Publications by authors named "Konstantinos Tsitskaris"

11 Publications

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Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS).

Knee Surg Relat Res 2021 Feb 25;33(1). Epub 2021 Feb 25.

Orthopaedics Department, Whipps Cross University Hospital, Barts Health NHS Trust, Whipps Cross Road, Leytonstone, London, E11 1NR, UK.

Background: To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS).

Materials And Methods: We conducted a systematic review of the literature. Five studies with a total of 552 TKAs were included for analysis. The methodological quality of the articles was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. Functional outcomes, complications and revision rates were assessed. The mean age was 61 years (range 33-94 years) and the mean follow-up period was 61.1 months (range 0.2-35 years).

Results: All the studies reported improvement in knee function following TKA. Post-operative stiffness was the most frequently reported complication, affecting 32.7% (n = 32) of patients in our review. Symptomatic recurrence of PVNS, component loosening, tibial-component fracture, instability and periprosthetic infection were the main factors leading to the need for revision TKA.

Conclusion: The findings of this review support the use of TKA to alleviate the functional limitations and pain due to knee degeneration in patients with PVNS. The operating surgeon should be aware of the increased risk of post-operative stiffness, as well as a potentially higher risk of infection. Implant survival should also be considered inferior to the one expected for the general population undergoing TKA.
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http://dx.doi.org/10.1186/s43019-021-00088-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905640PMC
February 2021

Total knee arthroplasty in patients with Paget's disease of bone: A systematic review.

World J Orthop 2018 Oct 18;9(10):229-234. Epub 2018 Oct 18.

Department of Trauma and Orthopaedic Surgery, Barts Health NHS Trust, London E1 1BB, United Kingdom.

Aim: To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with Paget's disease of bone (PDB).

Methods: A systematic review of the literature was performed. Four studies with a total of 54 TKAs were included for analysis. Functional outcomes, pain scores, complications and revision rates were assessed. The mean age was 72.0 years and the mean follow-up was 7.5 years.

Results: All studies reported significant improvement in knee function and pain scores following TKA. There were 2 cases of aseptic loosening, with one patient requiring revision of the femoral component 10 years after the index procedure. Malalignment, bone loss, soft tissue contractures were the most commonly reported intra-operative challenges. There were five cases (9%) that were complicated by intra-operative patellar tendon avulsion.

Conclusion: The findings support the use of TKA in patients with PDB. The post-operative functional outcomes are largely similar to other patients, however there are specific perioperative challenges that have been highlighted, in particular the high risk for patellar tendon avulsion.
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http://dx.doi.org/10.5312/wjo.v9.i10.229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198295PMC
October 2018

Internal bone transport using a cannulated screw as a mounting device in the treatment of a post-infective ulnar defect.

Strategies Trauma Limb Reconstr 2016 Apr 15;11(1):63-7. Epub 2016 Feb 15.

Department of Orthopaedics, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.

Bone transport techniques can be used to address the segmental bone loss occurring after debridement for infection. Secure fixation of the bone transport construct to the bone transport segment can be challenging, particularly if the bone is small and osteopenic. We report a case of a segmental ulnar bone defect in a young child treated with internal bone transport using a cannulated screw as the mounting device. We found this technique particularly useful in the treatment of bone loss secondary to infection, where previous treatment and prolonged immobilisation had led to osteopenia. This technique has not been previously reported.
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http://dx.doi.org/10.1007/s11751-016-0246-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814383PMC
April 2016

Treatment of articular cartilage lesions of the knee by microfracture or autologous chondrocyte implantation: a systematic review.

Arthroscopy 2015 Apr 3;31(4):732-44. Epub 2015 Feb 3.

Sydney Orthopaedic Research Institute, Sydney, Australia. Electronic address:

Purpose: We performed a systematic review of the treatment of articular cartilage lesions of the knee by microfracture or autologous chondrocyte implantation to determine the differences in patient outcomes after these procedures.

Methods: We searched PubMed/Medline, Embase, and The Cochrane Library databases in the period from January 10 through January 20, 2013, and included 34 articles in our qualitative analysis.

Results: All studies showed improvement in outcome scores in comparison with baseline values, regardless of the treatment modality. The heterogeneity of the results presented in the studies precluded a meta-analysis.

Conclusions: Microfracture appears to be effective in smaller lesions and is usually associated with a greater proportion of fibrocartilage production, which may have an effect on durability and eventual failure. Autologous chondrocyte implantation is an effective treatment that may result in a greater proportion of hyaline-like tissue at the repair site, which may in turn have a beneficial effect on durability and failure; it appears to be effective in larger lesions. Autologous chondrocyte implantation with periosteum has been shown to be associated with symptomatic cartilage hypertrophy more frequently than autologous chondrocyte implantation with collagen membrane. Matrix-associated autologous chondrocyte implantation is technically less challenging than the other techniques available, and in lesions greater than 4 cm(2), it has been shown to be more effective than microfracture.

Level Of Evidence: Level IV, systematic review of Level I-IV studies.
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http://dx.doi.org/10.1016/j.arthro.2014.11.023DOI Listing
April 2015

Osteoid osteoma as a cause of anterior ankle pain in a runner.

BMJ Case Rep 2014 May 23;2014. Epub 2014 May 23.

University College Hospital, London, UK.

We report the case of an osteoid osteoma in the dorsal talar neck of a healthy long-distance runner, masquerading as anterior ankle impingement syndrome. We discuss the diagnosis and successful treatment using percutaneous CT-guided laser photocoagulation. A concise review of the principles of the management of osteoid osteomas is also presented.
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http://dx.doi.org/10.1136/bcr-2014-204365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039962PMC
May 2014

Bilateral patellar tendon rupture.

JRSM Short Rep 2013 4;4(11):2042533313499557. Epub 2013 Oct 4.

Trauma and Orthopaedics Department, Whipps Cross University Hospital, Leytonstone, London E11 1NR, UK.

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http://dx.doi.org/10.1177/2042533313499557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831857PMC
December 2013

Pudendal nerve palsy in trauma and elective orthopaedic surgery.

Injury 2013 Dec 8;44(12):1721-4. Epub 2013 Sep 8.

Department of Trauma and Orthopaedics, University College Hospital, 235 Euston Road, London NW1 2BU, UK. Electronic address:

The incidence of pudendal nerve palsy following routine trauma and elective orthopaedic surgery procedures ranges from 1.9% to 27.6%. Excessive and/or prolonged traction against the perineal post of a traction table, leading to direct compression and localised ischaemia to the nerve are suggested mechanisms of injury. Misuse of traction and the inappropriate placement of the perineal post, leading to crushing and stretching of the pudendal nerve, are two main contributing factors leading to its postoperative palsy. The sequelae may be sensory, motor or mixed. In most cases, these injuries are transient and tend to resolve within several weeks or months. However, complete neurological recovery may be unpredictable and the effects of ongoing dysfunction potentially disastrous for the individual. In terms of preventative measures, magnitude and duration of traction time should be minimised; traction should be limited to the critical operative steps only. Additionally, the perineal post should be placed between the genitalia and the contralateral leg. A well-padded, large-diameter perineal post should be used (>10cm). Adequate muscle relaxation during anaesthesia is particularly important in young men who have strong muscles and thus require larger traction forces when compared to elderly patients. Orthopaedic surgeons should be aware of the pathophysiology behind the development of this palsy and the measures that can be employed to reduce its occurrence. In procedures where a traction table is employed, consenting for pudendal nerve palsy should be considered by the surgical team.
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http://dx.doi.org/10.1016/j.injury.2013.09.001DOI Listing
December 2013

The surgical anatomy of intra-abdominal prosthetic dislocation during hip arthroplasty.

Hip Int 2012 Mar-Apr;22(2):184-8

Department of Orthopaedics, Queen Mary's Hospital, Sidcup, UK.

Hip replacement surgery remains one of the most successful and common operations in modern orthopaedics. Many surgical approaches to the hip have been described. A potential anatomical weakness exists between the hip joint and the retroperitoneal space. We describe this potential space, which lies superficial to iliopsoas and its importance in hip replacement surgery. The clinical relevance of this space is illustrated by 2 cases of retro-peritoneal migration of prosthetic femoral heads and the consequences of these.
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http://dx.doi.org/10.5301/HIP.2012.9228DOI Listing
August 2012

The prevalence of cam-type femoroacetabular morphology in young adults and its effect on functional hip scores.

Hip Int 2012 Jan-Feb;22(1):68-74

Department of Orthopaedics, King's College Hospital, London, UK.

Pelvic computed tomography (CT) scans of forty five young adults were reviewed and the alpha angle was calculated. The patients were selected on the basis of an age of less than 40 years and the absence of any CT evidence of previous hip pathology. An alpha angle of >55º was considered positive for cam morphology. The non-arthritic hip score and the University of California Los Angeles activity score were completed by the selected group of patients. The mean age of the individuals was 33 years (range, 20 to 40). The mean alpha angle at the superoinferior position of the anterosuperior quadrant of the femoral neck was 50.1º on the right side and 49.6º on the left. The prevalence of cam morphology was found to be 20% in the right hip and 17.7% in the left hip. There was a relatively higher prevalence of cam morphology in men. We also compared the functional scores of patients with an alpha angle >55º and those with an alpha angle =55º. We found no statistically significant difference between the two groups for both scores.
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http://dx.doi.org/10.5301/HIP.2012.9074DOI Listing
July 2012