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Biomedical subjects

G Papachristou

Publications and source records attributed to G Papachristou.

At least 19 recordsLinked to original sources
PubMed2006

Deterioration of long-term results following high tibial osteotomy in patients under 60 years of age.

We have investigated, in a prospective study, the outcome of a valgus osteotomy of the tibia in patients less than 60 years of age with arthrosis of the medial compartment and a varus angle of no more than 177.7 degrees . Included in the study were 44 high tibial osteotomies (HTO) performed in 42 patients from 1981 until 1996. There were 35 females (2 bilateral) and 7 males, with an average age of 51 years (range: 30-60 years). Only patients in the first three grades, according to Ahlback's classification, were included. During a mean follow-up period of 10 years (range: 5-17 years), all but 2 patients experienced pain relief. The average loss of postoperative correction at 10 years was 2.4 degrees . The average postoperative Hospital for Special Surgery Knee Rating System score (HSSK) for patients with excellent or good results was 83.5 points. Survivorship analysis showed a success rate of 80% and 66% at 10 and 15 years respectively, and over 52.8% at 17 years of follow-up. HTO results in redistribution of the main stresses towards normal levels, although normal values are never attained. This is probably the reason why patients experienced good results only in the medium term.

Adult↗
PubMed2006

Early apoptosis of monocytes contributes to the pathogenesis of systemic inflammatory response and of bacterial translocation in an experimental model of multiple trauma.

The objective of this study was to investigate the occurrence of apoptosis of monocytes in an experimental model of multiple trauma and its probable correlation to bacterial translocation. Thirty-two rabbits were applied in three groups: A, controls; B, myotomy of the right femur; and C, myotomy and fracture of the right femur. Blood was sampled for the estimation of endotoxins [lipopolysaccharide (LPS)], tumour necrosis factor (TNF)-alpha, malondialdehyde (MDA) and isolation of peripheral blood mononuclear cells (PBMCs). PBMCs, derived after centrifugation over Ficoll, were incubated in flasks and apoptosis of non-adherent lymphocytes and adherent monocytes was estimated after staining for Annexin-V and flow cytometry. TNF-alpha of supernatants of cultured monocytes was also determined. Tissue segments were cultured after death. Median survival of groups A, B and C was > 14, > 14 and 9.00 days, respectively. Apoptosis of lymphocytes in group C was higher than group A at 2, 4 and 48 h and of monocytes in group C higher than group A at 2 and 4 hours. LPS in group C was higher than group A at 2, 4 and 48 h. Apoptosis of lymphocytes and monocytes was correlated positively with serum TNF-alpha and negatively with TNF-alpha of monocyte supernatants. Cultures of organ segments of group A were sterile. Pseudomonas aeruginosa was isolated from liver, lung and spleen in five animals in group B (45.45%) and in six in group C (54.54%). Early apoptosis of blood monocytes supervened after multiple trauma; the phenomenon was accompanied by apoptosis of blood lymphocytes and subsequent bacterial translocation.

Animals↗
PubMed2005

Total hip arthroplasty for developmental hip dysplasia.

We reviewed 38 hip replacements in 33 female patients (mean age 55.3 years) with developmental hip dysplasia. One patient had died and the remaining 32 patients (36 hips) had a mean follow-up of 12.2 years (range 8-19 years). All hips were replaced using the Müller cemented implant, and in 32 hips bulk femoral head autograft was used. In 33 hips the socket was reconstructed at the level of the true acetabulum. Complications included one intra-operative femoral fracture and two early dislocations. Correction of leg length discrepancy was possible in 30 patients. The post-operative mean modified Merle d'Aubigne and Postel scores for pain, movement and walking were 5.9, 5, and 5.3 respectively. One cup was revised due to aseptic loosening at ten years. All grafts united, but minor graft resorption was noticed in 24 hips, moderate in 2 hips and major in 1 hip.

Acetabulum↗
PubMed2004

[Management of painful pseudarthrosis of the carpal scaphoid bone with closed wedge osteotomy of the distal radius: a prospective study with long-term follow-up].

PURPOSE OF THE STUDY: We propose a different management scheme for painful post-traumatic osteoarthritis of the wrist resulting from pseudarthrosis of the carpal scaphoid bone. We report a prospective series with a maximum follow-up of 16 years. MATERIAL AND METHODS: From 1973 to 1990, we performed 100 first-intention wedge osteotomies of the distal radius in patients with painful pseudarthrosis of the carpal scaphoid bone. Inclusion criteria were painful wrists with established pseudarthrosis. The operation consisted in the removal of a small lateral wedge (base f 0.5 cm) without affecting the length of the radius nor the function of the distal radio-ulnar joint. Twenty patients were lost to follow-up and follow-up was less than two years for two. The present series corresponds to 77 patients (all male manual laborers) followed for at least two years. Mean follow-up was 4 years (range 216 years). To evaluate outcome, we developed a devoted scoring system, the Scaphoid Pseudarthosis Hand Score, (SPHS, max 60 points) with items for pain, range of motion, grasping strength, work capacity, wrist function and post-traumatic arthritis. RESULTS: At last follow-up, the SPHS was 45.66 points versus 19.98 before surgery. The pain score was 8.51 versus 3.19: 67 patients (86%) were pain free or experienced mild pain for heavy work. Bone fusion or fibrous union was observed in 49 patients (64%) who were free of post-traumatic osteoarthritis; some improvement of which was observed in 11 other patients (14%) with less sclerotic bone. All patients but two resumed their occupational activities. DISCUSSION: Wedge osteotomy relieves pain and improves hand function by reducing the pressure applied to the radial and scaphoid joint surfaces. It acts positively in the event of post-traumatic arthritis, altering the dynamics of the wrist and producing the beneficial effects of styloidectomy. Although it was not the target, sound union of the pseudarthrosis observed in 25 patients at last follow-up was attributed to the applied treatment.

Adult↗
PubMed2004

A bioresorbable calcium phosphate delivery system with teicoplanin for treating MRSA osteomyelitis.

To assess the effectiveness of calcium phosphate as a delivery system of teicoplanin, methicillin-resistant Staphylococcus aureus osteomyelitis was induced in 36 rabbits. Osteomyelitis was induced by inoculating 10 cfu of methicillin-resistant Staphylococcus aureus isolate into a 2-mm hole at the upper 1/3 of the femur for 3 weeks, when all animals had reoperations, and calcium phosphate cement with 3% teicoplanin was implanted. Animals were divided into six groups of six animals each, sacrificed at Weeks 1, 2, 3, 4, 5, and 6, respectively, after implantation. One rabbit in each group was used as a control. Substantial clinical improvement of the rabbits was observed after implantation, accompanied with sterile cultures of bone after the second week of treatment. Throughout the same period, 10 to 10 cfu/g of methicillin-resistant Staphylococcus aureus isolate was cultured from the control samples. Bacterial eradication signified a considerable decrease of the total histologic scores of osteomyelitis compared with controls, accompanied with newly growing host bone. The calcium phosphate with teicoplanin delivery system seems promising for treatment of bone infection attributable to methicillin-resistant Staphylococcus aureus. In addition, this mixture allows filling of bone defects by new host bone.

Analysis of Variance↗
PubMed2001

Prognosis of giant cell tumor of bone. Histopathological analysis of 15 cases and review of the literature.

BACKGROUND: The purpose of this study is the evaluation of certain markers determining the prognosis of giant cell tumor of bone. METHODS: A clinicopathological analysis of 15 cases of giant cell tumor is presented. RESULTS: Giant cell tumor of bone mainly affects women with an average age of 34 years and is located in the upper and distal ends of the long tubular bones (93.3%). 60% of the tumor biopsies was Grade I, 33.3 % Grade II and 6.7% Grade III. The recurrence rate was 33.3% and the malignant transformation was 13.3%. CONCLUSIONS: Prognosis of giant cell tumor of bone is likely to be mistaken if it is based only on the histological picture. On the contrary, considering important parameters, such as tumor location, size and tumor aggressiveness, frequency of recurrences and type of surgical management, one may predict in most cases the clinical outcome of the neoplastic process.

Adolescent↗
PubMed2000

Juxtacortical osteosarcoma. A distinct malignant bone neoplasm.

The purpose of this report is the study of a malignant bone tumor of similar histological picture with conventional (intramedullary) osteosarcoma. Contributing factors in the study of juxtacortical osteosarcoma are the clinical, X-ray and histologic pictures. A case of parosteal osteosarcoma in a 28-year-old male is reported. In conjuction with X-ray findings we review the histological characteristics of the tumor through serial sections of the peripheral, central and parosteal parts and the findings are described in detail. In addition to the histological findings, differential diagnosis and prognosis are also discussed. From the general study of the tumor it has been shown that juxtacortical osteogenic sarcoma behaves differently in contrast to classic osteosarcoma, depending on the degree of differentiation of the tumor.

Adult↗
PubMed2000

Extraskeletal chondroma, a rare soft tissue tumor. Case report.

A rare case of a chondroma of soft tissue located in the first metatarsophalangeal joint of the right foot in a 65-year-old male patient is reported. Defining elements of the tumor under study are: 1) the asymptomatic and harmless clinical course 2) the lack of connection between the tumor and the underlying bone 3) the slow tumor development 4) the absence of age and sex predominance and 5) the characteristic tumor histological picture.

Age of Onset↗
PubMed1998

Reconstruction of anterior cruciate ligament using the doubled tendon graft technique: an experimental study in rabbits.

In an attempt to assess reconstruction of the anterior cruciate ligament (ACL) by a new method, 18 New Zealand white rabbits underwent ACL replacement using the medial one-third of the patellar tendon and the semitendinosus tendon, thus partly reproducing the anatomical configuration of the ACL, with the semitendinosus tendon replacing the posterolateral bundle of the ACL and the patellar tendon replacing the anteromedial bundle. The Noulis-Trillat-Lachman test was performed before and after transection of the ACL, after reconstruction and before sacrifice. The animals were divided into four groups and were killed at 3, 6, 12 and 22 weeks after surgery. Femur-ligament-tibia complexes were evaluated postoperatively for gross morphology and histological appearance. The tendons of the first group showed compact parallel fibres with no definitive separation of their bundles and areas of disorganized collagen matrix. Tendons were surrounded by trabecular lamellar bone haphazardly arranged. The tendons of the second, third and fourth groups looked more like normal tendon. The trabecular bone surrounding the tendons formed a tunnel. The Noulis-Trillat-Lachman test result was negative before the procedure, 6.5 +/- 0.5 mm on average after transection of the ACL, 1.5 +/- 0.6 mm after the procedure, and negative again before sacrifice. The joints of the animals killed at 12 and 22 weeks showed signs of osteoarthritic lesions.

Animals↗
PubMed1997

Late results of surgical repair in recent ruptures of the lateral ligament of the ankle.

Between 1979 and 1994, 75 patients underwent primary repair of a Grade III rupture of the lateral ligament of the ankle. The operation was indicated after the demonstration of ankle instability on stress X-rays by anterior displacement of the talus by more than 8 mm or/and a talar tilt of more than 10 degrees. The patients were either young or engaged in sports activities or physically demanding jobs. An end-to-end suture of the torn ligament was undertaken under general anaesthesia. A non-weight-bearing cast was used for the first 2 weeks, followed by a walking cast until 6 weeks postoperatively. Sixty-one patients were followed up for 1-15 years (mean 10.3 years). At follow-up all but one patient had returned to their pre-injury level of activity without complaint or restriction.

Adolescent↗
PubMed1997

Treatment of tibial and femoral bone loss by distraction osteogenesis. Experience in 28 infected and 14 clean cases.

42 patients with diaphyseal bone defects (25 tibial and 17 femoral) who were treated by radical debridement and bone transport are reviewed. Their mean age was 35 (10-64) years and there were 29 men. 19 patients had active infections with drainage and 9 were previously infected. After resection of the infected and necrotic bone, the intercalate defect averaged 6 (3-12) cm. The mean duration of treatment was 10 (20-52) months. Regeneration of the distraction gap was achieved in all 42 patients. Union at the target zone was achieved in 38, and in the remaining 4 cases consolidation was achieved by application of autogenous bone grafts. The infection was eradicated in all 28 patients treated for bone defects associated with infection, without the need for a second operation. Complications were not severe and did not affect the final results. Residual malalignment remained in 2 patients, 1 femur and 1 tibia, with 10 degrees and 8 degrees of varus deformity, respectively. The final leg-length discrepancy never exceeded 1.5 cm. Residual fixed flexion of the knee was left in 5 cases, but never exceeded 10 degrees. Loss of 5 degrees to 10 degrees of dorsiflexion of the ankle joint remained in 7 patients. There were no intraoperative or postoperative neurovascular damage or compartment syndrome. Psychological intolerance was seen in 1 young patient. All patients, but 3 returned to their previous occupation. Bone transport is a simple and safe method for successful treatment of diaphyseal bone defects.

Adolescent↗
PubMed1989

Wedge osteotomy of the lower end of the radius in the treatment of painful pseudarthrosis of the carpal scaphoid bone.

The present authors have had encouraging results in the treatment of painful pseudarthrosis of the carpal scaphoid bone using wedge osteotomy on the lower end of the radius. After the operation, patients experienced restoration of joint movement, less painful or pain-free joints, and, in a few cases, sound union of the established pseudarthrosis of the carpal scaphoid bone. Osteotomy is a simple procedure of short duration and is without complications. In addition, in cases of failure, osteotomy does not exclude other forms of therapy.

Adult↗
PubMed1989

Experience with knee arthroplasty.

Knee arthroplasty is a suitable way of treating severely affected joints. During the years 1976-1987, 160 knee arthroplasties were performed at the author's institution. Of 142 followed. 41 cases were of the unconstrained type (Marmor, Bechtol, and Oxford), while 101 cases were of the constrained type (St. Georg hinge and Endo-Model). In the unconstrained group, two infected cases were encountered (one cured, one fused) and three loosenings requiring revision. Prompt and intensive physiotherapy was necessary in this younger and less affected group of patients in order to achieve a functioning knee joint. The average improvement of range of motion was 15 degrees. In the constrained group, full restoration of the normal axis was achieved with full extension; flexion was greater than 100 degrees, and there was a stable joint. Three infections occurred, all in rheumatoid patients. There were two early deaths from unrelated causes. Three late dislocations of the patella, with the knees still functioning, were encountered in this older group of patients with more severely affected joints. Proper function of the unconstrained prosthesis is also questionable in relation to the average geometry of the artificial models in use and the geometry of the human body. This relation, if not accurate, might result in loosening even in a well-installed prosthesis. The constrained artificial joint possessing its own mechanism of function allows full restoration of the leg axis and early ambulation and weight bearing, which are essential for the elderly. Bearing in mind the method of fixation, the function, and the results of the prosthesis used, the implantation of a constrained prosthesis more suitable to the elderly is strongly advised.

Adult↗
PubMed1977

Osteoid osteoma of the terminal phalanges.

Four cases of osteoid osteoma of the terminal phalanx--a very rare location--are presented. The clinical picture of cell cases is essentially the same, gradual swelling of the terminal phalanx with enlargement of the nail and pain, particularly at night and relievable by aspirin. The treatment was operative and of double value. 1. The osteoid osteoma is removed; 2. Cosmetic result is obtained by reduction of the size of the terminal phalanx.

Adult↗