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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 191 - 191
1 Feb 2004
Andrikoula S Êïntogeorgakos  Pafilas D Ìavrodontidis Á Chenakis T Soukakos P
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Aim: The aim of the study is to evaluate the results of the use of the Rotating Knee Endo Model not only as a revision implant, but as a primary choice too.

Method: It is a retrospective study of 73 patients who underwent primary total knee replacement (TKR) in 96 knees, during 1990–2001. The mean follow up is 5.6 years. The average age of the patients was 70.6 years (38 – 87 years), and 79.6 % were female. The indications for surgery were osteoarthritis in 66 knees, rheumatoid arthritis (R.A.) in 10 knees and aseptic osteonecrosis of femoral condyles in 3 knees. Seventy-nine prosthesis were examined both clinically and with plain films. Fifteen patients died in the mean time and 2 others could not participate in the follow up. The pre- and post-operative evaluation based on the «The Hospital for Special Surgery (HSS) knee rating scale».

Results: Fifty-eight knees were rated as excellent, 13 knees were rated as good and 8 knees were rated as fair. Deep venous thrombosis occured in 3 patients, non-fatal pulmonary embolism in 2, and 3 patients demonstrated superficial wound infection cured with oral antibiotic administration. One patient suffered dislocation of the apparatus, which required revision of the femoral component. The tibial insertion of the patellar tendon of one patient detached, which was reattached. Ectopic ossification was present in another patient 4 months after surgery and excised in a second stage, deep infection in 1 patient with history of osteomyelitis silent for 10 years, who eventually underwent an above-knee amputation.

Conclusions: The Rotating Knee Endo Model allows axial correction of the extremity, stabilization of the joint, useful range of motion and pain relief while the infection rate is considered low. So the prosthesis could be a good alternative not only in revision procedures but in primary TKA in cases of serious axial deformity and in rheumatoid knees with instability and muscular atrophy as well.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 160 - 160
1 Feb 2004
Mitsionis G Andrikoula S Kalos N Sioros V Beris A
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Purpose: We perform the results of the operative treatment of cubital tunnel syndrome, and a retrospective review of the surgical options of in situ decompression of the ulnar nerve, release and anterior transposition of the ulnar nerve and ulnar nerve release and partial medial epicondylectomy.

Material and Methods: Seventy four patients, 52 male and 22 female, (78 elbows), were treated surgically from October 1991 to November 2002.The mean age was 51 years (range, 13 to 72 years). Sixty four patients were assessed postoperatively with mean follow-up 80 months (range 6–139 months). Twenty patients underwent in situ decompression of the ulnar nerve, 34 patients release and anterior transposition and 14 ulnar nerve release and partial medial epicondylectomy. According to the McGowing evaluation system were classified in Grade I, none, Grade II, 38 patients and Grade III 26 patients. The 64 patients were evaluated clinically and 16 of them by EMG studies postoperatively.

Results: Sixty one patients had had subjective improvment of their symptoms. Thirty seven patients (57.8%) excellent, 21 patients (32.8%) good, 3 patients (4.6%) fair and 3 patients (4.6%) poor results. (Wilson & Krout). The comperative results among the surgical options of our study showed improvement in the subjective outcome of 32 out of 34 patients who had release and anterior transposition of the ulnar nerve. From the 20 patient who had in situ decompression of the ulnar nerve, 19 had improvement and from the rest 14 patients who had had ulnar nerve release and partial medial epicondylectomy, they all had improvement.

Conclusions: The results for the patients in this study who had ulnar nerve release and partial medial epicondylectomy, are comparable in good results with other operative treatment options for the cubital tunnel syndrome.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 178 - 179
1 Feb 2004
Koulouvaris P Stafilas K Andrikoula S Korompilias A Vekris M Xenakis T
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Aim: This study describes the clinical features and treatment of 94 patients with skeletal osteochondroma during the last 20 years.

Materials-methods: A retrospective review of various size solitary osteochondroma was evaluated. There were 51 males and 44 females with mean age 21 years. The mean follow-up was 8 years (1–12). There were 40 lesions in the distal femur, 6 in the greater trochanter, 19 in the proximal tibia, 1 in the proximal fibula, 1 in the calcaneus, 3 in the lateral malleolus, 1 in the medial malleolus, 3 in the talus, 2 in the tarsus, 3 in the metatarsals, 3 in the scapula, 4 in the humerus, 1 in the elbow,1 in the radius, 6 in the fingers. The lesions were diagnosed by history and plain radiographs. In two patients with large lesions around the knee an angiography was done

Results: Pain and local tenderness were the main symptoms. The treatment was en bloc excision of the tumor. There were no recurrence. Two patients had wound infection which was dealt with antibiotic.

Conclusion: The site and the results of this study are similar with the literature. The radiologic image is pathognomic for the tumor. The treatment consisted of en bloc excision. There is high possibility of recurrence in case of insufficient excision.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 170 - 170
1 Feb 2004
Chouliaras V Andrikoula S Motsis E Papageorgiou C Georgoulis A Beris A
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Introduction: Osteochondral lesions of the talus may cause persistent joint pain requiring surgical treatment, which today can be performed arthroscopically. The purpose of this study is to evaluate the effectiveness of arthroscopic treatment of these lesions.

Material and Method: Seventeen patients (7 males and 10 females) underwent ankle arthroscopy from 1998 through June 2002 for treatment of osteochondral lesions of the talus. Their age ranged from 11 – 68 years. The right talus was affected in 12 and the left in 5 patients. All but one had a history of previous trauma, for which they had been treated conservatively for at least 6 months.

Bone scanning, CT and MRI were performed for lesion staging according to Brent and Harty. One patient was stage I, 2 were stage II, 7 were stage III, and 7 were stage IV.

The patients underwent ankle arthroscopy without use of a distractor. Inspection of the joint was followed by shaving and debridement of the lesion with or without drilling.

Results: Follow-up had a mean duration of 15 months (range 8 – 24 months). Outcome was evaluated with the Ogilvie-Harris score for pain, swelling, stiffness, limp and patient activity level. All patients had excellent or good results. In all cases there was a reduction in lesion size.

Conclusions: Arthroscopy is effective for treatment of osteochondral lesions of the talus. It causes less morbidity than open surgery and patients are able to follow an early mobilization and rehabilitation protocol. However, specialized surgical tools, as well as an in-depth knowledge of joint anatomy are required to avoid iatrogenic damage.