Kosmas S. Stafilas

Normative data on hand grip strength in a Greek adult population.

The objectives of this study were to establish data concerning normal hand grip strength (GS) and to explore possible associations with anthropometric parameters. GS was measured in 232 individuals in a standard arm position using the Jamar dynamometer. We examined differences between right/left and dominant/nondominant hands. Possible correlations of GS with anthropometric values were evaluated. Right hand and dominant hand GS were found to be higher and statistically significant compared to left hand and nondominant hand GS, respectively. Men had higher values of GS compared to women. A negative association was observed between age and dominant hand GS. A positive association was documented between height and dominant hand GS, while the respective comparison for weight and dominant hand GS documented a statistically significant positive association only in the male group. A positive association between BMI and dominant hand GS was seen in female individuals. Additional factors associated with GS should be the goal of future investigations.RésuméEtablir des données concernant la force de serrage de la main (GS) et, explorer les possibles associations avec des paramètres anthropométriques. La force de la main: GS a été mesurée chez 232 individus en position standard du bras, utilisant le dynamomètre de Jamar. Nous avons examiné les différences entre les côtés droit et gauche et dominant/non-dominant. Les possibles corrélations de GS avec des valeurs anthropométriques ont été évaluées. Respectivement main droite et GS du côté dominant ont été retrouvées de manière significativement plus élevée que main gauche et GS non-dominant. Les hommes avaient des valeurs de GS plus élevées que les femmes. Une association négative a été retrouvée entre l’âge et la GS de la main dominante. Une association positive a été documentée entre la taille et la GS du côté dominant, tandis que la comparaison entre le poids et la GS du côté dominant montre une association positive de manière statistiquement significative, uniquement dans le groupe des hommes. Une association positive a été retrouvée entre le BMI et la GS du côté dominant dans le groupe des femmes. Des facteurs additionnels associés avec la GS devraient être le but d’une future investigation.

Decompressive surgery for degenerative lumbar spinal stenosis: long-term results

We report the outcome of 50 patients with degenerative lumbar spinal stenosis who were treated surgically by spinal decompression between 1984 and 1995. Their mean age at the time of surgery was 59.9 (45–77) years and the mean follow-up was 11.6 (6.1–17.2) years. Five patients had a concomitant spinal fusion. The preoperative data were collected retrospectively from the patients’ charts. The follow-up data were obtained from a clinical examination and questionnaire including overall pain, ability to work, walking ability, use of analgesics and satisfaction with surgery. The outcome was rated as excellent in 23 patients, good in 13 patients, fair in 9 patients and poor in 5 patients. Patients with concomitant fusion had good to excellent results and were more satisfied, whereas patients with long-standing preoperative symptoms had poor to fair result and were less satisfied.RésuméNous rapportons le résultat de 50 malades avec une sténose lombaire dégénérative qui a été traité chirurgicalement par décompression vertébrale entre 1984 et 1995. L’âge moyen à la chirurgie était 59,9 (45–77) ans et le suivi moyen était 11,6 (6.1–17.2) années. Cinq malades avaient une fusion vertébrale concomitante. Les données préopératoires ont été rassemblées rétrospectivement. Les données du suivi ont été obtenues par un examen clinique et un questionnaire qui inclut les douleurs , la capacité de travailler, la capacité de marcher, l’usage d’analgésiques et la satisfaction de la chirurgie. Le résultat a été estimé comme excellent pour 23 malades, bon pour 13 malades, juste pour 9 et mauvais pour 5 malades. Les patients avec une fusion concomitante avaient des résultats bons ou excellents et étaient plus satisfaits alors que ceux avec symptômes préopératoires anciens avaient des résultats moyens ou mauvais et étaient moins satisfaits.

Migration of the Trabecular Metal Monoblock Acetabular Cup System

Fifty-one primary total hip arthroplasties were performed using Trabecular Metal Monoblock Acetabular Cup System (Zimmer Inc, Warsaw, IN). In a 2-year prospective study, its behavior was closely monitored by clinical, radiologic, and component migration assessment by Ein-Bild-Röntgen-Analyse method. There were no complications. The mean Harris hip score was improved from 41 to 95. A polar gap at the postoperative radiograph was noted at 25% of the arthroplasties, most of which subsequently filled with bone within 6 months. The mean total absolute migration was 0.67 mm. The implant showed excellent early clinical and radiographic behavior. The 2-year migration rate study, as index of long-term survival and success, showed very good early implant stability and, in all cases except one, superior to the available studies for similar design acetabular cups.

Combined Radiotherapy and Indomethacin for the Prevention of Heterotopic Ossification after Total Hip Arthroplasty

Background and Purpose:Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. The aim of this study was to evaluate the efficacy of combined radiotherapy and indomethacin as compared to indomethacin alone for the prevention of HO after hip arthroplasty.Patients and Methods:96 patients were prospectively enrolled to receive either a single dose of postoperative radiotherapy of 7.0 Gy and indomethacin for the first 15 postoperative days or indomethacin alone for the same period. A historical group of 50 patients that received indomethacin alone served as control. Primary endpoint was the radiographic evidence of HO at 6 months. Secondary endpoints were the evaluation of factors related to HO development, side effects from each treatment, and group differences in the clinical assessment with the Merle d’Aubigné Score.Results:Four patients in the combined-therapy group developed HO compared to 13 patients in the indomethacin group (p < 0.05) and 13 patients in the historical group (p < 0.05). One patient each in the combined group and the historical group developed Brooker III HO (nonsignificant difference). Duration of surgery and congenital hip disease were associated with HO development in the indomethacin groups, while age and congenital hip disease showed such an association in the combined-therapy group. The side effects and mean Merle d’Aubigné Score did not differ significantly between the three groups.Conclusion:Combined radiotherapy and indomethacin was more efficacious in preventing HO after total hip arthroplasty compared to indomethacin alone and should be considered for future investigation.Hintergrund und Ziel:Heterotope Ossifikationen (HO) sind eine häufige Komplikation nach Implantation einer Hüfttotalendoprothese. In dieser Studie wurde die Wirksamkeit der Kombination von Radiotherapie und Indometacin im Vergleich mit alleinigem Indometacin zur HO-Prävention nach endoprothetischem Hüftgelenkersatz evaluiert.Patienten und Methodik:96 Patienten wurden prospektiv eingeschlossen und erhielten in den ersten 15 Tagen nach dem Eingriff entweder eine postoperative Radiotherapie mit einer Einzeldosis von 7,0 Gy und Indometacin oder nur Indometacin. Eine historische Gruppe von 50 nur mit Indometacin behandelten Patienten diente als Kontrolle. Primärer Endpunkt war die radiologische Evidenz von HO nach 6 Monaten. Sekundäre Endpunkte umfassten die Evaluierung von die HO-Entwicklung begünstigenden Faktoren, von Nebenwirkungen der jeweiligen Behandlung und von Gruppenunterschieden in der klinischen Beurteilung mit dem Score nach Merle d’Aubigné.Ergebnisse:Vier Patienten in der kombinierten Therapiegruppe entwickelten HO im Vergleich zu 13 Patienten in der Indometacingruppe (p < 0,05) und 13 Patienten in der historischen Gruppe (p < 0,05). Je ein Patient in der kombinierter und der historischen Gruppe entwickelte HO Brooker III (nichtsignifikanter Unterschied). Operationsdauer und kongenitale Hüftdysplasie waren in den Indometacingruppen mit der Entwicklung von HO assoziiert, während Alter und kongenitale Hüftdysplasie in der kombinierten Therapiegruppe eine solche Assoziation zeigte. Die Nebenwirkungen und der durchschnittliche Score nach Merle d’Aubigné zeigten keine signifikanten Unterschiede zwischen den drei Gruppen.Schlussfolgerung:Die Kombination von Radiotherapie und Indometacin war zur HO-Prävention nach Implantation einer Hüfttotalendoprothese effektiver als alleiniges Indometacin und erfordert weitere Untersuchungen.

Intrinsic haemangioma of the median nerve: report of a case and review of the literature.

Intrinsic haemangioma of the median nerve is an extremely rare tumor that represents a challenge to diagnose and treat. Only a few cases have been reported in the literature. We present a 10‐year‐old girl who was diagnosed having an intrinsic haemangioma of the median nerve and treated with total surgical resection of the tumor, under high magnification, using microneurolysis and without the need to resect and graft the median nerve. Three years later, the patient is free of symptoms and no recurrence of the mass was noticed.

Long Term Outcomes of Total Hip Arthroplasty With Custom Made Femoral Implants in Patients With Congenital Disease of Hip.

We evaluated the outcomes of total hip arthroplasty in 67 patients (86 hips) with congenital hip disease and excessive abnormal anatomy of the proximal femur with the use of custom-made femoral stems. The design of the stem was based on CT data following the principles of CAD-CAE-CAM technique. No serious complications attributed to the femoral stem were seen. Within a median follow-up of 127.5 months the 10-year survival of any of the components was 95.4% and respective value when aseptic loosening of the stem was considered was 98.1%. Patients with high dislocations had a 10-fold risk for loosening compared to those with low dislocations. No other parameter was associated with outcomes. The clinical and radiological evaluation was in consistency with the above outcomes.