B. 30
THE COMEBACK OF A SEVERELY INJURED MUSICIAN. THE COMBINATION OF THE WILL AND THE ORTHOPAEDIC SURGERY
P. Givissis
Εισήγηση στο 2nd International Musicians Medicine Congress in Greece – Workshop
Thessaloniki, 2-6 April 2008
B. 31
THE CHOICE OF ACETABULAR COMPONENT IN THE REVISION TOTAL HIP REPLACEMENT
Petsatodis, G. Stavridis, S. Karataglis, D. Giannoulis, K. Givissis, P. Christodoulou, A.
Ανακοινώθηκε στο 8th European Hip Society (EHS) Meeting, Madrid, Spain, 2008
Introduction: The increase of the number of total hip replacements in the last years has lead to an equivalent increase in the number of revision procedures. Revision of THR is a demanding procedure and the choice of the adequate acetabular component is a matter of paramount importance.
Materials and methods: From 1998 to 2005 62 acetabular component revisions were performed in our institution. The mean patients’ age was 62 y (49-81). Following prostheses were used: 47 hemispherical porous coated press fit cups fixed with 1-2 screws, 10 Symbios-Hilock hydroxyapatite coated cups, 3 Burch-Schneider cups and 2 cemented cups. Post-operative follow-up included hip plain x-rays and the use of D’ Aubigne-Postel score, with a mean follow-up time of 4,8 years (2-9 y).
Results: Revision of the acetabular component was needed in only one case due to loosening. Observed early post operative complications were as follow: symptomatic deep venous thrombosis occurred in 2 patients, 2 patients developed respiratory infection and 2 superficial haematomas. Early-onset infection was evident in one case and was treated with surgical debridement and administration of antibiotics, while one patient suffered from hip dislocation.
Radiological evaluation revealed radiolucent lines in 12 patients, without further signs of component loosening. According to D’ Aubigne-Postel score, the result was excellent in 53 patients and good in 7 patients.
Conclusion: Acetabular component revision by using non-cemented prostheses is the best choice, since it is associated with a low complication rate, preservation of adequate bone stock, low rate of aseptic loosening and high prostheses survival rate.
B. 32
TREATMENT OF CERVICAL RADICULOPATHY/MYELOPATHY WITH DISC ARTHROPLASTY: SHORT TERM CLINICAL AND RADIOLOGICAL OUTCOMES.
A Christodoulou, P.Antonarakos, L. Katranitsa, P. Givissis, G. Petsatodis
Ανακοινώθηκε στο 6th Conference of Spine Expert Group, 4-6/12/2008, Sofia, Bulgaria
This is a retrospective study to assess the early clinical and radiological outcomes of cervical disc arthroplasty with the Bryan and Prestige LP cervical disc prostheses. Between 2004 -07 a total of 30 patients (19 males – 11 females, mean age: 37.5 y) underwent disc arthoplasty of a single level for cervical radiculopathy and/or myelopathy(C4-5, C5-6 or C6-7 levels). In one case with cervical myelopathy we performed a double level cervical arthroplasty. Mean follow-up period was 15 months (range 4-40 months). All patients were evaluated for cervical alignment, range of motion and cervical stability with static and dynamic radiographs pre- and postoperatively. Clinical outcome was assessed using the visual analogue scale (VAS) and the neck disability index (NDI). There were no early or late clinical or device-related complications within this period. Subjective symptoms as well as the NDI and VAS scores were improved postoperatively. Radiologically the range of movement of the cervical spine was preserved, the sagittal alignment of the whole cervical spine presented lordotic especially with the Prestige LP CDP. With the Bryan prosthesis some degree of segmental kyphosis remained at the level of arthroplasty in 8 out of the 11 cases, possibly due to inherent limitations of the device to restore normal lordosis or due to over-milling of the superior end-plate during preparation or the presence of segmental kyphosis preoperatively. It is believed that motion preservation may potentially reduce the rate of adjacent-level cervical disc disease. Disc arthroplasty has shown satisfying clinical and radiological results in the short term. Further studies need to prove the superiority of motion preserving techniques in the long term.
B. 33
CORRECTION OF SEVERE SCOLIOSIS WITH A MODIFIED COTREL-DUBOUSET 3-ROD TECHNIQUE AND POSTERIOR ONLY PEDICLE SCREW INSTRUMENTATION
Christodoulou A., Antonarakos P., Katranitsa, Christodoulou E, Givissis P.
Ανακοινώθηκε στο 6th Conference of Spine Expert Group, 4-6/12/2008, Sofia, Bulgaria
We present a 3-rod technique for the management of the severe and stiff forms of scoliosis. From 2000 to 2007 nine patients with severe scoliosis were treated surgically All curves were of S type with the thoracic component of the deformity being the larger and the stiffer. Cobb’s angles for the main curve ranged from 78° to 122° with a mean of 100,7° and for the compensatory curve from 46° to 92° with a mean of 64°. Side bending correction of the main curve was 83,6° (range 68°-100°) and of the compensatory curve was 40,4° (range 20°-71°). The mean age of the patients at the time of operation was 22.42 years. Surgical technique included a typical posterior approach, wide excision of facet joints and spinal ligamentous structures to release the spine, followed by the insertion of 3 corrective rods, two at the concave side and one at the convex side of the curve. The mean follow up was 51 months (12-90 months). The preoperative flexibility of the main curve was 11% (range 5% to 20%) and the flexibility of the compensatory curve was 39% (range 23% to 59%). Postoperatively the major thoracic curve reduced to 51.6° (range 37° to 67°) and the compensatory curve reduced to 21,7° (7° to 32°). The average improvement was 50,6% (range 39% to 63%) for the major curve and 60,1% (range 30,4% to 77%) for the compensatory curve. Average loss of correction was less than 4° in the coronal plane and less than 2° in the sagittal plane. There were no reoperations for implant failure, pseudarthrosis or infection and no neurologic injuries in any of the patients in this study.The 3-rod technique has been shown to be safe and equally effective compared with other techniques applied for the management of the severe and stiff forms of scoliosis
B. 34
MANAGEMENT OF COMMON PERIARTICULAR FRACTURES.
RADIUS – DISTAL PART. LOCKING PLATES
P. Givissis
Lecture at ΑΟ Cource.
Patras, 13-14 February 2009
B.35
ARTHROSCOPIC SURGERY OF THE WRIST
P. GIVISSIS
Lecture given at the 7th Turkish-Greek Intra-University Orthopaedic Meeting
Izmir, Turkey, 7-9 May 2009
B.36
SCAPHOLUNATE – LUNORTIQUETRAL INSTABILITY. PATHOMECHANICS
P. Givissis
Lecture at 3rd International Seminar Wrist Problems.
Thessaloniki , 29-30 January 2010
Β.37
DISTAL RADIUS FRACTURES. ELECTION OF SURGICAL TECHNIQUE
P. Givissis
Lecture at 3rd International Seminar Wrist Problems.
Thessaloniki , 29-30 January 2010
B.38
CLINICAL APPLICATION IN LIMB RECONSTRUCTION.
P. Givissis
Case Presantation at 4th International Course of Experimental Vascularised Flaps.
Attica –Greece, 4-6 February 2010
B.39
PRINCIPLES OF TREATING ATRICULAR FRACTURES.
P. Givissis
Lecture at ΑΟ Cource.
Thessaloniki , 20 February 2010