Publications by authors named "Ioan-Cristian Stoica"

6 Publications

  • Page 1 of 1

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Results in Superior Rotational Stability Compared with Isolated Anterior Cruciate Ligament Reconstruction in High Grade Pivoting Sport Patients: A Prospective Randomized Clinical Trial.

J Knee Surg 2021 May 1. Epub 2021 May 1.

Foişor Orthopaedics Hospital, Bucharest, Romania.

The purpose of the current randomized clinical trial (RCT) was to evaluate the clinical outcomes of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction and to compare them with those of isolated ACL reconstruction. The hypothesis was that combined ACL and ALL reconstruction will result in superior clinical outcomes in terms of the rotational stability of the knee. This prospective RCT included 57 patients (44 men and 13 women, mean age = 31 ± 7.1 years) who underwent ACL reconstruction either isolated (Group I: 25 patients) or combined with ALL reconstruction (Group II: 32 patients). The evaluation of the patients was done preoperatively and postoperatively at 6 weeks, 12 weeks, 6 months, and 12 months including a clinical examination (Lachman's test, Pivot shift's test, and Rolimeter differential anterior laxity), an objective clinical scores (objective: the International Knee Documentation Committee [IKDC] score) and a subjective clinical scores (subjective: IKDC's score, Lysholm's score, and Tegner's activity score). Postoperative complications of all the patients were recorded. There was a significant difference between the study groups at all follow-up intervals when evaluating the postoperative pivot shift test ( < 0.05) with a superior rotational stability in the group of combined ACL and ALL reconstruction. At the final follow-up evaluation, 36% of the patients from Group I and 6.2% in Group II had a grade I positive pivot shift test ( < 0.05). There was a statistically significant difference between the two groups regarding the number of patients with a grade A IKDC objective score ( < 0.05) at the 6- and 12-month follow-up intervals ( = 0.007). There was a significant difference concerning the IKDC subjective score between the two study groups in favor of the combined ACL and ALL reconstruction group at 12 months postoperatively ( = 0.048). Combined ACL and ALL reconstruction technique was demonstrated to be effective in obtaining a superior control of the rotational knee instability and to improve the clinical objective and subjective outcomes when compared with isolated ACL reconstruction in sports patients with high-grade pivoting shifts.
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http://dx.doi.org/10.1055/s-0041-1729621DOI Listing
May 2021

MoM total hip replacements in Europe: a NORE report.

EFORT Open Rev 2019 Jun 3;4(6):423-429. Epub 2019 Jun 3.

Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.

The purpose of this paper is to determine the prevalence of metal-on-metal (MoM) total hip replacement (THR) in European registries, to assess the incidence of revision surgery and to describe the national follow-up guidelines for patients with MoM THR including resurfacings.Eleven registries of the Network of Orthopaedic Registries of Europe (NORE) participated totalling 54 434 resurfacings and 58 498 large stemmed MoM THRs.The resurfacings and stemmed large head MoM had higher pooled revision rates at five years than the standard total hip arthroplasties (THA): 6.0%, 95% confidence interval (CI) 5.3 to 6.8 for resurfacings; 6.9%, 95% CI 4.4 to 9.4 for stemmed large head MoM; and 3.0%, 95% CI 2.5 to 3.6 for conventional THA.The resurfacings and stemmed large head MoM had higher pooled revision rates at ten years than the standard THAs: 12.1%, 95% CI 11.0 to 13.3 for resurfacings; 15.5%, 95% CI 9.0 to 22 for stemmed large head MoM; and 5.1%, 95% CI 3.8 to 6.4 for conventional THA.Although every national registry reports slightly different protocols for follow-up, these mostly consist of annual assessments of cobalt and chromium levels in blood and MRI (MARS) imaging. Cite this article: 2019;4 DOI: 10.1302/2058-5241.4.180078.
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http://dx.doi.org/10.1302/2058-5241.4.180078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549109PMC
June 2019

Combined Anatomic Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction.

Maedica (Bucur) 2017 Jan;12(1):30-35

Foisor Orthopaedics Clinical Hospital, 35-37 Ferdinand Avenue, Bucharest, Romania ; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

Purpose: The purpose of the current paper was to report the surgical technique of combined anatomic anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction as well as the short term clinical results after this surgical procedure.

Material And Methods: The current prospective study included 32 patients (5 females and 27 males) with combined ACL and ALL reconstruction performed between December 2015 and July 2016. The patients were included in the study taking into consideration the following criteria: chronic ACL lesion, high grade rotational instability (pivot shift grade II and III) and participation in high grade pivoting sports. Patient evaluation followed an established clinical and imaging protocol both preoperatively and at 6 and 12 weeks postoperatively. This included clinical knee stability testing (Lachman test, Pivot shift test), Rolimeter differential laxity testing, subjective and objective IKDC scores and Lysholm score and Tegner score.

Results: Postoperative stability at 6 weeks and 12 weeks as tested with Lachman test (p=0.02 and 0.01, respectively), pivot shift test (p=0.03 and 0.01, respectively) and the Rolimeter arthrometer (p=0.008 and 0.006, respectively) showed a statistically significant difference as compared to preoperative values. Postoperative scores at 6 weeks and 12 weeks as measured using objective IKDC form (p=0.008 and 0.006, respectively), subjective IKDC form (p=0.04 and 0.03, respectively) and Lysholm form (p=0.02 and 0.01, respectively) were statistically significant improved as compared to preoperative values. All patients had a negative Lachman test at 6 and 12 weeks postoperatively. One patient had a positive grade I pivot shift test at 6 weeks postoperatively and two patients had a positive grade I pivot shift test at 12 weeks postoperatively. Differential anteroposterior laxity as measured with the Rolimeter arthrometer improved from 7.19±1.96 mm preoperatively to 0.28±0.45 mm and 0.13±0.34 mm, at 6 weeks and 12 weeks postoperatively, respectively. According to the objective IKDC form, 29 patients were normal or nearly normal (grade A and B) at 6 weeks postoperatively and 31 patients were normal or nearly normal at 12 weeks postoperatively. Subjective IKDC score improved from 47.72±17.18 preoperatively to 56.52±11.74 and 73.38±14.28 at 6 and 12 weeks postoperatively, respectively. Lysholm score improved from 63.44±23.01 preoperatively to 80.41±11.94 and 90.47±8.22 at 6 and 12 weeks postoperatively, respectively. Improved Tegner activity scores were present at 12 weeks postoperatively as compared with 6 weeks postoperatively, but still lower as compared to pre-traumatic scores. No significant complications were present in the current study group.

Conclusions: Combined ACL and ALL reconstruction is an effective surgical procedure, with improved postoperative clinical results and no significant short term complications. Longer follow-up is necessary in order to better evaluate the results of this procedure.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574069PMC
January 2017

Unicameral bone cyst of the calcaneus - minimally invasive endoscopic surgical treatment. Case report.

Rom J Morphol Embryol 2017 ;58(2):689-693

Department of Orthopedics and Trauma, "Carol Davila" University of Medicine and Pharmacy, "Foisor" Orthopedics Hospital, Bucharest, Romania;

The role of arthroscopic surgery for the treatment of various orthopedic pathologies has greatly improved during the last years. Recent publications showed that benign bone lesion may benefit from this minimally invasive surgical method, in order to minimize the invasiveness and the period of immobilization and to increase visualization. Unicameral bone cysts may be adequately treated by minimally invasive endoscopic surgery. The purpose of the current paper is to present the case report of a patient with a unicameral bone cyst of the calcaneus that underwent endoscopically assisted treatment with curettage and bone grafting with allograft from a bone bank, with emphasis on the surgical technique. Unicameral bone cyst is a benign bone lesion, which can be adequately treated by endoscopic curettage and percutaneous injection of morselized bone allograft in symptomatic patients.
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April 2018

Romanian medicine, European medicine.

Knee Surg Sports Traumatol Arthrosc 2017 Jun 28;25(6):1666-1668. Epub 2016 Dec 28.

Centre Hospitalier de Luxembourg - Clinique d'Eich, 78, rue d Eich, 1460, Luxembourg, Luxembourg.

The aim of the present paper is to present the message transmitted by the Presidential Lecture given during the first congress of arthroscopy organised in Romania, in March 2016, by the Romanian Society of Arthroscopy and Sports Trauma (SRATS). The goal was to present the evolution of medical care in Romania over the years, with the remarkable progress made in the first half of the twentieth century and the current status of arthroscopic surgery as seen from the point of view of medical professionals, as well as from a governmental point of view.
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http://dx.doi.org/10.1007/s00167-016-4412-7DOI Listing
June 2017

Venous thromboembolism following major orthopedic surgery.

Maedica (Bucur) 2013 Jun;8(2):189-94

Foisor Clinical Hospital of Orthopedics, Traumatology and Osteo-Articular Tuberculosis, Department of Orthopedic Surgery, Bucharest, Romania.

Abstract: Venous thromboembolism (VTE) is an important complication of major orthopedic surgery (total hip arthroplasty-THA, total knee arthroplasty-TKA, hip fracture surgery-FHS) and is associated with significant morbidity and mortality. Despite this, not all patients receive an appropriate prophylaxis, often due to a disproportionate fear of bleeding complications. A challenge in the management of VTE prophylaxis is to balance the benefits of the treatment with the risk of bleeding. In this article, we review the latest guidelines recommendations regarding prevention of postoperative VTE in patients undergoing orthopedic surgery.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865129PMC
June 2013