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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 97 - 97
1 Mar 2009
Pafilas D Vekris M Gartzonikas D Korompilias A Beris A
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Introduction: Digital nerve lesions with nerve gaps require reconstruction with the use of some form of graft or guide. Neurotube, a bioabsorbable polyglycolic acid (PGA) conduit, has been proposed as an effective solution for this kind of defect in emergency and planned surgery.

Methods: Nineteen posttraumatic lesions of common (5 cases) or proper (14 cases) palmar digital nerves were repaired by means of Neurotube from January 2003 till January 2006. The nerve gap size averaged 22 mm (range 15–35 mm). Thirteen lesions had associated vascular, tendon or osseous injury.

Results: Nerve regeneration was evaluated at a mean of 17 months postoperative interval. Positive results in recovery of sensibility were noticed in 73 % of the cases; static and moving two point discrimination was excellent (less than 6mm and 4mm respectively) in 9 cases and fair in 5 (7–15mm and 5–7mm respectively). Dysesthesia was present in 6 patients, cold intolerance in two, delayed wound healing in one and one patient complained for painful scar. There was no infection, conduit extrusion or allergic reaction.

Discussion and Conclusion: Bioabsorbable polyglycolic acid conduit presents an attractive and useful alternative for the reconstruction of digital nerve lesions with a small nerve gap, especially when a direct anastomosis of the two stumps is not possible, or when the suture appears to be in tension. Its use is simple, safe and also eliminates the donorsite morbidity associated with nerve-graft harvesting.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 179 - 179
1 Feb 2004
Fotinopoulos E Pafilas D Kanellopoulos D Tsirlis T Kourtzis N
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This randomized study is about 100 patients with hip fracture that were treated with hemiarthroplasty in 4 groups of 25.

Group A includes patients who were given :

- recombined human erythropoetin (r-HuEPO) 40.000 I.U. sc the day −1, +1, +3, +7 (day 0 = day of surgery).

- sulfate iron per os from the day −1 till +15

- blood from the autotranfusion apparatus (it is the patient’s blood that is collected in the autotransfusion apparatus the 5 first postoperative hours).

Group B includes patients who were given :

- sulfate iron per os from the day −1 till +15

- blood from the autotranfusion apparatus

Group C includes patients who were given :

- recombined human erythropoetin (r-HuEPO) 40.000 I.U. sc the day −1, +1, +3, +7 (day 0 = day of surgery).

- sulfate iron per os from the day −1 till +15

Group D is the control group (that was not given none of the above therapies).

We study and present the first results of the effect of the recombined erythropoetin, the sulfate iron per os and the patient’s blood from the autotransfusion apparatus to patients with hip fracture who were treated with hemiarthroplasty in concern to the transfused blood units for the restoration of the hematocrit to a tolerable level.


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 168 - 168
1 Feb 2004
Korompilias A Tokis M A Beris A Xenakis T Mitsionis G Koulouvaris P Pafilas D Soucacos P
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Purpose: Although transient osteoporosis of the hip was initially described in pregnant women, now most frequently identified in middle-age and older men. Has also been reported to occur in either hip and in both successively. This condition is referred as migratory transient osteoporosis of the hip. In this study the authors describe five cases of migratory hip osteoporosis and the differential diagnosis with osteonecrosis is also discussed.

Material and Methods: Thirty-four patients with transient osteoporosis were presented. Of the 34 patients five had a similar episode of severe pain in the contralateral hip 14 months mean time later. Early bone scans and MRI of the hips had been carried out in all of the patients. After the evaluation of these findings and thorough exclusion of other conditions diagnosis of migratory transient osteoporosis was demonstrated, and confirmed by the natural course of the disease.

Results: All cases were treated with nonsteroidal anti-inflammatory medications and protected weight-bearing. The course of the disease has not been appreciably altered by medical treatment, and the mean time interval from the onset of symptoms to clinical recovery was 4.6 months (range 3 to 6 months). Imaging findings on MR confirmed the diagnosis during both episodes and paralleled the reduction of pain.

Conclusions: Migratory transient osteoporosis of the hip is a rare self-limited condition of uncertain etiology and pathogenesis, which “migrate” from one hip to the other. Magnetic resonance imaging is highly sensitive in the early detection of this condition and moreover is helpful in the exclusion of other entities. Although the diagnosis is one of exclusion, it must be considered and contrasted with hip osteonecrosis.