Panagiotis Megas

Panagiotis Megas
Πανεπιστημιακό Γενικό Νοσοκομείο Πατρών · Department of Orthopaedics

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104
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Publications

Publications (104)
Article
Full-text available
Background There is great design variability on short femoral stems available on the market. This study aims to evaluate the short-term clinical and radiological results of two different design short femoral stems, both classified as shortened tapered stems. Methods From March 2016 to March 2018, a prospective, randomized, parallel-group design st...
Article
Full-text available
Objectives: To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total knee arthroplasty (TKA). Methods: Seventy-two p...
Article
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Background: The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-impla...
Article
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Objectives: Test the reliability and validity of the modified Clinical test of Sensory Interaction in Balance (mCTSIB) of the Balance Platform Biodex Balance System (BBS) in a female community dwelling population. Method: 100 women over 65 years community dwellers mean age 71.8 (SD±6, ranging from 65 to 91) years, were examined using the posturogra...
Article
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Background: Total hip replacement has recently followed a progressive evolution towards principles of bone- and soft-tissue-sparing surgery. Regarding femoral implants, different stem designs have been developed as an alternative to conventional stems, and there is a renewed interest towards short versions of uncemented femoral implants. Based on...
Article
Introduction: The purpose of this study was to examine the ability of a surgeon to predict survival of a total hip replacement (THR) based on the patient's diagnosis, demographics, postoperative activity level and the surgical technique. Methods: 4 experienced hip surgeons were asked to predict the longevity of 131 Charnley THRs, performed by th...
Article
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Background: Brown tumors represent a rare clinical manifestation reported in approximately 3% of patients with primary hyperparathyroidism and correspond to radiologically osteolytic lesions with well-defined borders in different parts of the skeleton. Case presentation: We report the case of a 53-year-old white man who presented to our hospital...
Article
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[Purpose] The main purpose of the study was to examine the relationship of a battery of frequently used functional assessment tests with quadriceps and hamstrings isokinetic strength in Knee-osteoarthritis (OA) patients. Secondarily, the predictability of isokinetic strength on these performance variables was also assessed. [Subjects and Methods] S...
Conference Paper
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Can the six-minute walk test for functional assessment of the elderly be replaced by other shorter functional test in patients with Knee Osteoarthritis? Objectives: Knee osteoarthritis (KOA) is a disabling disease and various functional tests are recommended for the assessment of patients. Those include, the 6 Minutes' Walk Test (6MWT), the Timed U...
Conference Paper
Objectives: High anxiety and depression levels frequently coexist in people with long-term pain conditions such as osteoarthritis (OA). The purpose of this study was to examine: a) the short-term effects of a 2 months supervised holistic therapeutic exercise program (SHTEP) in anxiety nand depression parameters in people with Knee-OA b) the same ef...
Article
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Background Although ceramic head fracture occurs infrequently today, in the event of a fracture, the resulting revision surgery can prove very challenging, since the ceramic particles lodge into the surrounding soft tissue and can cause rapid implant failure Case Presentation A case of long term survivorship of a severed notched femoral stem after...
Article
Total knee arthroplasty (TKA) is the gold standard for treatment of knee osteoarthritis demonstrating excellent long term results in terms of functional outcome and revision rates [1-3]. Joint deformity is due to a combination of factors such as extra or intra articular deformity, bone destruction and defects, soft tissue contractures and ligamento...
Chapter
Total knee arthroplasty (TKA) has provided high success rates (90 %), with many studies reporting survival rates over 95 % after 10 or more years [1-10]. As technology has evolved several different TKA designs, such as the PCL retaining TKA (CR TKA) the posterior stabilized TKA (PS TKA), and the anterior stabilized TKA (AS TKA or ultra-congruent TK...
Article
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Background The transfemoral and the extended trochanteric osteotomies are the most common osteotomies used in femoral revision, both when proximal or diaphyseal fixation of the new component has been decided. We present an alternative approach to the trochanteric osteotomies, most frequently used with distally fixated stems, to overcome their short...
Article
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The authors report a case of dissociation at the neck–stem interface without hip dislocation that occurred during walking, and discuss strategies to avoid and treat this complication of THA. Introduction Modular femoral components have the advantages of: •Reducing the need to stock numerous stem and head sizes •Allowing the final choice of neck...
Article
Modular necks are a relatively new innovation in total hip arthroplasty (THA). They offer the surgeon the potential to effectively restore hip biomechanics with the ability to independently adjust offset, version, and limb length during operation. These should theoretically improve implant stability, decrease the dislocation and impingement rate, a...
Article
Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) have become some of the most successful elective surgical procedures in modern medicine that it has been described as "the operation of the twentieth century". Worldwide, it is estimated that approximately one million are implanted every year. About 270,000 hip arthroplasties are d...
Article
Surgical revision of the failed total hip arthroplasty (THA) due to implant failure and osteolysis is becoming an increasingly more common surgical procedure. Even with the improvement of prosthetic designs, the number of necessary revisions will increase due to increased life expectancy as well as younger average age of initial implantation. In ge...
Article
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Background: Intramedullary nailing is the standard treatment of long bones’ fractures. Despite advances in instrumentation, distal locking still remains a demanding step of the procedure. The S2 intramedullary nailing system introduces a novel proximally mounted distal targeting device. Aim: In a prospective randomized study, the outcome of this ne...
Article
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Modular femoral and acetabular components are now widely used, but only a few complications related to the modularity itself have been reported. We describe a case of dissociation of the modular total hip arthroplasty (THA) at the femoral neck-stem interface during walking. The possible causes of this dissociation are discussed. Successful treatmen...
Article
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The purpose of this study is to retrospectively evaluate the efficacy of radiofrequency ablation as a curative treatment method for benign bone tumours. Twenty-nine osteoid osteomas were treated with radiofrequency ablation. Primary success rate was 89.6% and total secondary success rate was 93.1%. Mean clinical follow-up period was 26.7 months (ra...
Article
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We report the results of 62 hips in 62 patients (17 males, 45 females) with mean age of 62.4 years (37 to 81), who underwent revision of the acetabular component of a total hip replacement due to aseptic loosening between May 2003 and November 2007. All hips had a Paprosky type IIIa acetabular defect. Acetabular revision was undertaken using a Proc...
Article
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Total Hip Arthroplasty aims at fully recreating a functional hip joint. Over the past years modular implant systems have become common practice and are widely used, due to the surgical options they provide. In addition Big Femoral Heads have also been implemented in the process, providing more flexibility for the surgeon. The current study aims at...
Article
In the management of malignancies of the extremities, limb salvage procedures have recently taken on greater significance. For those patients under intense adjuvant chemotherapy and with massive bone loss, free vascularized fibular grafting is currently advocated as a reliable reconstructive option, maybe because of the controversial results of bon...
Article
The purpose of this study was to demonstrate the effectiveness of the Ilizarov method and circular external fixator in order to eradicate the infection and restore bone union, limb anatomy and functionality in cases with infected nonunion of the tibia following intramedullary nailing. During 7 years nine patients suffering from infected nonunion of...
Article
Unstable distal radius fractures remain a challenge for the treating orthopaedic surgeon. We present a retrospective follow-up study (mean follow-up 12.5 months) of 20 patients with 21 unstable distal radius fractures that were reduced in a closed manner and stabilized with a nonbridging Ilizarov external fixator. Subsequent insertion of olive wire...
Article
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Different types of bone-graft substitutes have been developed and are on the market worldwide to eliminate the drawbacks of autogenous grafting. This experimental animal study was undertaken to evaluate the different histological properties of various bone graft substitutes utilized in this hospital. Ninety New Zealand white rabbits were divided in...
Article
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Previous studies examining the multifidus fiber characteristics among low back pain (LBP) patients have not considered the variable of physical activity. The present study sought to investigate the muscle fiber size and type distribution of the lumbar multifidus muscle among LBP patient groups with different physical activity levels and healthy con...
Article
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Intramedullary nailing under fluoroscopic guidance is a common operation. We studied the intraoperative radiation dose received by both the patient and the personnel. 25 intramedullary nailing procedures of the tibia were studied. All patients suffered from tibial fractures and were treated using the Grosse-Kempf intramedullary nail, with free-hand...
Article
Aneurysmal bone cyst (ABC) is an uncommon, benign but locally destructive bone lesion of unknown origin. Differential diagnosis can be challenging as it shares common radiological and pathological features with other benign and malignant bone lesions. The degree of diagnostic difficulty grows even more when an unusual location has to be taken into...
Article
Full-text available
This retrospective, multicentre study aimed to evaluate reamed intramedullary nailing (IMN) for the treatment of 30 cases of aseptic femoral shaft non-union after plating failure. Following nailing, 29 non-unions had healed by a mean 7.93 months. In one case a hypertrophic non-union required renailing after 8 months, using a nail of greater diamete...
Article
The ideal management of complex proximal humeral fractures continues to be debatable. Evolution of proximal humeral fracture management, during the past decade, led to the implementation of many innovations in surgical treatment. Even though the pendulum of treatment seems to swing towards new trends such as locked plating, hemiarthroplasty remains...
Article
Treatment of small but painful osteoid osteomas was traditionally based on either prolonged medication or resection. In the era of rapidly evolving minimally invasive techniques, reluctance has been posed against surgical interventions mostly due to their relatively high rates of recurrence, complications, or persistent pain. Nonetheless, incomplet...
Article
Distal locking is one challenging step during intramedullary nailing of femoral shaft fractures that can lead to an increase of radiation exposure. In the present study, the authors describe a technique for the distal locking of femoral nails, implementing a new targeting device in an attempt to reduce radiation exposure and operational time. Over...
Article
A 67-year-old woman presented with erythema and swelling over her left elbow. She felt pain during palpation of the olecranon, while the range of elbow motion was slightly reduced (02 in circle-302 in circle-1302 in circle). She had been treated conservatively elsewhere for 3 months with nonsteroidal anti-inflammatory drugs and splint immobilizatio...
Article
Spinal cord injury without radiographic abnormalities (SCIWORA) is thought to represent mostly a pediatric entity and its incidence in adults is rather underreported. Some authors have also proposed the term spinal cord injury without radiologic evidence of trauma, as more precisely describing the condition of adult SCIWORA in the setting of cervic...
Article
Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femor...
Article
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Bracing is the most effective non-operative treatment for mild progressive spinal deformities in adolescence but it has shown a considerable impact on several aspects of adolescents' functioning. This cross-sectional study investigated the self-perceived health status of adolescents with the two most common deformities, treated with body orthosis....
Article
Solitary bone plasmacytoma of the clavicle is an extremely rare tumor, with an incidence of approximately 0.05% among the primary tumors of the skeleton, defying a challenging diagnostic and therapeutic problem. The absence of particular clinical signs and laboratory tests and the abated sensitivity of modern imagination to differentiate the benign...
Article
A case of a fractured ceramic femoral head without subsequent trauma, 14months after a primary total hip arthroplasty, in a 40-year-old woman with hip dysplasia is reported. Intraoperative findings were multifragment femoral head and a damaged polyethylene insert along with diffuse metallosis and excessive wear of the cone of the stem. Both the ste...
Article
This article compares the functional and radiographic outcomes of intraarticular distal radial fractures treated with augmented external fixation in which autologous cancellous bone grafting or Norian SRS (Norian Corp, Cupertino, Calif) was used for filling the metaphyseal void. Thirty non-randomized patients, 15 in each group, with AO type C dista...
Article
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Increased mortality after a hip fracture has been associated with age, sex, and comorbidity. In order to estimate the long-term mortality with reference to hip fracture type, we followed 499 patients older than 60 years who had been treated surgically for a unilateral hip fracture for 10 years. At admission, patients with femoral neck fractures (n...
Article
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The present study investigates the correlation between radiological parameters of wrist fractures and the clinical outcome expressed by objective clinical parameters and the level of patient-rated wrist dysfunction. Thirty consecutive cases of unstable distal radial fractures treated with closed reduction and percutaneous fixation were prospectivel...
Article
A substantial number of experimental and clinical studies have established that the cornerstones for successful bone-healing are biomechanical stability and biological vitality of the bone, as they both provide an environment in which new bone can be formed. Non-union of long bones is a significant consequence in treating fractures. Many approaches...
Conference Paper
AIM: To determine the ability of scintigraphy with 99`"Tc-Sulesomab (LeukoScan®), to diagnose and localize periprosthetic septic lesions in patients with hip arthroplasty. MATERIALS AND METHODS: 21 patients with hip arthroplasty were studied between 2001-2004, for possible periprosthetic infection and septic loosening. Mean follow up was 4,4 years...
Article
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In this study, we initiated a prospective, randomised, clinical trial comparing the AMBI, TGN and PFN operations used for treatment of unstable fractures, for differences in intra-operative use, consolidation, complications and functional outcome. We have compared the pre-, intra- and post-operating variables of AMBI, TGN and PFN operations that we...
Article
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Diagnosis of septic loosening of hip endoprosthesis with antigranulocyte scintigraphy (AGS) was analysed. Twenty-one hip prostheses were studied using laboratory tests and, in cases of elevated values, three-phase bone scan (BS) and AGS. Elective SPECT/CT scans were performed. Histologic and microbiologic exams verified the diagnosis. The AGS analy...
Article
Diagnosis of septic loosening of hip endoprosthesis with antigranulocyte scintigraphy (AGS) was analysed. Twenty-one hip prostheses were studied using laboratory tests and, in cases of elevated values, three-phase bone scan (BS) and AGS. Elective SPECT/CT scans were performed. Histologic and microbiologic exams verified the diagnosis. The AGS analy...
Article
Full-text available
Maffucci's syndrome is a congenital, non-hereditary mesodermal dysplasia associated with multiple enchondromas and after some years accompanied by hemangiomas. We describe a rare case of "reverse" Maffucci's syndrome in a 42-year-old woman who has suffered from multiple hemangiomas for the last 24 years. The last two years she complained for heel p...
Article
Aim: We have performed a retrospective comparative study between the trochanteric gamma nail (TGN) and the proximal femoral nail (PFN). Method: During the period 1998-2003, 97 TGN and 83 PFN were used for the treatment of pertrochanteric fractures. Most of the fractures were of the A3 type according to the AO/ASIF classification. Clinical and radio...