Haris Vasiliadis - Academia.edu (original) (raw)
Papers by Haris Vasiliadis
Revista Colombiana de Anestesiología, 2011
Revista Colombiana de Anestesiología, 2011
Knee Surgery, Sports Traumatology, Arthroscopy, 2011
Purpose Regaining adequate strength of the quadriceps and hamstrings after anterior cruciate liga... more Purpose Regaining adequate strength of the quadriceps and hamstrings after anterior cruciate ligament (ACL) reconstruction is important for maximizing functional performance. However, the outcome of muscle strength after either BPTB or hamstrings autograft is unclear given the plethora of published studies that report post-operative muscle strength. The purpose of this study was to systematically compare the muscle strength of patients who have undergone ACL reconstruction using either Bone Patellar Tendon Bone (BPTB) or Hamstrings (HST) autograft. Methods The databases of MEDLINE, Cinahal and EM-BASE were systematically searched for articles that report muscle strength outcome following ACL reconstruction. The quality of the studies was evaluated and a meta-analysis of the muscle strength outcomes was conducted on reported data. Results Fourteen studies were included in this systematic review: eight Randomized Control Studies (RCT) and six non-Randomized Control Studies (non-RCT). A metaanalysis was performed involving eight of the included studies (4 RCTs & 3 non-RCTs). At 60°/s and 180°/s, patients with BPTB graft showed a greater deficit in extensor muscle strength and lower deficit in flexor muscle strength compared with patients with HST. Conclusion This systematic review of Level III evidence showed that isokinetic muscle strength deficits following ACL reconstruction are associated with the location of the donor site. These deficits appear to be unresolved up to 2 years after ACL reconstruction. Level of evidence III.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruct... more Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports. Type of Study: Case control series study. Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone-patellar tendon-bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to testing, and 11 matched controls. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects performed the following task: they jumped off a 40-cm platform and landed on the ground. After foot contact, the subjects were instructed to pivot at 90°and walk away from the platform. The evaluation period was identified from initial foot contact with the ground with both legs, included the pivoting of the ipsilateral leg, and was completed on touchdown of the contralateral leg. Results: Significant differences were found between the reconstructed leg of the ACL group and the healthy control, and between the deficient leg of the ACL-deficient group and the healthy control. We also found no significant differences between the deficient leg of the ACL-deficient group and the reconstructed leg of the ACL reconstructed group. Conclusions: It was concluded that, under high-stress activities, ACL reconstruction may not restore tibial rotation to the previous physiological level, even though anterior tibial translation is restored. Future research on ACL reconstruction should focus on the development of new surgical procedures and/or grafts to address this problem. Level of Evidence: Level III.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
Intra-articular ganglia are rare and mostly incidental findings on magnetic resonance imaging (MR... more Intra-articular ganglia are rare and mostly incidental findings on magnetic resonance imaging (MRI) and arthroscopy. We present 4 cases of intra-articular ganglion cysts associated with the anterior cruciate ligament (ACL) in 3 patients. The most commonly occurring symptoms were pain aggravated after stressing activities and limited knee range of motion. In 1 patient, ganglion cysts appeared in both knees with a time difference of 1 year. An MRI revealed typical signs of ganglion cysts in the substance of the ACL. Arthroscopy was performed for further evaluation and treatment. Histologic examination of the tissue removed revealed the presence of features consistent with ganglion cysts. Therefore, in the case of chronic knee discomfort with nonspecific clinical signs and symptoms and without a clear cause, an intra-articular ganglion cyst should be considered as causing pathology. An MRI is the most sensitive and specific method for diagnosis. However, the relatively slow progression of symptoms may delay the patient's decision to seek medical attention. Delayed diagnosis makes arthroscopic total resection of the ganglion technically demanding or not possible at all, and extensive debridement of the ACL may be required.
Osteoarthritis and Cartilage, 2010
Knee Surgery Sports Traumatology Arthroscopy, 2005
This report presents a 16 year old girl with persistent left knee pain caused by an intra-articul... more This report presents a 16 year old girl with persistent left knee pain caused by an intra-articular synovial lipoma (IASL) of the knee. Arthroscopy revealed a lipoma arising from the posterior aspect of the synovial membrane, extending in the femoral intercondylar notch, between the femoral attachments of anterior cruciate ligament and posterior cruciate ligament. Histological examination confirmed the diagnosis of IASL.
Journal of the Neurological Sciences, 2011
Multiple sclerosis (MS) is a demyelinating inflammatory disease of the central nervous system ori... more Multiple sclerosis (MS) is a demyelinating inflammatory disease of the central nervous system originated by a complex interplay of environmental and genetic factors. The association of MS with the human leukocyte antigen (HLA) class II alleles was investigated in MS patients in northwest Greece, in the geographical region of Epirus. Our aim was to estimate the prevalence of the HLA-DRB1*1501, HLA-DQB1*0602 and HLA-DQA1*0102 alleles, consisting the most common susceptibility haplotype in North European and North American Caucasians. We studied 126 MS patients and 93 age and sex matched healthy controls. HLA typing was performed by a polymerase chain reaction (PCR) amplification with sequence-specific primers (PCR-SSP) method. We found that HLA-DRB1*1501, HLA-DQB1*0602 and HLA-DQA1*0102 alleles were significantly more frequent among patients (34% versus 11%, p=0.00015; 69% versus 51%, p=0.01; 76% versus 55%, p=0.002, respectively). HLA-DRB1*1501, HLA-DQB1*0602, HLA-DQA1*0102 haplotype was significantly more common among patients (p=0.00067). HLA-DRB1*1501 and HLA-DQB1*0602 alleles were more frequently detected in patients with initial symptoms from the brainstem or the cerebellum (p=0.024). No significant correlation was observed among these alleles with sex, disease clinical course, or age at onset. This is the first study to investigate genetic susceptibility to MS in Greece. Our results are in line with previous reports in North European and North American patients.
Knee Surgery Sports Traumatology Arthroscopy, 2010
Autologous chondrocyte implantation (ACI) techniques are becoming more popular for the treatment ... more Autologous chondrocyte implantation (ACI) techniques are becoming more popular for the treatment of full thickness cartilage lesions of the knee joint. However, there is no systematic information for the efficacy of the new generation ACI techniques compared to other treatment options. A systematic review of the existing evidence from randomized clinical trials of ACI treatment would contribute to understanding the
American Journal of Sports Medicine, 2010
Background: The medium-term results of autologous chondrocyte implantation (ACI) have shown good ... more Background: The medium-term results of autologous chondrocyte implantation (ACI) have shown good to excellent outcomes for the majority of patients. However, no long-term results 10 to 20 years after the surgery have been reported.Hypothesis: Autologous chondrocyte implantation provides a durable solution to the treatment of full-thickness cartilage lesions of the knee, maintaining good clinical results even 10 to 20 years
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2006
The goal of this descriptive study was to investigate the anatomy of the carpal tunnel with respe... more The goal of this descriptive study was to investigate the anatomy of the carpal tunnel with respect to the related neurovascular structures, because a detailed knowledge of the complex anatomy of this region is essential to perform endoscopic carpal tunnel release. Sixteen fresh-frozen cadaveric hands were used for the study. Dissection of the palmar aspect of the hand was performed by use of magnifying loupes, an operative microscope, and microsurgical instruments. All anatomic components were photographed, and dimensions were recorded by use of a micrometer. The distance from the radial aspect of the os pisiformis and the proximal and distal portals to the main structures that may be injured was measured. Topography of the transverse ligament and possible adhesions to the tendons and median nerve were also recorded. The mean distance from the radial aspect of the os pisiformis to the radial border of Guyon's canal and the ulnar edge of the palmaris longus tendon was 10.3 mm (r...
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2007
Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-... more Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-year-old man with a 6-month history of right shoulder pain and decreased range of motion. Computed tomography and magnetic resonance imaging findings led us to the diagnosis of synovial chondromatosis of the shoulder. Arthroscopy revealed loose bodies in the glenohumeral joint, the biceps tendon
Knee Surgery Sports Traumatology Arthroscopy, 2006
This study investigated the anatomy of the structures that form the extensor mechanism of the kne... more This study investigated the anatomy of the structures that form the extensor mechanism of the knee joint using microsurgical techniques. Ten fresh-frozen human adult cadaveric knees were used. The quadriceps components, the infrapatellar tendon, the patellofemoral ligaments, and their relations to the neighboring anatomical structures were measured. The angles of the vastus lateralis and the vastus medialis muscle fibers to
Orthopaedics & Traumatology: Surgery & Research, 2010
Several researchers including our group have shown that knee joint biomechanics are impaired afte... more Several researchers including our group have shown that knee joint biomechanics are impaired after anterior cruciate ligament (ACL) injury, in terms of kinematics and neuromuscular control. Current ACL reconstruction techniques do not seem to fully restore these adaptations. Our research has demonstrated that after ACL reconstruction, excessive tibial rotation is still present in high-demanding activities that involve both anterior and rotational loading of the knee. These findings seem to persist regardless of the autograft selection for the ACL reconstruction. Our results also suggest an impairment of neuromuscular control after ACL reconstruction, although muscle strength may have been reinstated. These abnormal biomechanical patterns may lead to loading of cartilage areas, which are not commonly loaded in the healthy knee and longitudinally can lead to osteoarthritis. Muscle imbalance can also influence patients' optimal sports performance exposing them to increased possibility of knee re-injury. In this review, our recommendations point towards further experimental work with in vivo and in vitro studies, in order to assist in the development of new surgical procedures that could possibly replicate more closely the natural ACL anatomy and prevent future knee pathology.
Patellofemoral Pain, Instability, and Arthritis, 2010
World Journal of Orthopedics, 2013
We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One mont... more We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One month after the first X-ray, clinical and imaging deterioration was evident. Open biopsy revealed fibrous dysplasia. Three months later, the lytic lesion had spread to the whole distal third of the femur reaching the articular cartilage. The malignant clinical and imaging features necessitated excision of the lesion and reconstruction with a custom-made total knee arthroplasty. Intra-operatively, no obvious soft tissue infiltration was evident. Nevertheless, an excision of the distal 15.5 cm of the femur including 3.0 cm of the surrounding muscles was finally performed. The histological examination of the excised specimen revealed central low-grade osteosarcoma. Based on the morphological features of the excised tumor, allied to the clinical findings, the diagnosis of low-grade central osteosarcoma was finally made although characters of a fibrous dysplasia were apparent. Central low-grade osteosarcoma is a rare, well-differentiated sub-type of osteosarcoma, with clinical, imaging, and histological features similar to benign tumours. Thus, initial misdiagnosis is usual with the condition commonly mistaken for fibrous dysplasia. Central low-grade osteosarcoma is usually treated with surgery alone, with rare cases of distal metastases. However, regional recurrence is quite frequent after close margin excision.
... The effect of chain density on the frictional behavior of surfaces modified with alkylsiloxan... more ... The effect of chain density on the frictional behavior of surfaces modified with alkylsiloxanes and immersed in n-alcohols. Clear, Susannah C.; Nealey, Paul F ... Arcadio Vallego, Carlos (1904). Effect of Christianity upon the British Celts. Grunke, Kimberly Rachel (May 2008 ...
Patellofemoral Pain, Instability, and Arthritis, 2010
ABSTRACT The total functional stability is dependent on optimal synergic collaboration of the ske... more ABSTRACT The total functional stability is dependent on optimal synergic collaboration of the skeletal, ligamentous and muscular stabilizers, all working together. The skeletal geometry by its own creates a passive stability during knee motion. The geometry of the trochlear groove is of high importance during 0°-30° of flexion (30°-0° of extension) where most of the dislocations occur. The skeletal stability can be affected by patellofemoral dysplasia, where the geometric configuration of the trochlea is primarily not developed. The patella shape usually plays a secondary role even if it is found dysplastic
Reviews, 1996
ABSTRACT Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extr... more ABSTRACT Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. It is caused by increased pressure on the median nerve between the transverse carpal ligament and the carpal bones. Surgical treatment consists of the release of the nerve by cutting the transverse carpal ligament. This can be done either with an open approach or endoscopically. To assess the effectiveness and safety of the endoscopic techniques of carpal tunnel release compared to any other surgical intervention for the treatment of CTS. More specifically, to evaluate the relative impact of endoscopic techniques in relieving symptoms, producing functional recovery (return to work and return to daily activities) and reducing complication rates. This review fully incorporates the results of searches conducted up to 5 November 2012, when we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE. There were no language restrictions. We reviewed the reference lists of relevant articles and contacted trial authors. We also searched trial registers for ongoing trials. We performed a preliminary screen of searches to November 2013 to identify any additional recent publications. We included any randomised controlled trials (RCTs) and quasi-RCTs comparing endoscopic carpal tunnel release (ECTR) with any other surgical intervention for the treatment of CTS. We used standard methodological procedures expected by the Cochrane Collaboration. Twenty-eight studies (2586 hands) were included. Twenty-three studies compared ECTR to standard open carpal tunnel release (OCTR), five studies compared ECTR with OCTR using a modified incision, and two studies used a three-arm design to compare ECTR, standard OCTR and modified OCTR.At short-term follow-up (three months or less), only one study provided data for overall improvement. We found no differences on the Symptom Severity Scale (SSS) (scale zero to five) (five studies, standardised mean difference (SMD) -0.13, 95% CI -0.47 to 0.21) or on the Functional Status Scale (FSS) (scale zero to five) (five studies, SMD -0.23, 95% CI -0.60 to 0.14) within three months postoperatively between ECTR and OCTR. Pain scores favoured ECTR over conventional OCTR (two studies, SMD -0.41, 95% CI -0.65 to -0.18). No difference was found between ECTR and OCTR (standard and modified) when pain was assessed on non-continuous dichotomous scales (five studies, RR 0.69, 95% CI 0.33 to 1.45). Also, no difference was found in numbness (five studies, RR 1.14; 95% CI 0.76 to 1.71). Grip strength was increased after ECTR when compared with OCTR (six studies, SMD 0.36, 95% CI 0.09 to 0.63). This corresponds to a mean difference (MD) of 4 kg (95% CI 1 to 6.9 kg) when compared with OCTR, which is probably not clinically significant.In the long term (more than three months postoperatively) there was no significant difference in overall improvement between ECTR and OCTR (four studies, RR 1.04, 95% CI 0.95 to 1.14). SSS and FSS were also similar in both treatment groups (two studies, MD 0.02, 95% CI -0.18 to 0.22 for SSS and MD 0.01, 95% CI -0.14 to 0.16 for FSS). ECTR and OCTR did not differ in the long term in pain (six studies, RR 0.88, 95% CI 0.57 to 1.38) or in numbness (four studies, RR 0.64, 95% CI 0.31 to 1.35). Results from grip strength testing favoured ECTR (two studies, SMD 1.13, 95% CI 0.56 to 1.71), corresponding to an MD of 11 kg (95% CI 6.2 to 18.81). Participants treated with ECTR returned to work or daily activities eight days earlier than participants treated with OCTR (four studies, MD -8.10 days, 95% CI -14.28 to -1.92 days).Both treatments were equally safe with only a few reports of major complications (mainly with complex regional pain syndrome) (15 studies, RR 1.00, 95% CI 0.38 to 2.64).ECTR resulted in a significantly lower rate of minor complications (18 studies, RR 0.55, 95% CI 0.38 to 0.81), corresponding to a 45% relative drop in the probability of complications (95% CI 62% to 19%). ECTR more frequently resulted in transient nerve problems (ie, neurapraxia, numbness, and paraesthesiae), while OCTR had more wound problems (ie, infection, hypertrophic scarring, and scar tenderness). ECTR was safer than OCTR when the total number of complications were assessed (20 studies, RR 0.60, 95% CI 0.40 to 90) representing a relative drop in the probability by 40% (95% CI 60% to 10%).Rates of recurrence of symptoms and the need for repeated surgery were comparable between ECTR and OCTR groups.The overall risk of bias in studies that contribute data to these results is rather high; fewer than 25% of the included studies had adequate allocation concealment, generation of allocation sequence or blinding of the outcome assessor.The quality of evidence in this review may be considered as generally low. Five of the studies were presented only as abstracts, with insufficient information to judge their risk of bias. In selection bias, attrition bias or…
Reviews, 1996
Treatments for managing articular cartilage defects of the knee, including drilling and abrasion ... more Treatments for managing articular cartilage defects of the knee, including drilling and abrasion arthroplasty, are not always effective. When they are, long-term benefits may not be maintained and osteoarthritis may develop. An alternative is autologous chondrocyte implantation (ACI), the surgical implantation of healthy cartilage cells into the damaged areas. To determine the efficacy and safety of ACI in people with full thickness articular cartilage defects of the knee. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (3 December 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November Week 3 2008), EMBASE (1980 to Week 48 2008), SPORTDiscus (3 December 2008), the WHO International Clinical Trials Registry Platform (4 December 2008), and Current Controlled Trials (3 December 2008). Randomised and quasi-randomised trials comparing ACI with any other type of treatment (including no treatment or placebo) for symptomatic cartilage defects of the medial or lateral femoral condyle, femoral trochlea or patella. Review authors selected studies for inclusion independently. We assessed risk of bias based on adequacy of the randomisation and allocation concealment process, potential for selection bias after allocation and level of masking. We did not pool data due to clinical and methodological heterogeneity. Six heterogeneous trials were identified with 431 participants. Methodological flaws of the included trials included incomplete follow-up and inadequate reporting of outcomes. Three trials compared ACI versus mosaicplasty. One reported statistically significant results in favour of ACI at one year in the numbers of people with 'good' or 'excellent' functional results. Conversely, another trial found significant improvement for the mosaicplasty group when assessed using one functional scoring system at two years, but no statistically significant differences based on two other scoring systems. A third trial found no difference between ACI and mosaicplasty, 10 months on average after the surgery.There was no statistically significant difference in functional outcomes at two years in single trials comparing ACI with microfracture or characterised chondrocyte implantation versus microfracture. The results of the sixth trial comparing matrix-guided ACI versus microfracture were undermined by the severe loss to follow-up. There is insufficient evidence to draw conclusions on the use of ACI for treating full thickness articular cartilage defects in the knee. Further good quality randomised controlled trials with long-term functional outcomes are required.
Revista Colombiana de Anestesiología, 2011
Revista Colombiana de Anestesiología, 2011
Knee Surgery, Sports Traumatology, Arthroscopy, 2011
Purpose Regaining adequate strength of the quadriceps and hamstrings after anterior cruciate liga... more Purpose Regaining adequate strength of the quadriceps and hamstrings after anterior cruciate ligament (ACL) reconstruction is important for maximizing functional performance. However, the outcome of muscle strength after either BPTB or hamstrings autograft is unclear given the plethora of published studies that report post-operative muscle strength. The purpose of this study was to systematically compare the muscle strength of patients who have undergone ACL reconstruction using either Bone Patellar Tendon Bone (BPTB) or Hamstrings (HST) autograft. Methods The databases of MEDLINE, Cinahal and EM-BASE were systematically searched for articles that report muscle strength outcome following ACL reconstruction. The quality of the studies was evaluated and a meta-analysis of the muscle strength outcomes was conducted on reported data. Results Fourteen studies were included in this systematic review: eight Randomized Control Studies (RCT) and six non-Randomized Control Studies (non-RCT). A metaanalysis was performed involving eight of the included studies (4 RCTs & 3 non-RCTs). At 60°/s and 180°/s, patients with BPTB graft showed a greater deficit in extensor muscle strength and lower deficit in flexor muscle strength compared with patients with HST. Conclusion This systematic review of Level III evidence showed that isokinetic muscle strength deficits following ACL reconstruction are associated with the location of the donor site. These deficits appear to be unresolved up to 2 years after ACL reconstruction. Level of evidence III.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruct... more Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports. Type of Study: Case control series study. Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone-patellar tendon-bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to testing, and 11 matched controls. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects performed the following task: they jumped off a 40-cm platform and landed on the ground. After foot contact, the subjects were instructed to pivot at 90°and walk away from the platform. The evaluation period was identified from initial foot contact with the ground with both legs, included the pivoting of the ipsilateral leg, and was completed on touchdown of the contralateral leg. Results: Significant differences were found between the reconstructed leg of the ACL group and the healthy control, and between the deficient leg of the ACL-deficient group and the healthy control. We also found no significant differences between the deficient leg of the ACL-deficient group and the reconstructed leg of the ACL reconstructed group. Conclusions: It was concluded that, under high-stress activities, ACL reconstruction may not restore tibial rotation to the previous physiological level, even though anterior tibial translation is restored. Future research on ACL reconstruction should focus on the development of new surgical procedures and/or grafts to address this problem. Level of Evidence: Level III.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
Intra-articular ganglia are rare and mostly incidental findings on magnetic resonance imaging (MR... more Intra-articular ganglia are rare and mostly incidental findings on magnetic resonance imaging (MRI) and arthroscopy. We present 4 cases of intra-articular ganglion cysts associated with the anterior cruciate ligament (ACL) in 3 patients. The most commonly occurring symptoms were pain aggravated after stressing activities and limited knee range of motion. In 1 patient, ganglion cysts appeared in both knees with a time difference of 1 year. An MRI revealed typical signs of ganglion cysts in the substance of the ACL. Arthroscopy was performed for further evaluation and treatment. Histologic examination of the tissue removed revealed the presence of features consistent with ganglion cysts. Therefore, in the case of chronic knee discomfort with nonspecific clinical signs and symptoms and without a clear cause, an intra-articular ganglion cyst should be considered as causing pathology. An MRI is the most sensitive and specific method for diagnosis. However, the relatively slow progression of symptoms may delay the patient's decision to seek medical attention. Delayed diagnosis makes arthroscopic total resection of the ganglion technically demanding or not possible at all, and extensive debridement of the ACL may be required.
Osteoarthritis and Cartilage, 2010
Knee Surgery Sports Traumatology Arthroscopy, 2005
This report presents a 16 year old girl with persistent left knee pain caused by an intra-articul... more This report presents a 16 year old girl with persistent left knee pain caused by an intra-articular synovial lipoma (IASL) of the knee. Arthroscopy revealed a lipoma arising from the posterior aspect of the synovial membrane, extending in the femoral intercondylar notch, between the femoral attachments of anterior cruciate ligament and posterior cruciate ligament. Histological examination confirmed the diagnosis of IASL.
Journal of the Neurological Sciences, 2011
Multiple sclerosis (MS) is a demyelinating inflammatory disease of the central nervous system ori... more Multiple sclerosis (MS) is a demyelinating inflammatory disease of the central nervous system originated by a complex interplay of environmental and genetic factors. The association of MS with the human leukocyte antigen (HLA) class II alleles was investigated in MS patients in northwest Greece, in the geographical region of Epirus. Our aim was to estimate the prevalence of the HLA-DRB1*1501, HLA-DQB1*0602 and HLA-DQA1*0102 alleles, consisting the most common susceptibility haplotype in North European and North American Caucasians. We studied 126 MS patients and 93 age and sex matched healthy controls. HLA typing was performed by a polymerase chain reaction (PCR) amplification with sequence-specific primers (PCR-SSP) method. We found that HLA-DRB1*1501, HLA-DQB1*0602 and HLA-DQA1*0102 alleles were significantly more frequent among patients (34% versus 11%, p=0.00015; 69% versus 51%, p=0.01; 76% versus 55%, p=0.002, respectively). HLA-DRB1*1501, HLA-DQB1*0602, HLA-DQA1*0102 haplotype was significantly more common among patients (p=0.00067). HLA-DRB1*1501 and HLA-DQB1*0602 alleles were more frequently detected in patients with initial symptoms from the brainstem or the cerebellum (p=0.024). No significant correlation was observed among these alleles with sex, disease clinical course, or age at onset. This is the first study to investigate genetic susceptibility to MS in Greece. Our results are in line with previous reports in North European and North American patients.
Knee Surgery Sports Traumatology Arthroscopy, 2010
Autologous chondrocyte implantation (ACI) techniques are becoming more popular for the treatment ... more Autologous chondrocyte implantation (ACI) techniques are becoming more popular for the treatment of full thickness cartilage lesions of the knee joint. However, there is no systematic information for the efficacy of the new generation ACI techniques compared to other treatment options. A systematic review of the existing evidence from randomized clinical trials of ACI treatment would contribute to understanding the
American Journal of Sports Medicine, 2010
Background: The medium-term results of autologous chondrocyte implantation (ACI) have shown good ... more Background: The medium-term results of autologous chondrocyte implantation (ACI) have shown good to excellent outcomes for the majority of patients. However, no long-term results 10 to 20 years after the surgery have been reported.Hypothesis: Autologous chondrocyte implantation provides a durable solution to the treatment of full-thickness cartilage lesions of the knee, maintaining good clinical results even 10 to 20 years
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2006
The goal of this descriptive study was to investigate the anatomy of the carpal tunnel with respe... more The goal of this descriptive study was to investigate the anatomy of the carpal tunnel with respect to the related neurovascular structures, because a detailed knowledge of the complex anatomy of this region is essential to perform endoscopic carpal tunnel release. Sixteen fresh-frozen cadaveric hands were used for the study. Dissection of the palmar aspect of the hand was performed by use of magnifying loupes, an operative microscope, and microsurgical instruments. All anatomic components were photographed, and dimensions were recorded by use of a micrometer. The distance from the radial aspect of the os pisiformis and the proximal and distal portals to the main structures that may be injured was measured. Topography of the transverse ligament and possible adhesions to the tendons and median nerve were also recorded. The mean distance from the radial aspect of the os pisiformis to the radial border of Guyon's canal and the ulnar edge of the palmaris longus tendon was 10.3 mm (r...
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2007
Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-... more Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-year-old man with a 6-month history of right shoulder pain and decreased range of motion. Computed tomography and magnetic resonance imaging findings led us to the diagnosis of synovial chondromatosis of the shoulder. Arthroscopy revealed loose bodies in the glenohumeral joint, the biceps tendon
Knee Surgery Sports Traumatology Arthroscopy, 2006
This study investigated the anatomy of the structures that form the extensor mechanism of the kne... more This study investigated the anatomy of the structures that form the extensor mechanism of the knee joint using microsurgical techniques. Ten fresh-frozen human adult cadaveric knees were used. The quadriceps components, the infrapatellar tendon, the patellofemoral ligaments, and their relations to the neighboring anatomical structures were measured. The angles of the vastus lateralis and the vastus medialis muscle fibers to
Orthopaedics & Traumatology: Surgery & Research, 2010
Several researchers including our group have shown that knee joint biomechanics are impaired afte... more Several researchers including our group have shown that knee joint biomechanics are impaired after anterior cruciate ligament (ACL) injury, in terms of kinematics and neuromuscular control. Current ACL reconstruction techniques do not seem to fully restore these adaptations. Our research has demonstrated that after ACL reconstruction, excessive tibial rotation is still present in high-demanding activities that involve both anterior and rotational loading of the knee. These findings seem to persist regardless of the autograft selection for the ACL reconstruction. Our results also suggest an impairment of neuromuscular control after ACL reconstruction, although muscle strength may have been reinstated. These abnormal biomechanical patterns may lead to loading of cartilage areas, which are not commonly loaded in the healthy knee and longitudinally can lead to osteoarthritis. Muscle imbalance can also influence patients' optimal sports performance exposing them to increased possibility of knee re-injury. In this review, our recommendations point towards further experimental work with in vivo and in vitro studies, in order to assist in the development of new surgical procedures that could possibly replicate more closely the natural ACL anatomy and prevent future knee pathology.
Patellofemoral Pain, Instability, and Arthritis, 2010
World Journal of Orthopedics, 2013
We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One mont... more We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One month after the first X-ray, clinical and imaging deterioration was evident. Open biopsy revealed fibrous dysplasia. Three months later, the lytic lesion had spread to the whole distal third of the femur reaching the articular cartilage. The malignant clinical and imaging features necessitated excision of the lesion and reconstruction with a custom-made total knee arthroplasty. Intra-operatively, no obvious soft tissue infiltration was evident. Nevertheless, an excision of the distal 15.5 cm of the femur including 3.0 cm of the surrounding muscles was finally performed. The histological examination of the excised specimen revealed central low-grade osteosarcoma. Based on the morphological features of the excised tumor, allied to the clinical findings, the diagnosis of low-grade central osteosarcoma was finally made although characters of a fibrous dysplasia were apparent. Central low-grade osteosarcoma is a rare, well-differentiated sub-type of osteosarcoma, with clinical, imaging, and histological features similar to benign tumours. Thus, initial misdiagnosis is usual with the condition commonly mistaken for fibrous dysplasia. Central low-grade osteosarcoma is usually treated with surgery alone, with rare cases of distal metastases. However, regional recurrence is quite frequent after close margin excision.
... The effect of chain density on the frictional behavior of surfaces modified with alkylsiloxan... more ... The effect of chain density on the frictional behavior of surfaces modified with alkylsiloxanes and immersed in n-alcohols. Clear, Susannah C.; Nealey, Paul F ... Arcadio Vallego, Carlos (1904). Effect of Christianity upon the British Celts. Grunke, Kimberly Rachel (May 2008 ...
Patellofemoral Pain, Instability, and Arthritis, 2010
ABSTRACT The total functional stability is dependent on optimal synergic collaboration of the ske... more ABSTRACT The total functional stability is dependent on optimal synergic collaboration of the skeletal, ligamentous and muscular stabilizers, all working together. The skeletal geometry by its own creates a passive stability during knee motion. The geometry of the trochlear groove is of high importance during 0°-30° of flexion (30°-0° of extension) where most of the dislocations occur. The skeletal stability can be affected by patellofemoral dysplasia, where the geometric configuration of the trochlea is primarily not developed. The patella shape usually plays a secondary role even if it is found dysplastic
Reviews, 1996
ABSTRACT Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extr... more ABSTRACT Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. It is caused by increased pressure on the median nerve between the transverse carpal ligament and the carpal bones. Surgical treatment consists of the release of the nerve by cutting the transverse carpal ligament. This can be done either with an open approach or endoscopically. To assess the effectiveness and safety of the endoscopic techniques of carpal tunnel release compared to any other surgical intervention for the treatment of CTS. More specifically, to evaluate the relative impact of endoscopic techniques in relieving symptoms, producing functional recovery (return to work and return to daily activities) and reducing complication rates. This review fully incorporates the results of searches conducted up to 5 November 2012, when we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE. There were no language restrictions. We reviewed the reference lists of relevant articles and contacted trial authors. We also searched trial registers for ongoing trials. We performed a preliminary screen of searches to November 2013 to identify any additional recent publications. We included any randomised controlled trials (RCTs) and quasi-RCTs comparing endoscopic carpal tunnel release (ECTR) with any other surgical intervention for the treatment of CTS. We used standard methodological procedures expected by the Cochrane Collaboration. Twenty-eight studies (2586 hands) were included. Twenty-three studies compared ECTR to standard open carpal tunnel release (OCTR), five studies compared ECTR with OCTR using a modified incision, and two studies used a three-arm design to compare ECTR, standard OCTR and modified OCTR.At short-term follow-up (three months or less), only one study provided data for overall improvement. We found no differences on the Symptom Severity Scale (SSS) (scale zero to five) (five studies, standardised mean difference (SMD) -0.13, 95% CI -0.47 to 0.21) or on the Functional Status Scale (FSS) (scale zero to five) (five studies, SMD -0.23, 95% CI -0.60 to 0.14) within three months postoperatively between ECTR and OCTR. Pain scores favoured ECTR over conventional OCTR (two studies, SMD -0.41, 95% CI -0.65 to -0.18). No difference was found between ECTR and OCTR (standard and modified) when pain was assessed on non-continuous dichotomous scales (five studies, RR 0.69, 95% CI 0.33 to 1.45). Also, no difference was found in numbness (five studies, RR 1.14; 95% CI 0.76 to 1.71). Grip strength was increased after ECTR when compared with OCTR (six studies, SMD 0.36, 95% CI 0.09 to 0.63). This corresponds to a mean difference (MD) of 4 kg (95% CI 1 to 6.9 kg) when compared with OCTR, which is probably not clinically significant.In the long term (more than three months postoperatively) there was no significant difference in overall improvement between ECTR and OCTR (four studies, RR 1.04, 95% CI 0.95 to 1.14). SSS and FSS were also similar in both treatment groups (two studies, MD 0.02, 95% CI -0.18 to 0.22 for SSS and MD 0.01, 95% CI -0.14 to 0.16 for FSS). ECTR and OCTR did not differ in the long term in pain (six studies, RR 0.88, 95% CI 0.57 to 1.38) or in numbness (four studies, RR 0.64, 95% CI 0.31 to 1.35). Results from grip strength testing favoured ECTR (two studies, SMD 1.13, 95% CI 0.56 to 1.71), corresponding to an MD of 11 kg (95% CI 6.2 to 18.81). Participants treated with ECTR returned to work or daily activities eight days earlier than participants treated with OCTR (four studies, MD -8.10 days, 95% CI -14.28 to -1.92 days).Both treatments were equally safe with only a few reports of major complications (mainly with complex regional pain syndrome) (15 studies, RR 1.00, 95% CI 0.38 to 2.64).ECTR resulted in a significantly lower rate of minor complications (18 studies, RR 0.55, 95% CI 0.38 to 0.81), corresponding to a 45% relative drop in the probability of complications (95% CI 62% to 19%). ECTR more frequently resulted in transient nerve problems (ie, neurapraxia, numbness, and paraesthesiae), while OCTR had more wound problems (ie, infection, hypertrophic scarring, and scar tenderness). ECTR was safer than OCTR when the total number of complications were assessed (20 studies, RR 0.60, 95% CI 0.40 to 90) representing a relative drop in the probability by 40% (95% CI 60% to 10%).Rates of recurrence of symptoms and the need for repeated surgery were comparable between ECTR and OCTR groups.The overall risk of bias in studies that contribute data to these results is rather high; fewer than 25% of the included studies had adequate allocation concealment, generation of allocation sequence or blinding of the outcome assessor.The quality of evidence in this review may be considered as generally low. Five of the studies were presented only as abstracts, with insufficient information to judge their risk of bias. In selection bias, attrition bias or…
Reviews, 1996
Treatments for managing articular cartilage defects of the knee, including drilling and abrasion ... more Treatments for managing articular cartilage defects of the knee, including drilling and abrasion arthroplasty, are not always effective. When they are, long-term benefits may not be maintained and osteoarthritis may develop. An alternative is autologous chondrocyte implantation (ACI), the surgical implantation of healthy cartilage cells into the damaged areas. To determine the efficacy and safety of ACI in people with full thickness articular cartilage defects of the knee. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (3 December 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November Week 3 2008), EMBASE (1980 to Week 48 2008), SPORTDiscus (3 December 2008), the WHO International Clinical Trials Registry Platform (4 December 2008), and Current Controlled Trials (3 December 2008). Randomised and quasi-randomised trials comparing ACI with any other type of treatment (including no treatment or placebo) for symptomatic cartilage defects of the medial or lateral femoral condyle, femoral trochlea or patella. Review authors selected studies for inclusion independently. We assessed risk of bias based on adequacy of the randomisation and allocation concealment process, potential for selection bias after allocation and level of masking. We did not pool data due to clinical and methodological heterogeneity. Six heterogeneous trials were identified with 431 participants. Methodological flaws of the included trials included incomplete follow-up and inadequate reporting of outcomes. Three trials compared ACI versus mosaicplasty. One reported statistically significant results in favour of ACI at one year in the numbers of people with 'good' or 'excellent' functional results. Conversely, another trial found significant improvement for the mosaicplasty group when assessed using one functional scoring system at two years, but no statistically significant differences based on two other scoring systems. A third trial found no difference between ACI and mosaicplasty, 10 months on average after the surgery.There was no statistically significant difference in functional outcomes at two years in single trials comparing ACI with microfracture or characterised chondrocyte implantation versus microfracture. The results of the sixth trial comparing matrix-guided ACI versus microfracture were undermined by the severe loss to follow-up. There is insufficient evidence to draw conclusions on the use of ACI for treating full thickness articular cartilage defects in the knee. Further good quality randomised controlled trials with long-term functional outcomes are required.