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The Bone & Joint Journal
Vol. 103-B, Issue 3 | Pages 440 - 441
1 Mar 2021
Nikolaou VS Masouros P Floros T Chronopoulos E Skertsou M Babis GC


The Bone & Joint Journal
Vol. 103-B, Issue 3 | Pages 442 - 448
1 Mar 2021
Nikolaou VS Masouros P Floros T Chronopoulos E Skertsou M Babis GC

Aims

The aim of this study was to investigate the hypothesis that a single dose of tranexamic acid (TXA) would reduce blood loss and transfusion rates in elderly patients undergoing surgery for a subcapital or intertrochanteric (IT) fracture of the hip.

Methods

In this single-centre, randomized controlled trial, elderly patients undergoing surgery for a hip fracture, either hemiarthroplasty for a subcapital fracture or intramedullary nailing for an IT fracture, were screened for inclusion. Patients were randomly allocated to a study group using a sealed envelope. The TXA group consisted of 77 patients, (35 with a subcapital fracture and 42 with an IT fracture), and the control group consisted of 88 patients (29 with a subcapital fracture and 59 with an IT fracture). One dose of 15 mg/kg of intravenous (IV) TXA diluted in 100 ml normal saline (NS,) or one dose of IV placebo 100 ml NS were administered before the incision was made. The haemoglobin (Hb) concentration was measured before surgery and daily until the fourth postoperative day. The primary outcomes were the total blood loss and the rate of transfusion from the time of surgery to the fourth postoperative day.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_9 | Pages 30 - 30
1 May 2017
Malahias M Babis G Kaseta M Chronopoulos E Fandridis E Nikolaou V
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Background

To determine if double needle ultrasound-guided hydrodissolution and aspiration of intratendinous calcification is more effective treatment than blind subacromial corticosteroid injection.

Methods

A prospective randomised comparative clinical study of 32 patients suffering from chronic symptomatic calcific tendinosis of the supraspinatous tendon. Group A (16 patients) received a double needle ultrasound-guided aspiration of the calcification, while group B (16 patients) underwent a blind subacromial betamethazone injection. As far as group A, we attached a syringe in the first needle, including 10cc. of normal saline (N/S), that we injected targeting the calcium deposit. Then we tried to achieve consecutive aspirations through the second needle.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 159 - 159
1 Mar 2009
CHRONOPOULOS E Park H Gill H Tasaki A McFarland E
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Aim: The diagnosis of partial biceps tears cannot be made reliably with existing physical exam tests. Diagnostic arthroscopy is recommended if this diagnosis is suspected.

The accuracy of the physical examination for biceps pathology remains controversial. The goal of this study was to investigate the validity and clinical usefulness of various physical tests used for diagnosing partial tears of the biceps tendon.

Materials & Methods: The study was a prospective blinded study of 847 consecutive patients who underwent arthroscopic procedures for a variety of shoulder conditions. Forty subjects were found at the time of arthroscopy to have partial biceps tears (24 men and 16 women) with an average age of 59 YO (range from 18 to 83 YO). A pre-operative physical examination using 9 different commonly used tests was performed for all the patients. Statistical analysis included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and likelihood ratios (LR) for these tests.

Results: The prevalence rate of partial tears was 5 percent of all arthroscopic procedures. Associated conditions included rotator cuff tears (85 percent) and anterior instability (7.5 percent). The sensitivity, specificity, PPV, NPV and the LR for the Speed_s test were 50 percent, 67 percent, 8 percent and 96 percent and 1.51, respectively. None of the other tests was sensitive (less than 50 percent). The lift-off sign had a LR of 2.61 but had a sensitivity of only 28 percent.

Conclusion: The diagnosis of partial biceps tears cannot be made reliably with existing physical exam tests. Diagnostic arthroscopy is recommended if this diagnosis is suspected.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 158 - 158
1 Mar 2009
CHRONOPOULOS E Park H Tasaki A Gill H McFarland E
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Aim: Distal clavicle excision (DCE) is the treatment of choice for A–C joint arthritis.The overall complication rate for open, isolated DCE is higher than previously reported.

Distal clavicle excision (DCE) is the treatment of choice for A–C joint arthritis. Isolated DCE., as an open procedure has been considered to be a safe procedure, and it is the gold standard for comparison for arthroscopic distal clavicle excision. This study attempts to define the incidence of complications after isolated, open DCE.

Materials & Methods: This prospective, non-randomized study included 702 patients who underwent arthroscopic surgery of the shoulder. 580 patients were included in the control group. All patients underwent a thorough preoperative evaluation and final diagnosis was given after arthroscopic evaluation. There were 42 patients with isolated A–C joint arthritis, which underwent an open D.C.E. Mean follow up was 16.7 months. There were 30 men and 12 women with a mean age of 42,6 (± 12,5) years. The dominant arm was involved in 30 patients. 16 patients participated in sports while 9 of them were competitive athletes. 38 (90%) patients had symptomatic arthritis, 2(5%) cases were of osteolysis and separation arthritis each.

Results: 22 (52%) of the 42 patients developed complications. There were 2 deep infections and 2 stitches abscesses. 4 (9.5%) patients developed a stiff shoulder and 1(2.4%) patient developed heterotopic ossification. 16 (38%) patients had tenderness in A–C joint for a period over 3 months while 6 (14%) patients had local tenderness at the last follow up. Painful scar was present in 2 (5%) patients over 3 months.

Conclusions: The overall complication rate for open, isolated DCE is higher than previously reported. Patients should be advised of these possibilities and this study serves as a baseline for comparison for future study.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 212 - 212
1 Mar 2003
Papachristou C Efstathopoulos N Lazarettos J Kalliakmanis A Sourlas J Nikolaou V Chronopoulos E
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Purpose: The aim of this paper is to present a new surgical method for the reconstruction of the recurrent sprain of the ankle.

Material – Methods: From 1980 until 1997, 17 patients 3 females and 14 males, average age 25.53 (19 – 44) underwent surgery suffering recurrent sprain of the ankle. In 11 patients the right ankle was involved and in 6 patients the left ankle. The cause of the injury was: athletic activities in 9 cases, weekend activities in 7 cases and daily activities in 1 case.

The patients were suffering from ankle instability 4–15 years prior the operation. All the patients underwent reconstructive surgery of the anterolateral elements (capsule and ligaments) according to senior author’s method. This included shortening of the anterolateral elements, capsule and ligaments, overlaping the anterolateral part over the anterolateral one in such a way, that the anterior drawer and varus tests were negative with the patient under anaesthesia.

Results: The follow up is 2–12 years. A patient underwent for a second time surgery, because of a new injury. In 2 patients early signs of ankle osteoarthritis. In the rest of them, restoration of the function of the ankle joint was excellent, obtaining full activities 3 months postperatively.

Conclusion: This surgical method for the reconstruction of the recurrent sprain of the ankle is considered satisfactory and when indicated allows young patients and athletes to participate in a rather short period of time, in their previous level of activities.