ΠΛΗΡΩΣ ΑΡΘΡΟΣΚΟΠΙΚΗ ΑΠΟΚΑΤΑΣΤΑΣΗ ΧΟΝΔΡΙΝΩΝ ΚΑΙ ΟΣΤΕΟΧΟΝΔΡΙΝΩΝ ΒΛΑΒΩΝ ΓΟΝΑΤΟΣ ΜΕ ΕΜΦΥΤΕΥΣΗ ΚΑΛΛΙΕΡΓΗΜΕΝΩΝ ΧΟΝΔΡΟΣΦΑΙΡΙΔΙΩΝ ( ACT3D). ( Παρουσίαση περιστατικών στο Γερμανικό Ετήσιο Συνέδριο Χειρουργικής Ορθοπαιδικής και Τραυματιολογίας, Βερολίνο, 2008).
FULLY ARTHROSCOPICALLY PERFORMED 3-DIMENSIONAL AUTOLOGOUS CARTILAGE TRANSPLANTATION (ACT3D) FOR MEDIUM TO LARGE FOCAL CHONDRAL DEFECTS AT THE KNEE
Open debridement and radiocapitellar replacement in primary and post-traumati...Alberto Mantovani
Background: Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral
joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) prosthesis
has recently been developed for the treatment of lateral elbow arthritis. However, few data have been
published on LRE results.
Materials and methods: A prospective multicenter study was designed to assess LRE preliminary results.
There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11
and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis.
Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score
(MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick
Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months.
Results: At the last follow-up, the mean improvement of MEPS and m-ASES was 35 (P ¼ .001) and 34
(P ¼ .001) respectively; the average Quick DASH decreased by 29 (P ¼ .001). Average range of motion
was improved by 35 (P ¼.001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in
3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant
survival rate was 100%.
Conclusion: LRE showed promising results in this prospective investigation. Most patients had an
uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional
recovery at short-term follow-up. Further studies with longer follow-up are warranted.
Corrective Surgery for Malunited Tibial Plateau Fractureiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Open debridement and radiocapitellar replacement in primary and post-traumati...Alberto Mantovani
Background: Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral
joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) prosthesis
has recently been developed for the treatment of lateral elbow arthritis. However, few data have been
published on LRE results.
Materials and methods: A prospective multicenter study was designed to assess LRE preliminary results.
There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11
and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis.
Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score
(MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick
Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months.
Results: At the last follow-up, the mean improvement of MEPS and m-ASES was 35 (P ¼ .001) and 34
(P ¼ .001) respectively; the average Quick DASH decreased by 29 (P ¼ .001). Average range of motion
was improved by 35 (P ¼.001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in
3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant
survival rate was 100%.
Conclusion: LRE showed promising results in this prospective investigation. Most patients had an
uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional
recovery at short-term follow-up. Further studies with longer follow-up are warranted.
Corrective Surgery for Malunited Tibial Plateau Fractureiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
By replacing all or a portion of the meniscus with donor cartilage, the patient can regain the natural “shock absorber” in the knee and experience many additional years of activity, even in the presence of arthritis. Being "bone on bone" does not always mean that the joint needs to be artificially replaced, often the "bone on bone" is isolated to a portion of the knee joint and this can be repaired using meniscus transplant alone or in combination with any of the Biologic Knee Replacement procedures.
Update on ACL reconstruction, with information on current direction of demineralized bone matrix (DBM) use in bone tunnels and biocartilage on chondral lesions
A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
The existing medial meniscectomy (MMx) procedure in rodents involves transection of MCL and wide opening of the knee capsule followed by meniscus transection.
Laminectomy is a surgical procedure that removes the lamina - the back part of a vertebra that covers your spinal canal. Read the article to know more about the procedure.
Predictors of Patients’ Functional Outcome after Motor Nerve Transfers in Man...Professor M. A. Imam
To maximize outcome in nerve transfers:
1- The recipient nerve reinnervated close to the target muscle.
2- Direct repair without intervening grafts.
3- Similarly behaving neuromuscular units (agonistic donors and recipients)
By replacing all or a portion of the meniscus with donor cartilage, the patient can regain the natural “shock absorber” in the knee and experience many additional years of activity, even in the presence of arthritis. Being "bone on bone" does not always mean that the joint needs to be artificially replaced, often the "bone on bone" is isolated to a portion of the knee joint and this can be repaired using meniscus transplant alone or in combination with any of the Biologic Knee Replacement procedures.
Update on ACL reconstruction, with information on current direction of demineralized bone matrix (DBM) use in bone tunnels and biocartilage on chondral lesions
A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
The existing medial meniscectomy (MMx) procedure in rodents involves transection of MCL and wide opening of the knee capsule followed by meniscus transection.
Laminectomy is a surgical procedure that removes the lamina - the back part of a vertebra that covers your spinal canal. Read the article to know more about the procedure.
Predictors of Patients’ Functional Outcome after Motor Nerve Transfers in Man...Professor M. A. Imam
To maximize outcome in nerve transfers:
1- The recipient nerve reinnervated close to the target muscle.
2- Direct repair without intervening grafts.
3- Similarly behaving neuromuscular units (agonistic donors and recipients)
ABSTRACT- The purpose of this study was to access the outcome of modified manual small incision cataract surgery (M-MSICS) in terms of postoperative visual recovery (Best Corrected Visual Acuity). In this prospective study, the patients having cataracts with nuclear sclerosis not more than early grade 3 were randomly assigned in 2-groups with 50- patients in each group [Group A (C-MSICS), Group B (M-MSICS)]. Both techniques were compared for each stage in terms of postoperative visual recovery (Best Corrected Visual Acuity). Follow ups in postoperative period were carried out on 1st and 3rd postoperative days, 2 weeks, 4 weeks and 6 weeks. Significant early postoperative visual recovery was observed in Modified manual small incision cataract surgery (M-MSICS) as compare to conventional technique. Postoperative surgical induced astigmatism at 6 weeks was significantly less in M-MSICS group (p<0.05%). So it can be concluded that M-MSICS is better technique than C-MSICS in terms of early postoperative visual recovery & less postoperative surgical induced astigmatism.
Key-words- Conventional manual small incision cataract surgery (C-MSICS), Modified manual small incision cataract surgery (M-MSICS), Postoperative visual outcome
Clinical Outcomes in 995 Unselected Real-world Patients Treated With an Ultra-thin Biodegradable Polymer-coated
Sirolimus-eluting Stent:
12 Months Results from the FLEX Registry
Similar to ΠΛΗΡΩΣ ΑΡΘΡΟΣΚΟΠΙΚΗ ΑΠΟΚΑΤΑΣΤΑΣΗ ΧΟΝΔΡΙΝΩΝ ΚΑΙ ΟΣΤΕΟΧΟΝΔΡΙΝΩΝ ΒΛΑΒΩΝ ΓΟΝΑΤΟΣ (20)
A variety of autologous biologic products provided by Cellentis, a well-known Biotechnology company working in a close relation to Regenerative and Reconstructive Orthopaedic Department in IASO GENERAL HOSPITAL/Athens/Greece
Δείτε τις τελευταίες τεχνολογικές εξελίξεις στην Αθλητιατρική & τις Αθλητικές κακώσεις. Βλαστοκύτταρα και άλλα σύγχρονα βιολογικά προϊόντα, συνδυάζονται αρμονικά με υπερσύγχρονα φυσιοθεραπευτικά μηχανήματα και τεχνικές με σκοπό την επιτάχυνση της αποκατάστασης των μυικών κακώσεων και τη γρηγορότερη και ασφαλέστερη επάνοδο του αθλητή στην ενεργό δράση.
ΣΥΝΔΕΣΜΟΠΛΑΣΤΙΚΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΥΝΔΕΣΜΟΥ ΜΕ ΜΟΝΗ ΔΕΣΜΗ ΣΕ ΑΝΑΤΟΜΙΚΗ ΘΕΣΗ. ...STAVROS ALEVROGIANNIS
(Παρουσίαση σε Διεθνές Συνέδριο Εταιρείας Αρθροσκόπησης & Χειρουργικής Γόνατος της Πολωνίας, POZNAN 2011).
FREE HAND NOVEL ANATOMIC SINGLE BAND TECHNIQUE FOR ACLR
(X/O BUTTON,CONMED,LINVATEC,USA).PRELIMINARY RESULTS.
(POZNAN 2011)
ΠΡΟΓΡΑΜΜΑ ΠΡΟΛΗΨΗΣ ΤΡΑΥΜΑΤΙΣΜΩΝ ΣΕ ΕΠΑΓΓΕΛΜΑΤΙΕΣ ΑΘΛΗΤΕΣ. Π.Α.Ε ΟΛΥΜΠΙΑΚΟΣ- Α...STAVROS ALEVROGIANNIS
Διεθνές Συνέδριο ISOKINETIC υπό την αιγίδα της FIFA/ Bologna/Italy 2011
INNOVATINE INJURY PREVENTION PROGRAM FOR ELITE ATHLETES.
OLYMPIACOS F.C. FOOTBALL ACADEMY –U20 & U17 TEAMS. PRELIMINARY RESULTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
13. ARTICULAR CARTILAGE MANAGEMENT IN THE ATHLETE. Algorithm 2005 10 “patient directed” categorical situations Based on: lesion size, depth, alignment, ligament and meniscal integrity progress over time
18. CASE 3: LB (M). AGE 42. VALGUS LATERAL OA DFVO + MENISCAL TRANSPLANT Preop Post op Alignment
19. CASE 4: B.S (F). AGE 42. PATELLAR MAL-ALIGNMENT AND CHONDRAL DEFECT OF LATERAL FACET.
20. REHABILITATION FEMORAL AND TIBIAL DEFECTS Aqua jogging, >8w:biking >6 m: jogging, skating >6-12m: skiing >12m: contact sports Aqua training, swimming mobilization WALKING, SPORT Free movement (restricted by pain) CPM with restrictions femoral condyle: Week 2-3:0/0/60 0 Week 4-6: 0/0/90 0 Brace in extension MOBILIZATION Building up FWB within 3-6 weeks PWB (up to 50%) 3-point –walking with crutches Foot sole contact 3-point –walking with crutches WEIGHT BEARING > WEEK 6 WEEK 2-6 WEEK 1
21. REHABILITATION PATELLAR AND TROCHLEAR DEFECTS Building up FWB within 3-6 weeks PWB (up to 50%) 3-point –walking with crutches Foot sole contact 3-point –walking with crutches WEIGHT BEARING >WEEK 4 WEEK 3 - 4 0-14 DAYS Free movement (restricted by pain) CPM with restrictions : Week 2-3: 0/0/30 0 Week 4-5: 0/0/60 0 Week 6-7: 0/0/90 0 Brace in extension MOBILIZATION > WEEK 7 WEEK 2-7 WEEK 1
Mr President, dear colleagues, thank you in advance for the invitation in this congress.
The purpose of this presentation is to show you our preliminary results in using the chondrospheres in treating arthroscopically, medium to large focal chondral defects at the knee.
What you can see in the present slide is not of course the 3-dimensional ACI, but is the method we successfully used, in order to treat cartilage defects up to about a year ago, when we first used the ACT 3D .
The ACT3D is an innovative technique in treating medium to large chondral defects, because in addition to previous operative methods, the surgeon can apply the cultivated spheroids fully arthroscopically, in most of the cases, without any scaffold, or membrane and without any fibrin glue, or other fixation mode. The product is strictly autologous, without any host reactive changes.
The spheroids are small balls, consisted of 3-dimensional conglomerats of chondrocytes, together with their matrix. Their diameter is no more than 1mm and we can detect about 200.000 chondrocytes in each one of them, after the cultivation.. We need about 10-70 spheroids per square centimeter for the defect. They are grown up in patients own serum, without any antibiotics . They can express hyaline like specific markers and chondrogenic growth factors and subsequently suppress the expression of collagen type I.
We have treated operatively in our Dept., 35 symptomatic patients between March 2007 and May 2008. All pts were recreational athletes and the mean age was 32 years old. The mean area of cartilage defect was 6.75cm2 and all the cases were classified as grade III and IV according to Outerbrigde scale. 34 of them were treated fully arthroscopically, in addition to one case with multiple defects, we had to operate through an open arthrotomy, and was excluded from our final results.
22 out of 34 patients were male and 24 of them had the operation at the right knee.
Most of the cartilage lesions (18) were located in the weight-bearing surface of the medial femoral condyle, (8) in the lateral one ,(6) in the trochlea area and 2 in the lateral facet of the patella.
In most of the cases (19) the defect was due to trauma, .(8) of them were caused due to failed microfracturing technique.All of them had been performed elsewhere, more than 5 years ago. Of the remaining 7 cases, 2 were due to chondromalacia patella and 5 of them due to osteochondritis dissecans.
2 of our pts had previous partial medial meniscectomy, 1 partial lateral one. 8 of them had previous MFx ,as I have mentioned in previous slide, 1 had an arthroscopic debridement and another one an arthroscopic lateral release.
We strictly procceded, keeping always in mind the indications and contra-indications of the method .
What is more important, whatever method the surgeon prefers to perform for a chondral injury, is alignment. Nothing will work if alignment is out.
Keeping that in mind ,we currently use this algorithm as a baseline philosophy for every patient we treat having a cartilage defect.
According to this we have performed 15 applications of ACT 3D as single procedure. In 5 cases we had to perform a medial open wedge high tibial osteotomy due to varus leg, concommitant with ACT3D application, as a two stage procedure. Apart from that, we have performed 11 ACL reconstructions combined with the spheres, 1 case with concommitant open wedge distal femoral valgus osteotomy and lateral meniscal transplantation , 1 case with medial open wedge high tibial osteotomy and ACL reconstruction and another one with revision ACL reconstruction and medial open wedge high tibial osteotomy as a biologic knee replacement procedure. In all cases the osteotomies were performed in the first stage of ACI and the second stage was performed when the osteotomy had features of callus formation (mostly 5-6 weeks later).All the osteotomies were performed with use of either TOMOFIX or PUDDU plate. In the later cases we used the wedge shaped plate in order to avoid patella baja. All cases with ACL reconstruction (9 with hamstrings tendon and 2 with BPTB) were performed at the 2 nd stage of ACI and the rehab protocol was modified. In the revision ACL case ,the removal of the ACL xenograft was accompanied with placement of bone allograft in the tunnels, accompanied by revision ACL (anterior tibialis allograft) in 2 nd stage, 3 monthes later.
I will show you some of our cases. The first one is a 44 year old gentleman, with a medial genu varum and a concomittant chondral defect ,grade IV, 6.5cm 2 ,in the weight-bearing surface of MFC. He underwent an open wedge high tibial osteotomy with a TOMOFIX plate and ACT3D application 5 weeks later. You can easily see the consolidation of the osteotomy and the remaining space in the medial compartment.
Regarding the MRI scans, all of our patients underwent an MRI scan 6 and 12 m.p.o as a standard protocol. In all but one case we found no persisting subchondral oedema 6-12m.p.o and no graft hypertrophy. In one case ,in which the clinical score was excellent and the patient had no complaint at all, we found evidence of persisting subchondral oedema and not good consolidation of the graft and so we had to scope him.