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Bone & Joint Open
Vol. 4, Issue 5 | Pages 363 - 369
22 May 2023
Amen J Perkins O Cadwgan J Cooke SJ Kafchitsas K Kokkinakis M

Aims

Reimers migration percentage (MP) is a key measure to inform decision-making around the management of hip displacement in cerebral palsy (CP). The aim of this study is to assess validity and inter- and intra-rater reliability of a novel method of measuring MP using a smart phone app (HipScreen (HS) app).

Methods

A total of 20 pelvis radiographs (40 hips) were used to measure MP by using the HS app. Measurements were performed by five different members of the multidisciplinary team, with varying levels of expertise in MP measurement. The same measurements were repeated two weeks later. A senior orthopaedic surgeon measured the MP on picture archiving and communication system (PACS) as the gold standard and repeated the measurements using HS app. Pearson’s correlation coefficient (r) was used to compare PACS measurements and all HS app measurements and assess validity. Intraclass correlation coefficient (ICC) was used to assess intra- and inter-rater reliability.


The Bone & Joint Journal
Vol. 95-B, Issue 3 | Pages 419 - 423
1 Mar 2013
Petratos DV Kokkinakis M Ballas EG Anastasopoulos JN

McFarland fractures of the medial malleolus in children, also classified as Salter–Harris Type III and IV fractures, are associated with a high incidence of premature growth plate arrest. In order to identify prognostic factors for the development of complications we reviewed 20 children with a McFarland fracture that was treated surgically, at a mean follow-up of 8.9 years (3.5 to 17.4). Seven children (35%) developed premature growth arrest with angular deformity. The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale for all patients was 98.3 (87 to 100) and the mean modified Weber protocol was 1.15 (0 to 5). There was a significant correlation between initial displacement (p = 0.004) and operative delay (p = 0.007) with premature growth arrest. Both risk factors act independently and additively, such that all children with both risk factors developed premature arrest whereas children with no risk factor did not. We recommend that fractures of the medial malleolus in children should be treated by anatomical reduction and screw fixation within one day of injury.

Cite this article: Bone Joint J 2013;95-B:419–23.


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 4 | Pages 595 - 601
1 Apr 2010
Kafchitsas K Kokkinakis M Habermann B Rauschmann M

In a study on ten fresh human cadavers we examined the change in the height of the intervertebral disc space, the angle of lordosis and the geometry of the facet joints after insertion of intervertebral total disc replacements. SB III Charité prostheses were inserted at L3-4, L4-5, and L5-S1. The changes studied were measured using computer navigation sofware applied to CT scans before and after instrumentation.

After disc replacement the mean lumbar disc height was doubled (p < 0.001). The mean angle of lordosis and the facet joint space increased by a statistically significant extent (p < 0.005 and p = 0.006, respectively). By contrast, the mean facet joint overlap was significantly reduced (p < 0.001). Our study indicates that the increase in the intervertebral disc height after disc replacement changes the geometry at the facet joints. This may have clinical relevance.


The Journal of Bone & Joint Surgery British Volume
Vol. 91-B, Issue 6 | Pages 820 - 821
1 Jun 2009
Dabasia H Kokkinakis M El-Guindi M

A 66-year-old man presented with an infected resurfacing hip replacement in the immediate post-operative period following an uneventful transurethral resection of the prostate. Prophylactic antibiotics had been administered on induction of anaesthesia. The hip prosthesis had been inserted seven years previously and had been hitherto asymptomatic. The hip was washed out and microbiological examination identified Enterococcus faecalis as the infecting micro-organism.

Despite current recommendations, clinicians undertaking invasive procedures which can lead to bacteraemia in patients with prosthetic joint replacements should be aware of the risk of haematogenous seeding in such prostheses, which although low, has potentially disastrous consequences.