Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
The timing of performing knee arthroplasties in bilateral osteoarthritic knees remains controvers... more The timing of performing knee arthroplasties in bilateral osteoarthritic knees remains controversial. Our aim was to compare one-stage with two-stage bilateral knee arthroplasties (TKA). Between November 2004 and April 2008, 128 patients (72 female and 56 male) underwent one-stage bilateral TKAs. Another group of 115 patients that underwent two-stage procedures during the same period formed the control group. All patients received the same type of anaesthesia. Study parameters included age, weight, medical co-morbidities, length of hospital stay, blood loss, post-operative complications and functional outcome. There were no significant differences between the two groups. Co-morbidities and functional outcome based on the Knee Society Score were similar in both groups. In the one-stage group the length of hospital stay and blood losses were higher than the two-stage group; however less than double compared to the two-stage group. The early post-operative complications were higher but...
Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
Purpose: To evaluate the rate of anatomic restrictions on MR imaging which may prevent anterior c... more Purpose: To evaluate the rate of anatomic restrictions on MR imaging which may prevent anterior cruciate ligament (ACL) double-bundle reconstruction (DBr) technique. The hypothesis was that some patients may not meet the criteria for this procedure. Material and Methods: From November 2013 to June 2016, 680 consecutive knee magnetic resonance (MR) imaging studies, from 656 patients (322 males and 334 females; age range 2-85 years; mean age 44.5 years; SD ± 18.8) were retrospectively reviewed. Exclusion criteria included: (i) presence of non-anatomic parameters (open physes, severe osteoarthritic changes, multiligamentous injuries), (ii) previous ACL reconstruction and (iii) incomplete MR imaging examination. Following the exclusion of 128 patients (139 MR imaging studies), 528 patients (541 MR imaging studies) comprised the study group. The femoral notch width (FNw) was measured on coronal T1-w whereas the ACL tibial insertion site (TIS) length was measured on sagittal fat-suppresse...
Introduction: To investigate the healing process of the harvested patellar tendon at 12±2 and 24±... more Introduction: To investigate the healing process of the harvested patellar tendon at 12±2 and 24±2 months following Bone-Patellar-Bone (BTB) Anterior Cruciate Ligament (ACL) reconstruction. Methods: 30 football players were enrolled in our study and examined at 12±2 and 24±2 months postoperatively. Donor and contralateral tendons evaluated with a high frequency ultrasound transducer. The maximum anteroposterior (MAP) and maximum transverse (MT) diameters of the patellar tendon and associated defect at the site of the tendon incision measured at its proximal, middle and distal thirds. The presence of vascular flow was examined with Doppler imaging. Echogenicity of the patellar tendon defect was graded as low, mixed or normal compared to the contralateral tendon. Results: There was no statistically significant difference between the mean MAP and MT diameters of the donor tendons at 12±2 and 24±2 months postoperatively (P>0.05). The mean MAP and MT diameters of the patellar tendon d...
Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in ... more Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.
Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
The timing of performing knee arthroplasties in bilateral osteoarthritic knees remains controvers... more The timing of performing knee arthroplasties in bilateral osteoarthritic knees remains controversial. Our aim was to compare one-stage with two-stage bilateral knee arthroplasties (TKA). Between November 2004 and April 2008, 128 patients (72 female and 56 male) underwent one-stage bilateral TKAs. Another group of 115 patients that underwent two-stage procedures during the same period formed the control group. All patients received the same type of anaesthesia. Study parameters included age, weight, medical co-morbidities, length of hospital stay, blood loss, post-operative complications and functional outcome. There were no significant differences between the two groups. Co-morbidities and functional outcome based on the Knee Society Score were similar in both groups. In the one-stage group the length of hospital stay and blood losses were higher than the two-stage group; however less than double compared to the two-stage group. The early post-operative complications were higher but...
Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
Purpose: To evaluate the rate of anatomic restrictions on MR imaging which may prevent anterior c... more Purpose: To evaluate the rate of anatomic restrictions on MR imaging which may prevent anterior cruciate ligament (ACL) double-bundle reconstruction (DBr) technique. The hypothesis was that some patients may not meet the criteria for this procedure. Material and Methods: From November 2013 to June 2016, 680 consecutive knee magnetic resonance (MR) imaging studies, from 656 patients (322 males and 334 females; age range 2-85 years; mean age 44.5 years; SD ± 18.8) were retrospectively reviewed. Exclusion criteria included: (i) presence of non-anatomic parameters (open physes, severe osteoarthritic changes, multiligamentous injuries), (ii) previous ACL reconstruction and (iii) incomplete MR imaging examination. Following the exclusion of 128 patients (139 MR imaging studies), 528 patients (541 MR imaging studies) comprised the study group. The femoral notch width (FNw) was measured on coronal T1-w whereas the ACL tibial insertion site (TIS) length was measured on sagittal fat-suppresse...
Introduction: To investigate the healing process of the harvested patellar tendon at 12±2 and 24±... more Introduction: To investigate the healing process of the harvested patellar tendon at 12±2 and 24±2 months following Bone-Patellar-Bone (BTB) Anterior Cruciate Ligament (ACL) reconstruction. Methods: 30 football players were enrolled in our study and examined at 12±2 and 24±2 months postoperatively. Donor and contralateral tendons evaluated with a high frequency ultrasound transducer. The maximum anteroposterior (MAP) and maximum transverse (MT) diameters of the patellar tendon and associated defect at the site of the tendon incision measured at its proximal, middle and distal thirds. The presence of vascular flow was examined with Doppler imaging. Echogenicity of the patellar tendon defect was graded as low, mixed or normal compared to the contralateral tendon. Results: There was no statistically significant difference between the mean MAP and MT diameters of the donor tendons at 12±2 and 24±2 months postoperatively (P>0.05). The mean MAP and MT diameters of the patellar tendon d...
Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level... more Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.
Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in ... more Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.
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