Publications (5)7.04 Total impact
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Article: A two stage re-implantation protocol for the treatment of deep periprosthetic hip infection. Mid to long-term results.
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ABSTRACT: Deep periprosthetic hip infection is a devastating complication. Goal of treatment is infection eradication and durable functional reconstruction. Two-stage re-implantation is the standard of treatment. From January 1998 to December 2004 we treated 38 patients with an infected THA. There were 24 females and 14 males, with a mean age of 67 years (61-75). The infection occurred 13 months to 15 years (mean: 7.2 years) after the index operation. The mean follow-up was 11.6 years (7 to 14). 35 patients were available for review. Almost one third of the patients had been treated before with antibiotics. In 5 cases more than one pathogen were present. In 3 cases, it was not possible to isolate a causative organism. In 15 cases (43%), a resistant pathogen was isolated. We used a two stage re- implantation protocol. Spacer was not used in any of the cases. Femoral revision was performed with uncemented implants, 21 of distal (wagner type) fixation and 14 of modular type with proximal fixation. 24 press fit shells (17 oTMT cups) and 11 Muller rings were used. In 33 cases (94%) eradication of infection was achieved. The mean HHS improved from a mean of 38.2 preoperatively to a mean of 88.6 at final follow-up (p<0.001). There was no case of implant loosening or migration. Chronic late infection can be managed successfully with a two stage re-implantation protocol, without interim spacer, including neglected cases, previous long term antibiotics and cases with resistant pathogens.Hip international: the journal of clinical and experimental research on hip pathology and therapy 09/2012; 22 Suppl 8:54-61. · 0.34 Impact Factor -
Article: External fixation versus "pi" plate for distal radius fractures.
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ABSTRACT: Fractures of the distal radius are among the most common fractures in orthopedic practice. The purpose of our study was to explore the advantages and disadvantages of two methods of treatment for this type of fracture. One hundred thirteen fractures of the distal radius have been operated; 49 fractures were treated with an external fixator and 64 fractures by internal fixation using a "pi" plate. The mean follow-up was 12 months. Clinical evaluation was performed using the modified Gartland and Werley's Functional Scoring System. Radiographic evaluation was performed using the modified Lidstrom Radiographic Scoring System. Clinical results were similar between the two groups of patients (p = 0.46). Radiographic parameters were superior in the group of patients treated with open reduction and internal fixation (p = 0.028). Final functional results are comparable between external fixation and dorsal "pi" plating.The Journal of trauma 12/2009; 68(1):166-72. · 2.48 Impact Factor -
Article: Surgical outcome after spinal fractures in patients with ankylosing spondylitis.
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ABSTRACT: Ankylosing spondylitis is a rheumatic disease in which spinal and sacroiliac joints are mainly affected. There is a gradual bone formation in the spinal ligaments and ankylosis of the spinal diarthroses which lead to stiffness of the spine.The diffuse paraspinal ossification and inflammatory osteitis of advanced Ankylosing spondylitis creates a fused, brittle spine that is susceptible to fracture. The aim of this study is to present the surgical experience of spinal fractures occurring in patients suffering from ankylosing spondylitis and to highlight the difficulties that exist as far as both diagnosis and surgical management are concerned. Twenty patients suffering from ankylosing spondylitis were operated due to a spinal fracture. The fracture was located at the cervical spine in 7 cases, at the thoracic spine in 9, at the thoracolumbar junction in 3 and at the lumbar spine in one case. Neurological defects were revealed in 10 patients. In four of them, neurological signs were progressively developed after a time period of 4 to 15 days. The initial radiological study was negative for a spinal fracture in twelve patients. Every patient was assessed at the time of admission and daily until the day of surgery, then postoperatively upon discharge. Combined anterior and posterior approaches were performed in three patients with only posterior approaches performed on the rest. Spinal fusion was seen in 100% of the cases. No intra-operative complications occurred. There was one case in which superficial wound inflammation occurred. Loosening of posterior screws without loss of stability appeared in two patients with cervical injuries. Frankel neurological classification was used in order to evaluate the neurological status of the patients. There was statistically significant improvement of Frankel neurological classification between the preoperative and postoperative evaluation. 35% of patients showed improvement due to the operation performed. The operative treatment of these injuries is useful and effective. It usually succeeds the improvement of the patients' neurological status. Taking into consideration the cardiovascular problems that these patients have, anterior and posterior stabilization aren't always possible. In these cases, posterior approach can be performed and give excellent results, while total operation time, blood loss and other possible complications are decreased.BMC Musculoskeletal Disorders 09/2009; 10:96. · 1.58 Impact Factor -
Article: Foot and ankle injuries during the Athens 2004 Olympic Games.
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ABSTRACT: Major, rare and complex incidents can occur at any mass-gathering sporting event and team medical staff should be appropriately prepared for these. One such event, the Athens Olympic Games in 2004, presented a significant sporting and medical challenge. This study concerns an epidemiological analysis of foot and ankle injuries during the Games. An observational, epidemiological survey was used to analyse injuries in all sport tournaments (men's and women's) over the period of the Games. A total of 624 injuries (525 soft tissue injuries and 99 bony injuries) were reported. The most frequent diagnoses were contusions, sprains, fractures, dislocations and lacerations. Significantly more injuries in male (58%) versus female athletes (42%) were recorded. The incidence, diagnosis and cause of injuries differed substantially between the team sports. Our experience from the Athens Olympic Games will inform the development of public health surveillance systems for future Olympic Games, as well as other similar mass events.Journal of Foot and Ankle Research 05/2009; 2:9. · 1.33 Impact Factor -
Article: Cauda equina compression in an achondroplastic dwarf. Is complex anterior and posterior surgical intervention necessary?
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ABSTRACT: We report the case of an achondroplastic dwarf who presented with partial paraplegia due to cauda equina compression. The patient had marked thoracolumbar kyphosis and spinal stenosis at L2-L3. Although only posterior decompression is recommended in the literature for the treatment of achondroplastic patients presenting with neurological problems, a staged anterior and posterior decompression and stabilization was considered necessary for the treatment of this particular patient due to the presence of kyphosis. Satisfactory clinical results were achieved and sustained for six years following this complex operation.Scoliosis 01/2009; 3:18. · 1.31 Impact Factor
