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1.
Sofia I. Andrikoula Haris S. Vasiliadis Anastasios V. Tokis Paraskevi Kosta Anna Batistatou Anastasios D. Georgoulis 《Arthroscopy》2007
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. 相似文献
2.
Matheus Tzurbakis Andreas Diamantopoulos Theodoros Xenakis Anastasios Georgoulis 《Knee surgery, sports traumatology, arthroscopy》2006,14(8):739-749
The purpose of the study was to evaluate the mid-term results of surgical treatment in different groups of patients with multiple knee ligament injuries. Review of our patients’ records revealed that 48 acute and chronic patients were surgically treated for combined knee injury. Due to severe capsular damage in these injuries, open techniques were used. In our treatment protocol, avulsed ligaments and tears of the posterolateral and posteromedial corner were repaired if possible, whereas midsubstance tears of cruciate ligaments and chronic cases were reconstructed with autografts. Postoperatively, an accelerated program of rehabilitation was introduced, aiming to progressively mobilize the joint and improve muscle endurance. For the follow-up evaluation we designed a protocol composed of two parts. In the first part, anatomical lesions were recorded and in the second part, clinical evaluation was performed using the Lysholm score, the Tegner rating system, the IKDC evaluation form, and the KT1000. Student’s t tests and chi-square tests were used for data analysis. Forty-eight patients (mean age 28.6±11.9 years; 41 males) were classified according to the specific anatomical structures involved. Group A included 12 anterior cruciate ligament (ACL) and medial structure injuries, group B included 11 ACL or posterior cruciate ligament (PCL) ruptures combined with posterolateral injuries, and group C consisted of 25 knee dislocations (ACL and PCL ruptures which might be combined with damage of the collateral ligaments). Thirty-eight patients were surgically treated during the acute phase and ten patients were treated chronically. Forty-four patients (91.6%) were followed up at a mean of 51.3±29.9 months. Average Lysholm score was 87±12.3; average Tegner score was 5.09±2.19 before accident and 4.34±2.12 in re-examination; IKDC score was A in 10 cases, B in 22, C in 6, and D in 6. The mean range of motion was 129.9°±12.5°. The average loss of extension and flexion were 1.6°±2.5° and 7.6°±7.9°, respectively. The side-to-side difference in corrected anterior and posterior translation in quadriceps neutral angle and in anterior translation in 30° angle was <3 mm for about 65% of our patients. Surgical treatment of multiple knee ligament injuries, using autografts, provided satisfactory stability, range of motion, and subjective functional results. However, despite the improvement of the quality of life, the preinjury patients’ activity level was not fully obtained in re-examination. Patients underwent surgical treatment during the acute phase had better scores in several points, but finally there was no statistical significance between acute and chronic patients. Moreover, no statistically significant differences were observed among the groups with specific damaged anatomical structures. 相似文献
3.
28 patients with a fracture of the distal end of the radius were treated by a T-plate osteosynthesis through the volar approach. There were 7 unstable distal metaphyseal fractures and 21 dislocated intra-articular fractures. 21 patients were investigated 6 months to 8 years after operation according to the scheme of Sarmiento. 17 patients had a good or excellent result, 4 patients a fair or poor result. 2 patients developed a Sudeck's dystrophy (Algodystrophy), one of them with a radial-ulnar bone bridge. The volar application of the plate is indicated for flexion and extension fractures. In cases with compression of the dorsal cortex a bone graft is indicated to improve a stable osteosynthesis. A conventional tomography on two views helps to diagnose exactly an intra-articular fracture and to decide whether to use a plate or pins and external fixation after open reduction. Remanipulation or an operation 2 weeks after trauma increases the risk of a Sudeck's dystrophy and leads to a poor result. 相似文献
4.
Theodore H. Xenakis Konstantinos N. Malizos Alexandros E. Beris Marios Vekris Anastasios D. Georgoulis Panayotis N. Soucacos 《Microsurgery》1994,15(7):479-484
Reconstruction of large bony defects of long bones was performed using vascularised fibular grafts in four patients at the Department of Orthopaedic Surgery of the University of Ioannina Medical School. Indications for grafting procedures in this small series had been the loss of bone due to the extensive resection of avascular and necrotic bone from septic pseudoarthrosis in three patients and congenital pseudarthrosis secondary to neurofibromatosis in a child. Primary skeletal union with graft hypertrophy occurred in three of the patients. The fourth patient had an asymptomatic nonunion at the proximal end of the graft. The result in each patient was the presence of a well-aligned limb that had normal or nearly normal motion and acceptable length. © 1994 Wiley-Liss, Inc. 相似文献
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Kostas Patras Giorgos Ziogas Stavros Ristanis Elias Tsepis Nicholas Stergiou Anastasios D. Georgoulis 《Knee surgery, sports traumatology, arthroscopy》2009,17(8):977-984
Anterior cruciate ligament (ACL) reconstruction reestablishes electromyographic activity during moderate activities such as
walking but is unclear if this is also the case in sports activities such as high intensity running that results in accumulation
of metabolic fatigue. Nine bone-patella tendon-bone ACL reconstructed athletes were evaluated 19.2 (5.7) months post-operatively
using a telemetric electromyographic system. The neuromuscular response of vastus lateralis and biceps femoris muscles was
tested bilaterally on separate occasions during 10 min running at moderate intensity (20% below the lactate threshold) and
10 min running at high intensity (40% above the lactate threshold). During moderate intensity running, electromyographic activity
did not change for either leg. During high intensity running, electromyographic activity did not change for the vastus lateralis
of the ACL reconstructed leg [267.8 (142.8)–263.8 (128.9) μV, P > 0.05] while it increased significantly [294.2 (120.6)–317.1 (140.5) μV, P = 0.03] for the vastus lateralis of the intact leg. High intensity exercise that is associated with accumulation of metabolic
fatigue, results in an impaired neuromuscular response for the vastus lateralis muscle of the ACL reconstructed leg. 相似文献
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Excessive tibial rotation has been documented in anterior cruciate ligament (ACL) deficiency during walking. ACL reconstruction has been unable to correct this abnormality in activities that are more demanding than walking and involve both anterior and rotational loading of the knee. These findings persist regardless of graft selection for the ACL reconstruction (bone-patellar tendon-bone or semitendinosus gracilis). Based on this research work, we propose a theoretical perspective for the development of osteoarthritis in both the ACL-deficient and the ACL-reconstructed knee. We propose that excessive tibial rotation will lead to abnormal loading of the cartilage areas that are not commonly loaded in the healthy knee. Over time, this abnormal loading will lead to osteoarthritis. We hypothesise that the development of new surgical procedures and grafts, such as a more horizontally oriented femoral tunnel or a double-bundle ACL reconstruction, could possibly restore tibial rotation to normal levels and prevent future knee pathology. However, in vivo gait analysis studies are needed to examine the effects of these surgical procedures on tibial rotation. Prospective in vivo and in vitro studies are also necessary to verify or refute our theoretical proposition for the development of osteoarthritis. 相似文献