Replacement Arthroplasty: Soucacos PN

Babis GC, Soucacos PN. · No affiliation provided · J Surg Orthop Adv. · Pubmed #18851796 No free full text.

This publication has no abstract.

Babis GC, Soucacos PN. · First Department of Orthopaedic Surgery, University of Athens Medical School, KAT Hospital, 2 Nikis Street, Kifissia 14561, Athens, Greece. · Orthop Clin North Am. · Pubmed #15271544 No free full text.

Abstract: Total hip replacement initially showed universally bad results when performed in hips with advanced stages of osteonecrosis. Newer techniques and implants remarkably improved these results. Today cementless or hybrid total hip arthroplasty for osteonecrosis is proven to be safe and effective and to have survivorship similar to cases with osteoarthritis. Newer,more durable bearing surfaces will further improve the longevity of this procedure.

Kontovazenitis PI, Starantzis KA, Soucacos PN. · Department of Surgery, Attikon University Hospital, University of Athens, School of Medicine, Athens, Greece. · J Surg Orthop Adv. · Pubmed #19327266 No free full text.

Abstract: This report describes an 80-year-old woman who underwent intraarticular steroid treatment for her arthritic knee and ended up with avascular necrosis of her medial femoral condyle. This rare complication should alert all clinicians that even minor procedures such as arthrocentesis may result in complications.

Hadjicostas PT, Soucacos PN, Thielemann FW. · Department of Trauma and Reconstructive Surgery, Schwarzwald-Baar Clinic, Teaching Hospital, University of Freiburg, Rontgen Strasse 20, D 78054 Villingen Schenningen, Germany. · J Bone Joint Surg Br. · Pubmed #18978262 No free full text.

Abstract: We describe the mid-term results of a prospective study of total knee replacement in severe valgus knees using an osteotomy of the lateral femoral condyle and computer navigation. There were 15 knees with a mean valgus deformity of 21 degrees (17 degrees to 27 degrees) and a mean follow-up of 28 months (24 to 60). A cemented, non-constrained fixed bearing, posterior-cruciate-retaining knee prosthesis of the same design was used in all cases (Columbus-B. Braun; Aesculap, Tuttlingen, Germany). All the knees were corrected to a mean of 0.5 degrees of valgus (0 degrees to 2 degrees). Flexion of the knee had been limited to a mean of 85 degrees (75 degrees to 110 degrees) pre-operatively and improved to a mean of 105 degrees (90 degrees to 130 degrees) after operation. The mean Knee Society score improved from 37 (30 to 44) to 90 points (86 to 94). Osteotomy of the lateral femoral condyle combined with computer-assisted surgery gave an excellent mid-term outcome in patients undergoing total knee replacement in the presence of severe valgus deformity.

Mavrodontidis AN, Andrikoula SI, Kontogeorgakos VA, Babis GC, Xenakis TA, Beris AE, Soucacos PN. · Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece. · J Surg Orthop Adv. · Pubmed #18851803 No free full text.

Abstract: One hundred thirty-six knees were treated with the Endomodel rotating hinge knee prosthesis as primary total knee arthroplasty (TKA). The indications for surgery included osteoarthritis (110 knees), rheumatoid arthritis (18 knees), and osteonecrosis (8 knees). Patients were divided into four study groups according to follow-up duration. Group A was followed up from 10 to 15 years, group B from 8 to 10 years, group C from 5 to 8 years, and group D from 2 to 5 years. The Hospital for Special Surgery knee score, as well as each parameter individually, showed statistically significant improvement in all groups postoperatively. A total of 88.23% were rated as excellent, 3.67% as good, and 8.08% as fair. The results suggest that the Endomodel rotating hinge prosthesis can be considered a good alternative for primary TKA in cases of serious axial deformity and collateral ligament deficiency and in rheumatoid arthritis patients.

Babis GC, Zahos KA, Tsailas P, Karaliotas GI, Kanellakopoulou K, Soucacos PN. · Department of Orthopaedic Surgery, University of Athens, School of Medicine, Athens, Greece. · J Surg Orthop Adv. · Pubmed #18851802 No free full text.

Abstract: The incidence of periprosthetic knee infection is generally low, but the economic impact is great. Treatment should take into account the acuteness of the infection, the overall immune/medical status of the patient, and the local factors at the site of the infection. The aim of this study was to evaluate the two-phase exchange arthroplasty with the use of antibiotic-impregnated articulating spacer, as an alternative treatment of chronic periprosthetic knee infection in patients with minimum systemic and no local compromising factors. Staphylococcus aureus was the most common pathogen followed by Staphylococcus epidermidis and Pseudomonas aeruginosa. Twenty-four patients were treated with this regiment. All of them returned to normal everyday activity and no infection recurrence was noted over a 2- to 10-year follow-up. Excellent long-term results can be achieved for patients staged as III-A-1 and III-B-1 according to the Musculoskeletal Infection Society staging system, when treated with the aforementioned protocol and intravenous antibiotics.

Papagelopoulos PJ, Mavrogenis AF, Giannitsioti E, Kikilas A, Kanellakopoulou K, Soucacos PN. · First Department of Orthopaedics, Athens University Medical School, Athens, Greece. · J Arthroplasty. · Pubmed #17400104 No free full text.

Abstract: Multidrug-resistant infections present a serious clinical and therapeutical problem. Colistin is an old-used polymyxin with rather poor pharmacokinetic profile and a remarkable nephrotoxicity. However, the emergence of multidrug-resistant bacteria has recently led to the increased use of colistin as a potentially available therapy. This article presents a 75-year-old diabetic woman with an early onset total knee arthroplasty infection by a multidrug-resistant Pseudomonas aeruginosa bacterial isolate that was managed successfully with surgical removal of the knee prosthesis, antibiotic impregnated cement and intravenous administration of colistin for 6 weeks, and second stage revision knee surgery. Two years later, laboratory and imaging studies showed no evidence of recurrence of infection.

Mastrokalos DS, Zahos KA, Korres D, Soucacos PN. · First Department of Orthopaedics of the University of Athens, General University Hospital ATTIKON, Haidari, Greece. · Arthroscopy. · Pubmed #17027419 No free full text.

Abstract: We report on a case of arthroscopic treatment of septic arthritis of the elbow joint in a 65-year-old man with an elbow endoprosthesis. Two months after arthroplasty of the elbow joint, the patient developed acute septic arthritis of the right elbow. Methicillin-sensitive Staphylococcus aureus was identified as the causative organism. Six days after the onset of symptoms, the patient was treated with a single arthroscopic procedure of the infected periprosthetic joint, including irrigation with 5 L of Ringer's lactate solution, debridement, and partial synovectomy with a 4.5-mm curved shaver. Intravenous antibiotic therapy was also used for 3 months including rifampicine and fucidic acid according to the intraoperative cultures. The acutely infected total elbow arthroplasty could be cured without removal of the endoprosthesis of the elbow. Ten months postoperatively, the patient remains free of symptoms and his blood rates are within normal limits.

Kitsoulis PB, Stafilas KS, Siamopoulou A, Soucacos PN, Xenakis TA. · Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece. · J Pediatr Orthop. · Pubmed #16439893 No free full text.

Abstract: From 1984 to 2002, 20 total hip arthroplasties in children with juvenile chronic arthritis were performed in the authors' department. All patients had polyarticular disease. Average age of patients was 15.8 (range 13-24) years. Early onset of the disease occurred at an average age of 7.3 (4-10) years. In six patients the physes were open at the time of surgery. All patients had complete loss of joint space and various combinations of subchondral sclerosis, flattening of the femoral head, and anterior inclination of the neck. All patients used crutches for walking and joint function was very restricted. All patients were operated on under general anesthesia. One of them was supported additionally with laryngeal mask because of cervical spine involvement. No intra- or postoperative complications occurred. Mobilization of the patients started immediately after surgery, followed by a special rehabilitation program. Follow-up examination was based on the Merle d'Aubigne et Postel scale as modified by Charnley. Patients were followed at 6 weeks and 3 months after surgery and thereafter every 6 months with clinical and radiologic examination. Average follow-up was 9.2 (2-20) years. All patients had no pain and full functional ability. Although total hip arthroplasty is technically difficult in this age, it should be performed in specialized centers because pain relief, decreased deformity, and improved quality of life can be achieved in most patients. The only disadvantage is wear of the prosthesis.

Mavrodontidis AN, Papadonikolakis A, Moebius UG, Gelalis I, Motsis E, Soucacos PN. · Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Ioannina, Greece. · Arthroscopy. · Pubmed #12724667 No free full text.

Abstract: Posterior tibial subluxations because of combined or isolated posterior cruciate ligament (PCL) injuries require detailed evaluation. PCL reconstructions are difficult procedures because of the low rate of such injuries and the complex anatomy of the ligament. We report on 2 cases of failed PCL reconstruction because of malpositioned femoral tunnels. These 2 cases support the existing biomechanical evidence that the correct placement of the tunnels, especially in the femur, is a major factor in defining the outcome. It seems that the drilling of the tunnels, especially in the femur, during PCL reconstruction must be performed with accuracy and always be evaluated in cases of graft failure. In addition, failed PCL reconstructions are usually accompanied by a short-term excessive arthritis that results in poor functional outcome.

Xenakis TA, Gelalis J, Koukoubis TA, Zaharis KC, Soucacos PN. · Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Greece. · Clin Orthop Relat Res. · Pubmed #11347854 No free full text.

Abstract: Treatment of patients with osteonecrosis of the femoral head focuses on pain relief and improved function of the hip. Total hip arthroplasty remains an effective tool for the treatment of patients with end-stage osteonecrosis with collapse of the femoral head, although there is a greater risk for failure. The aim of the current study was to assess the long-term survival of cementless total hip arthroplasties in 28 patients (36 hips) with osteonecrosis of the femoral head (Steinberg Stage V and Stage VI) with an average followup of 11.2 years (range, 10-15 years). There were 19 women and nine men with an average age of 51.4 years (range, 28-65 years). A threaded titanium cup CST (Conical Screwed Titanium) was used in all patients and different cementless femoral components were used depending on the optimal fit in the femoral canal as assessed during preoperative templating. No serious complications were encountered postoperatively. The patients were evaluated preoperatively and postoperatively with the Merle d'Aubigné and Postel scale. After cementless total hip arthroplasty, the average pain score improved 3.6 points, walking ability improved 1.6 points, and range of motion improved 1 point. Two patients had thigh pain. Radiographic evaluation on anteroposterior and lateral radiographs of the proximal femur was excellent in 10 hips postoperatively. No heterotropic ossification was observed, although proximal femoral atrophy was seen in 15 hips. Clinical and radiologic findings did not correlate. There were two revisions of the acetabular implants in one patient with bilateral idiopathic osteonecroses and total hip replacement. Overall, survival of the prostheses was 93.4% at the average followup of 11.2 years.

Soucacos PN, Beris AE, Malizos K, Koropilias A, Zalavras H, Dailiana Z. · Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Greece. · Clin Orthop Relat Res. · Pubmed #11347825 No free full text.

Abstract: Two hundred twenty-eight hips in 187 patients with avascular necrosis of the femoral head were treated with vascularized fibular transplant from March 1989 to March 2000. The etiologic factors associated with the disease included corticosteroids in 84 patients (44%; 101 hips, trauma in 25 patients (13%; 29 hips), alcohol abuse in 24 patients (12%; 28 hips), and 41 hips (18%) were classified as idiopathic. Systemic disorders, including systemic lupus erythematosus, sickle cell anemia, inflammatory bowel disease, pregnancy, and dysbaric disease were observed in 12, nine, four, three, and one hip(s), respectively. Of the 228 hips operated on, 184 hips (152 patients) were assessed postoperatively with followup ranging from 1 to 10 years (mean, 4.7 years). Using the Steinberg classification system, 39 hips (21%) were in Stage II; 45 hips (25%) were in Stage II; 77 hips (42%) were in Stage IV; and 23 hips (12%) were in Stage V. Of the 184 hips treated, 101 (54%) remained stable postoperatively, whereas 69 (38%) had progression, and 14 hips (8%) were converted to total hip arthroplasty. Of the 69 hips that had progression, 44 (64%) did not progress until 6 to 10 years after the procedure, whereas 25 (36%) progressed within the first 5 years postoperatively. The best results were obtained in patients with Stage II osteonecrosis in whom 95% of the hips did not progress postoperatively. In contrast, only 39% of the hips in patients with Stage V osteonecrosis remained stable. Preoperative and postoperative clinical evaluation using the Harris hip score showed an increase from 85 to 96 points in hips with Stage II disease; from 74 to 91 points in hips with Stage III disease; from 69 to 85 points in hips with Stage IV disease; and from 61 to 76 in hips with Stage V disease. The current results show that the vascularized fibular graft is an excellent procedure for the precollapse stages and a valuable alternative for patients with Stages III, IV, and V of the disease.