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Pulmonary embolism after shoulder surgery:Is it a real threat?

World Journal of Methodology 2025年第1期15卷 42-50页

作者： Charalampos Pitsilos Pericles Papadopoulos Panagiotis Givissis byron chalidis 2^(nd)Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54635Greece 1^(st)Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

Pulmonary embolism(PE)is a rare but devastating complication of shoulder *** from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional *** frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 *** is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of *** usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be *** for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT *** ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 *** most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of *** with DVT may also present with swelling and pain of the respective *** treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,*** instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal *** important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital *** physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.

关键词： Pulmonary embolism Venous thromboembolism Shoulder surgery Shoulder arthroscopy Shoulder arthroplasty

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Management of geriatric acetabular fractures:Contemporary treatment strategies

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World Journal of Clinical Cases 2024年第13期12卷 2151-2156页

作者： Theodoros Tosounidis byron chalidis Academic Department of Orthopaedic Surgery Heraklion University HospitalUniversity of CreteGreeceHeraklion 71500Greece 1^(st)Department of Orthopaedic School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 57010Greece

Acetabular fractures in the geriatric population are typically low-energy fractures resulting from a fall from standing *** bone quality in the elderly,as well as this population’s concomitant medical comorbidities,render the management of such fractures challenging and ***-operative management remains the mainstay of treatment,although such a choice is associated with numerous and serious complications related to both the hip joint as well as the general condition of the *** the other hand,operatively treating acetabular fractures(e.g.,with osteosynthesis or total hip arthroplasty)is gaining *** can be performed with open reduction and internal fixation or with minimally invasive *** hip arthroplasty could be performed either in the acute phase combined with osteosynthesis or as a delayed procedure after a period of non-operative management or after failed osteosynthesis of the *** of the implemented treatment,orthogeriatric co-management is considered extremely crucial,and it is currently one of the pillars of a successful outcome after an acetabular fracture.

关键词： Acetabular fractures Geriatric fractures Fracture fixation Total hip arthroplasty Mortality Morbidity

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Graft choices for anterolateral ligament knee reconstruction surgery: Current concepts

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World Journal of Clinical Cases 2022年第24期10卷 8463-8473页

作者： byron chalidis Charalampos Pitsilos Dimitrios Kitridis Panagiotis Givissis 1^(st)Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece 2^(nd)Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54635Greece

The anterolateral ligament(ALL)is a primary structure of the anterolateral complex of the knee that contributes to internal rotational stability of the *** of the ALL is commonly associated with rupture of the anterior cruciate *** left untreated,ALL lesions may lead to residual anterolateral rotational instability of the knee after anterior cruciate ligament reconstruction,which is a common cause of anterior cruciate ligament graft *** function of the ALL can be restored by lateral extraarticular tenodesis or anterolateral ligament reconstruction(ALLR).In the lateral extraarticular tenodesis procedure,a strip of the iliotibial band is placed in a non-anatomical position to restrain the internal rotation of the tibia,while in ALLR,a free graft is fixed at the insertion points of the native *** and semitendinosus grafts have mainly been utilized for ALLR,but other autografts have also been ***,allografts and synthetic grafts have been applied to minimize donor-site morbidity and maximize the size and strength of the ***,there has been no strong evidence to fully support one method over another thus *** present review presents a detailed description of the graft choices for ALLR and the current literature available in regard to the effectiveness and outcomes of published surgical techniques.

关键词： Anterolateral ligament Reconstruction Lateral extraarticular tenodesis Anterior cruciate ligament Hamstrings Gracilis Semitendinosus

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Tibial tubercle osteotomy in revision total knee arthroplasty: A systematic review

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World Journal of Orthopedics 2020年第6期11卷 294-303页

作者： byron chalidis Dimitrios Kitridis Panagiotis Givissis 1^st Orthopaedic Department Aristotle University of ThessalonikiGeorge Papanikolaou HospitalThessaloniki 55210Greece

BACKGROUND Tibial tubercle osteotomy(TTO) is a well-established surgical technique to deal with a stiff knee in revision total knee arthroplasty(RTKA). However, several reports have described potential osteotomy-related complications such as nonunion, tibial tubercle migration and fragmentation, and metalware related *** To evaluate the literature and estimate the efficiency of TTO in RTKA in terms of osteotomy union, knee mobility and *** MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials were investigated for completed studies until February 2020. The principle outcome of the study was the incidence of union of the osteotomy. Secondary outcomes were the knee range of motion as well as the TTO-related and overall procedure complication *** Fifteen clinical studies with a total of 593 TTOs were included. The TTO union rate was 98.1%. Proximal migration and anterior knee pain were the most common TTO-related complications accounting for 6.9% and 6.4% of all cases,respectively. However, only 2.2% of cases suffering from anterior knee pain needed hardware removal. Knee flexion was improved from 82.9° preoperatively to 100.1° postoperatively and total knee range of motion was increased from 73.4° before surgery to 97° after surgery. Stiffness requiring manipulation under anesthesia was recorded in 4.6% of cases. No major complications were *** The current systematic review supports the use of TTO in RTKA, as it is associated with high union rate, significant improvement in knee motion and low osteotomy-related complication risk that rarely leads to secondary tibial tubercle procedures.

关键词： Tibial tubercle osteotomy Knee flexion Extension lag Union Revision total knee arthroplasty Stiff knee

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Surgical treatment outcome of painful traumatic neuroma of the infrapatellar branch of the saphenous nerve during total knee arthroplasty

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World Journal of Orthopedics 2021年第12期12卷 1008-1015页

作者： byron chalidis Dimitrios Kitridis Panagiotis Givissis The First Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient *** To present the results of surgical treatment for ISN after primary TKA,the level of pain relief,and the improvement of knee motion and *** Fifteen patients(13 women,2 men)with persistent medial pain for more than six months after primary TKA,due to osteoarthritis,underwent surgical excision of *** diagnosis was confirmed with the presence of Tinel’s sign along the course of the infrapatellar branch of the saphenous nerve and with pain relief after selective nerve block using local *** loosening,malalignment,instability and infection were excluded systematically in all patients as a source of *** relief in terms of visual analog scale(VAS),active knee range of motion(ROM),and the Knee Society Score(KSS)for pain and function were evaluated preoperatively and at least six months *** The mean patients’age was 71.3±5.4 years *** mean interval between TKA and neuroma excision was 10 mo(range,6 to 14 mo),while the mean follow-up was 8 mo(range:6 to 11 mo).All 15 patients experienced almost complete immediate pain relief and resolution of allodynia and hyperesthesia after *** on the VAS scale improved from 8.6±1.3 preoperatively to 0.8±0.9 at the final follow-up(P=0.001).KSS pain and function scores were improved from 49.3±5.9 and 62.7±12.8 before surgery to 91.8±4.2 and 75.3±11.3 after surgery,respectively(P=0.001 and P=0.015).Active knee ROM was also increased postoperatively from 96±4 to 105±6 degrees(P=0.001).There were no complications and no further operations *** ISN should be considered a potential cause of persistent pain following *** excision not only provides immediate pain relief an

关键词： Total knee arthroplasty Infrapatellar branch of saphenous nerve Neuroma Neurogenic pain Knee osteoarthritis

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In vitro laboratory infection research in orthopaedics:Why,when,and how

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World Journal of Orthopedics 2023年第8期14卷 598-603页

作者： Konstantinos Tsikopoulos Lorenzo Drago Gabriele Meroni Dimitrios Kitridis byron chalidis Fotios Papageorgiou Paraskevi Papaioannidou 1^(st)Department of Pharmacology School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54124Greece Department of Biomedical Sciences for Health School of MedicineUniversity of MilanMilan 20133Italy Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20133Italy 1^(st)Department of Orthopaedic School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 57010Greece Department of Orthopaedic Surgery 404 General Army HospitalLarisa 41222Greece 1^(st)Department of Pharmacology Aristotle University of ThessalonikiThessaloniki 54124Greece

The musculoskeletal system involves multiple tissues which are constantly exposed to being exposed to various biological and mechanical *** such,isolating and studying a particular system from a complex human clinical environment is not always a realistic *** top of that,recruitment limitations,in addition to the nature of orthopaedic interventions and their associated cost,sometimes preclude consideration of human trials to answer a clinical ***,in this mini review,we sought to rationalize the rapid evolution of biomedical research at a basic scientific level and explain why the perception of orthopaedic conditions has fundamentally changed over the last *** more detail,we highlight that the number of orthopaedic in vitro publications has soared since *** but not least,we elaborated on the minimum requirements for conducting a scientifically sound infection-related laboratory experiment to offer valuable information to clinical *** also explained the rationale behind implementing molecular biology techniques,ex vivo experiments,and artificial intelligence in this type of laboratory research.

关键词： Biofilm In vitro Laboratory research Methodology

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Assessing the accuracy of arthroscopic and open measurements of the size of rotator cuff tears: A simulation-based study

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World Journal of Orthopedics 2021年第12期12卷 983-990页

作者： Dimitrios Kitridis Dimosthenis Alaseirlis Nikolaos Malliaropoulos byron chalidis Patrick McMahon Richard Debski Panagiotis Givissis Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54124Greece William Harvey Research Institute Centre for Sports and ExerciseBarts and The London School of Medicine and DentistryQueen MaryUniversity of LondonLondon EC1M 6BQUnited Kingdom McMahon Orthopedics and Rehabilitation University of PittsburghPittsburghPA 15203United States Department of Bioengineering Swanson School of EngineeringUniversity of PittsburghPittsburghPA 15219United States

BACKGROUND Arthroscopic procedures are commonly performed for rotator cuff *** of rotator cuff tears is a commonly performed *** intraoperative evaluation of the tear size and pattern contributes to the choice and completion of the technique and the prognosis of the *** To compare the arthroscopic and open measurements with the real dimensions of three different patterns of simulated rotator cuff tears of known size using a plastic shoulder *** We created three sizes and patterns of simulated supraspinatus tears on a plastic shoulder model(small and large U-shaped,oval-shaped).Six orthopaedic surgeons with three levels of experience measured the dimensions of the tears arthroscopically,using a 5 mm probe,repeating the procedure three times,and then using a ruler(open technique).Arthroscopic,open and computerized measurements were *** A constant underestimation of specific dimensions of the tears was found when measured with an arthroscope,compared to both the open and computerized measurements(mean differences up to-7.5±5.8 mm,P<0.001).No differences were observed between the open and computerized measurements(mean difference-0.4±1.6 mm).The accuracy of arthroscopic and open measurements was 90.5%and 98.5%,*** comparing between levels of experience,senior residents reported smaller tear dimensions when compared both to staff surgeons and *** This study suggests that arthroscopic measurements of full-thickness rotator cuff tears constantly underestimate the dimensions of the *** of more precise arthroscopic techniques or tools for the evaluation of the size and type of rotator cuff tears are necessary.

关键词： Shoulder Arthroscopy Simulation model Rotator cuff tear Supraspinatus tear Cuff tear size

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Subclavian vessels injury:An underestimated complication of clavicular fractures

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World Journal of Critical Care Medicine 2024年第4期13卷 35-43页

作者： byron chalidis Vasileios Davitis Pericles Papadopoulos Charalampos Pitsilos First Orthopaedic Department School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 57010Greece Second Orthopaedic Department School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54635Greece

Clavicle fractures are frequent orthopedic injuries,often resulting from direct trauma or a *** clavicle fractures are treated conservatively without any complications or adverse *** injuries of the subclavian vein or artery are rarely encountered and most commonly associated with high-energy trauma or comminuted clavicle *** are potentially life-threatening conditions leading to hemorrhage,hematoma,pseudoaneurysm or upper limb ***,the clinical presentation might be obscure and easily missed,particularly in closed and minimally displaced clavicular fractures,and timely diagnosis relies on early clinical ***,computed tomography angiography has largely replaced conventional angiography for the assessment of subclavian vessel patency,as it demonstrates high accuracy and temporal resolution,acute turnaround time,and capability of multiplanar *** on the hemodynamic stability of the patient and the severity of the injury,subclavian vessel lesions can be treated conservatively with observation and serial evaluation or *** vascular techniques should be considered in patients with serious hemorrhage and limb ischemia,followed by stabilization of the displaced clavicle *** review aims to provide a comprehensive overview of the incidence,clinical presentation,diagnostic approaches,and current management strategies of clavicle fractures associated with subclavian vessel injuries.

关键词： Clavicle Fracture Subclavian artery Subclavian vein Fracture non-union Postoperative complications

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