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Biomedical subjects

E Tsiridis

Publications and source records attributed to E Tsiridis.

16 recordsLinked to original sources
PubMed2006

Sacral insufficiency fractures: current concepts of management.

BACKGROUND: Sacral insufficiency fractures (SIFs) are often overlooked in elderly patients presenting with low back and pelvic pain following no or minimal trauma. OBJECTIVE: The aim of this review is to raise awareness and outline the clinical presentation, methods of diagnosis and treatment of SIFs. DISCUSSION: Insufficiency fractures represent a special category of stress fractures that occur in bones with reduced mineral content and elastic resistance. SIFs, a well-defined subgroup of the latter group, are not uncommon, but lack of clinical suspicion results in many being undiagnosed. SIFs are set to become an important clinical entity of both social and economic significance as the Western population ages. Subtle clinical presentations and signs coupled with radiographic findings that can mimic other unrelated or overlapping conditions, such as sacroiliac joint infection, spinal stenosis and metastatic bone disease, often make SIF diagnosis a challenge. The aim of this review is to increase awareness among clinicians, highlighting SIFs as an important differential diagnosis to be considered when patients present with low back and pelvic pain and subsequently allow prompt management. The paper provides an overview of epidemiology, anatomical considerations, relevant pathophysiology and risk factors, presenting symptoms and signs, investigations and imaging techniques, differential diagnoses and current treatment methods available for the management of SIFs.

Bone Density Conservation Agents↗
PubMed2006

Sporting activity following Birmingham hip resurfacing.

The purpose of the study was to assess whether patients who undergo hip resurfacing arthroplasty are able to take part in sporting activity following surgery. Sporting activity before and after surgery was assessed by means of a questionnaire in 43 patients who underwent a total of 51 hip resurfacing procedures. Thirty-three hips (65 %) participated in sports before surgery. This increased to 47 (92 %) following surgery. Fourteen out of the 18 hips (78 %) that did not participate in sports before surgery went on to take part in at least one sport following surgery. There were also significant increases in intensity and frequency of sports participation following surgery. In conclusion, patients who participate in sports before surgery are able to return to sports following the procedure. Furthermore a significant proportion of patients who did not do any sports before surgery are able to take part in sports after surgery.

Arthroplasty, Replacement, Hip↗
PubMed2005

Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest.

We describe the intramuscular transformation of a hydroxyapatite/osteogenic protein-1 (HA/OP-1) composite implant, into a vascularised pedicled bone flap useful for reconstruction of a hemi-mandible. Extraskeletal induction of a bone flap for transplantation was achieved without the addition of harvested bone, bone marrow, or stem cells. Five months after apparent clinical success, an MRSA infection of the graft led to its failure. The background to ectopically induced bone flaps is introduced, with our experience in a human case presented. The results from this emerging biotechnology are discussed in the light of limited human clinical experience.

Bone Morphogenetic Protein 7↗
PubMed2005

L5 radiculopathy secondary to intrapelvic placement of acetabular cup fixation screw.

We report a case of L5 radiculopathy secondary to intrapelvic placement of an acetabular screw impinging on the lumbosacral trunk. A 43-year-old man underwent revision of an uncemented total hip replacement to a custom-made femoral component and uncemented cup. He subsequently developed hip pain, dysesthesia, and L5 radiculopathy. Spiral computed tomography (CT) and plain radiographs raised the possibility of an acetabular screw abutting the neurovascular bundle within the pelvis. Operative removal of the intrapelvic portion of the screw resulted in the immediate relief of the patient's radicular symptoms. This case report highlights the importance of the positioning of intrapelvic screws and the need for an anatomic awareness of the structures at risk during acetabular screw placement.

Acetabulum↗
PubMed2004

Intraspinal lumbar synovial cysts: diagnosis and surgical management.

BACKGROUND: Lumbar synovial cysts are a common association of facet joint degenerative disease. However, it is relatively rare for these cysts to cause symptoms of radiculopathy and nerve root compression. PATIENTS AND METHODS: We report a series of eight cases which were treated over a period of 20 months. There were five female and three male patients with a mean age of 66 years, and an average follow-up of seventeen months. All patients had pre-operative flexion/extension radiographs and MRI scans. Two patients had failed non-surgical treatment, two were associated with a Grade 1 spondylolisthesis, and all were associated with facet joint arthropathy. There were five cases occurring at L4/5 and three at L5/S1. RESULTS: All patients underwent identical procedures, which involved exploration, hemi-laminotomy, flavectomy and minimal facet joint excision. No patient required posterior lumbar interbody fusion and at follow-up five patients had excellent and three had good results.

Aged↗
PubMed2004

Impaction femoral allografting and cemented revision for periprosthetic femoral fractures.

We reviewed retrospectively the outcome of the treatment by impaction grafting of periprosthetic femoral fractures around loose stems in 106 patients with Vancouver type-B2 and type-B3 fractures. Eighty-nine patients had a cemented revision with impaction grafting and a long or short stem. The remaining 17 had cemented revision without impaction grafting. Fractures treated by impaction grafting and a long stem were more than five times likely to unite than those treated by impaction grafting and a short stem (odds ratio = 5.5, 95% confidence interval (CI) 1.54 to 19.6; p = 0.009). Furthermore, those with impaction grafting and a long stem were significantly more likely to unite than those with a long stem without impaction grafting (odds ratio = 4.07, 95% CI 1.10 to 15.0; p = 0.035). There was also a trend towards a higher rate of union in those treated by impaction grafting than in those without (odds ratio = 2.69, 95% CI 0.86 to 8.45; p = 0.090). Impaction grafting is being increasingly widely used for the restoration of femoral bone stock. It can be successfully applied to periprosthetic femoral fractures but a long stem should be used to bypass the distal fracture line.

Accidental Falls↗
PubMed2003

A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain.

To the best of our knowledge, this prospective study is the first to investigate the prevalence of acetabular labrum tears in athletes presenting with groin pain. Eighteen athletes who presented to our sports clinic with groin pain, underwent clinical assessment and magnetic resonance arthrography (MRa) to detect presence or absence of acetabular labrum tears. Ethical committee approval and informed consent was obtained from each patient. In four out of these eighteen athletes (22%) the MRa demonstrated the presence of acetabular labrum tear. Three of them underwent arthroscopic debridement of their acetabular labrum tears and returned to their sporting activities within 8 months. Clicking sensation of the hip was a sensitive (100%) and specific (85%) clinical symptom to predict labral tears. The internal rotation-flexion-axial compression manoeuvre was sensitive (75%) but not specific (43%). The Thomas test was neither sensitive nor specific. The conclusion of the study is that acetabular labrum tears can be a common cause of groin pain in athletes. Sports clinicians managing athletes with groin pain have to be well aware of the condition.

Acetabulum↗
PubMed2003

High-intensity zone, intradiscal electrothermal therapy, and magnetic resonance imaging.

Magnetic resonance imaging changes to the symptomatic intervertebral disc following intradiscal electrothermal therapy were determined in this prospective study. Magnetic resonance images before the intradiscal electrothermal therapy procedure were compared with those taken at 6 months postprocedure in 10 patients. The presence and absence of high-intensity zone, the disc height and hydration, and Modic changes were determined from the images. In six of the 10 patients, a high-intensity zone was present on the magnetic resonance images of the disc before the intradiscal electrothermal therapy procedure. In all six patients, a high-intensity zone was still present after the procedure. In all 10 patients, there were no changes to other disc parameters assessed. Our findings question the clinical relevance of the high-intensity zone. They also suggest that the main mechanism of action of intradiscal electrothermal therapy may be other than that of sealing the anular tear.

Adult↗
PubMed2003

"Pig Tail" technique in intradiscal electrothermal therapy.

To describe a new method of catheter insertion in intradiscal electrothermal therapy, which eliminates the need for reinsertion of the cannula and catheter from the contralateral side in those patients in whom optimal positioning is not achieved with the standard technique. This new technique has not been described before. In those patients in whom adequate catheter position cannot be achieved with the standard technique, instead of withdrawing the cannula after the initial treatment, we recommend rotating the cannula 180 degrees through its long axis. This will allow the catheter to hit the anterior anulus and deflect backwards toward the cannula. It can then be negotiated across the midline to adequately thermally treat the whole posterior anulus. We have performed our technique in 42 consecutive patients in whom initial navigation was difficult. This new method proved to be simple and did not cause patients additional discomfort. The "pig tail" technique is safe and effective in intradiscal electrothermal therapy of those patients with difficult navigation. It avoids the need for second needle insertion, therefore avoiding the use of more local anesthesia, further discomfort for the patient, and additional radiographic exposure.

Algorithms↗
PubMed2003

Acetabular labrum and its tears.

Groin pain is a major cause of morbidity in athletes. Only in the last decade have acetabular labrum tears been recognised as a possible diagnosis. Awareness of this condition is important for appropriate management. The basic science and pathological and clinical features of acetabular labrum tears are reviewed, and diagnostic and treatment options are presented.

Acetabulum↗
PubMed2001

Diagnosing slipped upper femoral epiphysis.

The key to diagnosing slipped upper femoral epiphysis is a high index of suspicion. This article summarizes the important clinical features of the disorder and points out the pitfalls in diagnosis.

Adolescent↗