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Panayiotis J Papagelopoulos

Publications and source records attributed to Panayiotis J Papagelopoulos.

At least 19 recordsLinked to original sources
PubMed2007

Linezolid for the treatment of adults with bone and joint infections.

We reviewed the available evidence regarding the effectiveness and safety of linezolid administration for the treatment of patients with orthopaedic infections due to multidrug-resistant Gram-positive cocci. Although the reports published to date include promising results for the use of linezolid for bone and joint infections, controlled studies will be needed to reach safe conclusions. Attention should be paid to adverse effects that may be related to linezolid administration, especially bone marrow suppression with prolonged administration of the antibiotic. In addition, early identification of linezolid-induced peripheral neuropathy is necessary because this may be an irreversible event.

Acetamides↗
PubMed2006

Current trends in the management of extra-abdominal desmoid tumours.

Extra-abdominal desmoid tumours are slow-growing, histologically benign tumours of fibroblastic origin with variable biologic behaviour. They are locally aggressive and invasive to surrounding anatomic structures. Magnetic resonance imaging is the modality of choice for the diagnosis and the evaluation of the tumours. Current management of desmoids involves a multidisciplinary approach. Wide margin surgical resection remains the main treatment modality for local control of the tumour. Amputation should not be the initial treatment, and function-preserving procedures should be the primary treatment goal. Adjuvant radiation therapy is recommended both for primary and recurrent lesions. Chemotherapy may be used for recurrent or unresectable disease. Overall local recurrence rates vary and depend on patient's age, tumour location and margins at resection.

Journal Article↗
PubMed2006

Spondylodiscitis after facet joint steroid injection: a case report and review of the literature.

Spondylodiscitis is a rare complication after facet joint steroid injection. This article presents a 78-y-old male with chronic back pain and facet joint arthritis who developed Pseudomonas aeruginosa L2-L3 and L3-L4 spondylodiscitis after computed tomography-guided facet joint steroid injection. Magnetic resonance imaging, fine needle aspiration and cultures confirmed the diagnosis. The patient was treated with intravenous administration of amikacin, and imipenem plus cilastatin for 4 weeks, followed by oral administration of ciprofloxacin for another 10 weeks. Sterile preparation prior to facet joint steroid injection should be stressed. To the best of our knowledge, this is the only reported case of iatrogenic spondylodiscitis after facet joint steroid injection. This iatrogenic complication should be considered in the risk-benefit analysis of facet joint diagnostic or therapeutic injections.

Aged↗
PubMed2006

Survivorship analysis in patients with periosteal chondrosarcoma.

UNLABELLED: To investigate outcome and identify prognostic factors, we retrospectively reviewed 24 consecutive patients with periosteal chondrosarcomas. There were 17 males and seven females with a mean age of 37.6 years (range, 15-73 years). The femur was involved in 12 patients, the proximal humerus in five, the tibia in two, and the distal fibula, ilium, pubis, metatarsal, and rib in one patient each. The mean greatest dimension of the lesions was 8.1 cm (range, 1.5-27 cm). Based on the histologic pattern, there were 18 Grade 1 tumors and six Grade 2 tumors. All patients were treated surgically. Two patients had intralesional excisions, five patients had marginal excisions, and 17 patients had wide resections. With a mean followup of 17 years (range, 28 months-47 years), seven of 24 patients (29%) had one or more local recurrences. The 5-year local recurrence-free survival was less in patients treated with intralesional or marginal excisions (25%) than for patients treated with wide resections (93%). At the latest followup, six of 24 patients (25%) had died of pulmonary metastases. The overall 5-year metastasis-free survival was 83%. The 5-year metastasis-free survival was less for patients with Grade 2 tumors (50%) than for patients with Grade 1 tumors (94%). LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2006

Outcome of partial medial epicondylectomy for cubital tunnel syndrome.

UNLABELLED: Partial medial epicondylectomy aims to eliminate potential drawbacks of total epicondylectomy for treatment of cubital tunnel syndrome. In this series, we retrospectively evaluated 80 patients (80 elbows) who had partial medial epicondylectomies for established cubital tunnel syndrome. Our main purpose was to compare clinical outcomes among partial, minimal, and total epicondylectomies. Specific attention was given to the functional outcome in severely impaired patients, and potential postoperative complications of total epicondylectomy, such as elbow instability, and medial elbow pain. Preoperatively, 16 patients were classified as having McGowan Grade I lesions, 40 had Grade II lesions, and 24 had Grade III lesions. The mean followup was 32 months (range, 26 months-4.2 years). There was improvement of at least one McGowan grade in 86.2% of the patients, with a 66.7% improvement in severely impaired patients (McGowan Grade III lesions). There was no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability. However, 45% of patients reported mild pain at the 6-month followup. Partial medial epicondylectomy seems to be safe and reliable for treatment of cubital compression neuropathy at the elbow. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.

Adult↗
PubMed2006

Advances and challenges in diagnosis and management of skeletal metastases.

The treatment of metastatic disease remains challenging. The number of patients who will be diagnosed with metastatic bone disease will continue to increase as survival from the primary cancer diagnosis continues to improve. Although it often is impossible to cure these patients, the task of maximizing their quality of life must be met with valiant efforts. Although a large number of medical and technological advances have occurred, perhaps the recognition of the importance of a well-qualified multidisciplinary team approach to treatment of these complex patients has done more to improve the field than any other single achievement. As basic science continues to further unravel potential treatment options, we must not forget this integrated approach and we must embrace "the bench" at the bedside.

Bone Neoplasms↗
PubMed2006

Optimal treatment of fibrodysplasia ossificans progressiva with surgical excision of heterotopic bone, indomethacin, and irradiation.

A case report is presented of an 18-year-old boy with advanced fibrodysplasia ossificans progressiva. The patient's right hip was ankylosed in 35 degrees of flexion. Excision of the heterotopic bone from the right hip was followed by a combination of a single fraction irradiation (7Gy) given in the first postoperative day, and an 11-day treatment with indomethacin (25 mg, three times daily, orally). One year postoperatively, the patient ambulates nearly normally and he is able to sit and stand up without significant difficulty. Radiographs of the right hip showed a small amount of heterotopic bone formation at the operative site. In contrast with the results published in the literature, the clinical result of the operation is considered satisfactory. Further investigation of the combined use of indomethacin and single fraction irradiation as a preventive measure after surgical excision of heterotopic bone in patients with fibrodysplasia ossificans progressiva FOP should be performed.

Adolescent↗
PubMed2005

Chance-type fractures of the axis.

STUDY DESIGN: A retrospective study was performed to identify horizontal fractures of the body of the axis, with special attention to their pattern, prevalence, and clinical outcome. OBJECTIVE: The prevalence of this type of injury and the long-term clinical behavior are examined. SUMMARY OF BACKGROUND DATA: Although isolated cases have been reported, horizontal Chance-type fractures of the body of the axis are not common cervical spine injuries. METHODS: The medical records of 674 consecutive patients with fractures of the cervical spine admitted to the authors' institute from 1970 to 2002 were reviewed. Of them, 2 (0.3%) had a horizontal Chance-type fracture of the body of the axis. Neurologic deficits were not diagnosed at admission. Mechanism of injury, treatment, and long-term follow-up were evaluated. RESULTS: Both patients were treated nonoperatively. At the latest follow-up, 3 and 12 years, respectively, both patients had a satisfactory clinical outcome. CONCLUSION: Horizontal fractures of the Chance-type of the body of the axis are rare. Conservative treatment proved to be effective.

Aged↗
PubMed2005

Complications after tibia plateau fracture surgery.

High-energy tibial plateau fractures are often the result of blunt trauma and are associated with severe soft-tissue injury. Fixation techniques demand considerable surgical skill and mature judgment. The available surgical options do not always guarantee a favourable outcome. Operative treatment includes internal and external fixation, hybrid fixation and arthroscopically assisted techniques. Operative management of high-energy fractures remains difficult and challenging and may be associated with serious complications, such as knee stiffness, ankylosis, deep infection, post-traumatic arthritis, malunion and nonunion. Prevention of the complications can optimise the clinical outcome in these patients.

Adult↗
PubMed2005

Changes of meniscal interhorn distances: an in vivo magnetic resonance imaging study.

The aim of this study was to evaluate the changes of the internal (IID) and external meniscal interhorn distance (EID) of the medial and the lateral meniscus under loading. Sagittal magnetic resonance images of 15 knees were studied. The medial and lateral meniscus were examined with the knee at 0 degrees and 30 degrees of flexion, under no load, with load equal to 50% of body weight and with load equal to 100% of body weight. Under no load, the mean IID was 19.9 mm for the medial meniscus and 12.3 mm for the lateral meniscus and the mean EID was 44.6 mm for the medial meniscus and 34.4 mm for the lateral meniscus. Under load equal to 50% and 100% of patient's body weight, there was a significant increase in both distances (p<0.05). Under constant loading, flexion of the knee from 0 degrees to 30 degrees , decreased the EID of both menisci. In conclusion, loading increases both IID and EID. Knee position affects only the EID. The quality of magnetic resonance images may affect the reliability of such measurements.

Adult↗
PubMed2005

Tuberculous sacroiliitis. A case report and review of the literature.

BACKGROUND: Infections of the musculoskeletal system are tuberculous in nature in 1-5% of cases. The sacroiliac joint is involved in 3-9.7%. We describe the case of a 32-year-old man with tuberculous sacroiliitis presented as a growing mass on the lateral aspect of his right proximal and mid-thigh. Open biopsy, histology, cultures and PCR established the diagnosis of tuberculosis. RESULTS: After surgical drainage of the abscess, the patient was administrated a triple antibiotic regimen for 12 months. Seven years postoperatively, the patient is disease-free with no functional limitation. This case report highlights the importance of continued awareness for early detection and treatment of a tuberculous sacroiliac joint infection.

Adult↗
PubMed2005

Unusual presentation of osteoid osteoma of the scaphoid.

The small carpal bones are infrequent sites for osteoid osteomas, and their clinical and imaging pictures may be quite confusing leading to suspect other etiologies. The authors present herein an unusual case of osteoid osteoma of the scaphoid superimposed on a wrist injury caused by a fall on the outstretched hand.

Adult↗
PubMed2005

Open reduction and internal fixation of distal radial fractures using the Pi-plate.

The authors reviewed 22 patients with 23 fractures of the distal radius, who were treated by open reduction and internal fixation using the low profile contourable titanium dorsal distal radius AO Pi-plate. There were four men and 18 women with a mean age of 57 years. The mean follow up period was 26 months (range, 12-48 months). The modified Lidstrom's radiographic scoring system and the modified Gartland and Werley' functional scoring systems were used for evaluation of the outcome. An excellent clinical outcome was present in four patients, a good in 10, a fair in seven, and a poor in two. Radiographic results were excellent in 12 patients, good in 10, and fair in one patient. Seven patients required removal of the plate for median nerve compression and tendonitis. The Pi-plate can be used in a wide spectrum of distal radial fractures including complex comminuted intra-articular (AO type C3) fractures with satisfactory functional outcome and low rate of complication.

Adult↗
PubMed2005

Lateral malleolus en bloc resection and ankle reconstruction for malignant tumors.

UNLABELLED: Four children and six adults required en bloc resection of the lateral malleolus for malignant tumors. There were four osteosarcomas, three chondrosarcomas, two Ewing's sarcomas, and one adamantinoma. Surgical margins were wide in seven patients, marginal in two, and intralesional in one. A primary ankle arthrodesis was done in four adults and bracing without any reconstruction was done in four children and two adults. During a mean followup of 14.5 years (range, 3-30 years), there were two local recurrences (two of 10 patients) after a marginal excision and an intralesional excision. One patient had reoperation for a skip osteosarcoma lesion in the proximal fibula. Other complications included chronic osteomyelitis, a lateral talus subluxation and cavovarus deformity, and recurrent ankle instability and degenerative changes of the ankle. At the latest followup, all 10 patients showed no evidence of disease. Five patients who had primary or late ankle arthrodesis had a Musculoskeletal Tumor Society and International Society of Limb Salvage functional score of 28 points (92%), and two adolescents who had postoperative bracing alone had a functional score of 24 points (80%). The three remaining patients had a salvage amputation. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series--no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗