulos E. Mitchell's osteotomy augmented with bio-absorbable pins for the treatment of hallux valgus: A comparative finite element study. J Musculoskelet Neuronal Interact 2019; 19:234-244. [PMID: 31186396 PMCID: PMC6587079] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
BACKGROUND There is an inadequacy of conventional means to assess the surgical outcomes of a bunion surgery. We used the Finite Element Analysis for evaluating the typical Mitchell's procedure outcomes with or without bio-absorbable pins. METHODS We developed a 3D FE model based on the CT images of a female volunteer with hallux valgus. A typical procedure was simulated on the foot model and two pins were virtually inserted for enhancing the fixation. We validated our model by comparing the predicted pressure results with the plantar pressure measured by a specific platform. RESULTS The comparison of the plantar pressure distribution revealed similar patterns. A greater displacement was observed on the medial side of the osteotomy, but it was decreased after using pins. The maximum average pressure under the 1st metatarsal head was decreased after the osteotomy. The respective pressure under the 3rd and 5th metatarsal head was decreased more after using pins, while, under the 2nd and 4th metatarsal head, an increase was developed. CONCLUSION The use of pins had no significant influence on the healing process but gave additional stability inside the osteotomy and could be used in cases where enhancement is needed. The surgeon should be familiar with the expected stress rising to the other metatarsal, considering the concomitant pathology or the additional interventions that should be performed.
Collapse
Affiliation(s)
- Emmanouil V. Brilakis
- 3rd Orthopaedic Department of “Hygeia” General Hospital, Athens, Greece,Corresponding author: Emmanouil Brilakis, 30A Str. Aiolou, 17561 Palaio Faliro, Greece E-mail:
| | | | | | - Dimitrios Mastrokalos
- 1st Orthopaedic Department of National and Kapodistrian University of Athens, Athens, Greece
| | - Christopher Provatidis
- Mechanical Design & Control Systems Section National Technical University of Athens, Athens, Greece
| | - Nicolas Efstathopoulos
- 2nd Orthopaedic Department of National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Chronopoulos
- 2nd Orthopaedic Department of National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
10
|
Mandragos E, Pistiki A, Tsangaris I, Routsi C, Paraschos M, Droggiti DI, Savvidou O, Mastrokalos D, Papagelopoulos PJ, Netea MG, Giamarellos-Bourboulis EJ. Survival after multiple traumas is associated with improved outcomes from gram-negative sepsis: Clinical and experimental evidence. J Infect 2016; 74:163-171. [PMID: 27826063 DOI: 10.1016/j.jinf.2016.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We investigated the susceptibility to Gram-negative sepsis after multiple traumas (MT). METHODS From a prospective cohort of 5076 Greek patients with sepsis, 16 with Gram-negative bacteremia after MT were compared with 204 patients well-matched for severity, comorbidities and appropriateness of antimicrobials; circulating mononuclear cells were isolated and stimulated for the release of interleukin (IL)-10. Male C57Bl6J mice were subject to MT (right pneumothorax and right femur fracture) followed after 72 h by the intravenous challenge with Pseudomonas aeruginosa. Survival was recorded and splenocytes were isolated for cytokine stimulation. RESULTS 28-day mortality after MT was 18.8% compared to 48.0% of comparators (48.0%) (odds ratio 0.25, p: 0.035). This was confirmed after logistic regression analysis taking into consideration comorbidities and age. Stimulation of IL-10 was enhanced from MT patients. Survival of mice challenged by P. aeruginosa 72 h after MT was prolonged compared to mice challenged by P. aeruginosa without prior MT. Cytokine production was decreased 24 h after MT and restored 96 h thereafter. Production of IL-10 was particularly pronounced from splenocytes of mice challenged by P. aeruginosa after MT. CONCLUSIONS Survival after MT is accompanied by favorable immune responses allowing survival benefit from Gram-negative sepsis. This is associated with increased IL-10 release.
Collapse
Affiliation(s)
- Eleftherios Mandragos
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece
| | - Aikaterini Pistiki
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece
| | - Iraklis Tsangaris
- 2nd Department of Critical Care Medicine, National and Kapodistrian University of Athens, Medical School, Greece
| | - Christina Routsi
- 1st Department of Critical Care Medicine, National and Kapodistrian University of Athens, Medical School, Greece
| | - Michael Paraschos
- Intensive Care Unit, "Korgialeneion-Benakeion" General Hospital, Athens, Greece
| | - Dionyssia-Irene Droggiti
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece
| | - Olga Savvidou
- 1st Department of Orthopaedics, National and Kapodistrian University of Athens, Medical School, Greece
| | - Dimitrios Mastrokalos
- 1st Department of Orthopaedics, National and Kapodistrian University of Athens, Medical School, Greece
| | | | - Mihai G Netea
- Department of Internal Medicine, Radboud University Nijmegen, The Netherlands
| | | |
Collapse
|
11
|
Stathopoulos K, Zoubos A, Papaioannou N, Mastrokalos D, Galanos A, Papagelopoulos P, Skarantavos G. Differences of bone mineral mass, volumetric bone mineral density, geometrical and structural parameters and derived strength of the tibia between premenopausal and postmenopausal women of different age groups: a peripheral Quantitative Computed Tomography (pQCT) study. J Musculoskelet Neuronal Interact 2016; 16:113-21. [PMID: 27282455 PMCID: PMC5114354] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Menopause constitutes a significant cause of bone loss, and it is currently debated whether bone mass is preserved or begins to decline substantially before that time in women. We used pQCT of the tibia to estimate differences of bone mineral mass, bone geometry and derived strength between premenopausal and postmenopausal Caucasian women of different age-groups per decade of age (20-79y). For each individual, we assessed total, trabecular and cortical bone mineral content (BMC, mg) and volumetric bone mineral density (BMD, mg/cm3); total and cortical cross-sectional areas (CSA, mm2); periosteal circumference (PERI_C, mm); endosteal circumference (ENDO_C, mm); mean cortical thickness (CRT_THK, mm); and Stress-Strain Index (SSI) . Comparisons were made both between premenopausal (N=84) and postmenopausal (N=231) women as distinct groups, and among women of the different age-groups. Our results indicated that premenopausal women had significantly higher trabecular and cortical BMC and vBMD, with higher cortical CSA, CRT_THK and SSI than postmenopausal women. Moreover, significant differences of trabecular but not cortical BMC, vBMD or SSI were found between women of the younger (<48y) age-groups. PERI_C, ENDO_C displayed lower values in the 20-29y group and higher values in the 70-79y group, denoting significant differences of bone geometry with aging.
Collapse
Affiliation(s)
- K.D. Stathopoulos
- Bone Metabolic Unit, 1st Department of Orthopedics, University of Athens, School of Medicine, “Attikon” University General Hospital, Greece,Corresponding author: Konstantinos D. Stathopoulos, Xylouri 28-30, Athens 14123, Greece E-mail:
| | - A.B. Zoubos
- Bone Metabolic Unit, 1st Department of Orthopedics, University of Athens, School of Medicine, “Attikon” University General Hospital, Greece
| | - N.A. Papaioannou
- Laboratory for Research of the Musculoskeletal System (LRMS), University of Athens, School of Medicine, KAT General Hospital, Athens, Greece
| | - D. Mastrokalos
- Bone Metabolic Unit, 1st Department of Orthopedics, University of Athens, School of Medicine, “Attikon” University General Hospital, Greece
| | - A. Galanos
- Laboratory for Research of the Musculoskeletal System (LRMS), University of Athens, School of Medicine, KAT General Hospital, Athens, Greece
| | - P.J. Papagelopoulos
- Bone Metabolic Unit, 1st Department of Orthopedics, University of Athens, School of Medicine, “Attikon” University General Hospital, Greece
| | - G. Skarantavos
- Bone Metabolic Unit, 1st Department of Orthopedics, University of Athens, School of Medicine, “Attikon” University General Hospital, Greece
| |
Collapse
|
12
|
Adoni A, Paraskeuopoulos T, Saranteas T, Sidiropoulou T, Mastrokalos D, Kostopanagiotou G. Prospective randomized comparison between ultrasound-guided saphenous nerve block within and distal to the adductor canal with low volume of local anesthetic. J Anaesthesiol Clin Pharmacol 2014; 30:378-82. [PMID: 25190947 PMCID: PMC4152679 DOI: 10.4103/0970-9185.137271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background and Aims: The anatomic site and the volume of local anesthetic needed for an ultrasound-guided saphenous nerve block differ in the literature. The purpose of this study was to examine the effect of two different ultrasound-guided low volume injections of local anesthetic on saphenous and vastus medialis nerves. Materials and Methods: Recruited patients (N = 48) scheduled for orthopedic surgery were randomized in two groups; Group distal adductor canal (DAC): Ultrasound-guided injection (5 ml of local anesthetic) distal to the inferior foramina of the adductor canal. Group adductor canal (AC): Ultrasound-guided injection (5 ml local anesthetic) within the adductor canal. Following the injection of local anesthetic, block progression was monitored in 5 min intervals for 15 min in the sartorial branches of the saphenous nerve and vastus medialis nerve. Results: Twenty two patients in each group completed the study. Complete block of the saphenous nerve was observed in 55% and 59% in Group AC and DAC, respectively (P = 0.88). The proportion of patients with vastus medialis weakness at 15 min in Group AC, 36%, was significantly higher than in Group DAC (0/22), (P = 0.021). Conclusions: Low volume of local anesthetic injected within the adductor canal or distally its inferior foramina leads to moderate success rate of the saphenous nerve block, while only the injection within the adductor canal may result in vastus medialis nerve motor block.
Collapse
Affiliation(s)
- Areti Adoni
- Department of Anesthesia and Cardiovascular Critical Care, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| | - Tilemachos Paraskeuopoulos
- Department of Anesthesia and Cardiovascular Critical Care, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| | - Theodosios Saranteas
- Department of Anesthesia and Cardiovascular Critical Care, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| | - Tatiana Sidiropoulou
- Department of Anesthesia and Cardiovascular Critical Care, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| | - Dimitrios Mastrokalos
- Department of Orthopedic, School of Medicine, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| | - Georgia Kostopanagiotou
- Department of Anesthesia and Cardiovascular Critical Care, University of Athens, Attikon University Hospital of Athens, Athens, Greece
| |
Collapse
|
13
|
Soultanis K, Karaliotas GI, Mastrokalos D, Sakellariou VI, Starantzis KA, Soucacos PN. Lumbopelvic fracture-dislocation combined with unstable pelvic ring injury: one stage stabilisation with spinal instrumentation. Injury 2011; 42:1179-83. [PMID: 20609436 DOI: 10.1016/j.injury.2010.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 06/08/2010] [Indexed: 02/02/2023]
Affiliation(s)
- Konstantinos Soultanis
- First Orthopaedical Department, Athens University Medical School, General University Hospital ATTIKON, Rimini 1 Street, 12462 Haidari, Athens, Greece
| | | | | | | | | | | |
Collapse
|
14
|
Apostolopoulos A, Lallos SN, Mastrokalos D, Michos LV, Darras N, Tzomaki M, Efstathopoulos NE. Kinematic and Kinetic Analysis of the Knee Joint before and after a PCL Retaining Total Knee Replacement during Gait and Single Step Ascent. J Long Term Eff Med Implants 2011; 21:339-48. [DOI: 10.1615/jlongtermeffmedimplants.v21.i4.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
15
|
Stamatakos M, Stefanaki C, Mastrokalos D, Arampatzi H, Safioleas P, Chatziconstantinou C, Xiromeritis C, Safioleas M. Mesenteric ischemia: still a deadly puzzle for the medical community. TOHOKU J EXP MED 2009; 216:197-204. [PMID: 18987453 DOI: 10.1620/tjem.216.197] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The main goal of this article is to update etiology, epidemiology, diagnosis, treatment and outcome of the various causes of mesenteric ischemia in order to elucidate its labyrinthine clinical riddle, by reviewing the current English medical literature. Mesenteric ischemia is a quite uncommon disorder, observed in the emergency department. It is a life-threatening vascular emergency that requires early diagnosis and intervention to restore mesenteric blood flow and to prevent bowel necrosis and patient death. Consequently, it is a vital diagnosis to make because of its high mortality rate and its thorny complications. The underlying causes vary, and the prognosis depends on the specific findings during clinical examination. Vague and nonspecific clinical findings and limitations of diagnostic studies make the diagnosis a significant challenge. The prognosis of acute mesenteric ischemia of any type is grave. The complications following this medical jigsaw puzzle are also severe. Patients in whom the diagnosis is missed until infarction occurs have a mortality rate of 90%. Even with good treatment, up to 50-80% of patients die. Survivors of extensive bowel resection face lifelong disability. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of treatment modalities, the entity remains a diagnostic challenge for clinicians. Delay in diagnosis contributes to a high mortality rate. Early diagnosis and adequate treatment can improve the clinical outcome. Even if diagnostic modalities have improved since the first successful attempts to confront effectively this clinical entity, mesenteric ischemia still remains a lethal diagnostic enigma for the medical community.
Collapse
Affiliation(s)
- Michael Stamatakos
- Second Department of Propaedeutic Surgery, Medical School, University of Athens, Laiko General Hospital, Athens, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Papaioannou N, Mastrokalos D, Papagelopoulos PJ, Tyllianakis M, Athanassopoulos J, Nikiforidis PA. Nonunion after primary treatment of tibia fractures with external fixation. Eur J Orthop Surg Traumatol 2001. [DOI: 10.1007/bf01686895] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|