FORCE-VELOCITY RELATIONSHIP BETWEEN SPRINTING AND JUMPING TESTING PROCEDURES

The aim of this study was to examine the relationship between the mechanical characteristics of the horizontal and vertical Force-velocity (F-v) profile as well as the performance variables of the sprinting and jumping testing procedures. Twenty high-level sprinters performed two maximal sprints and squat jumps against multiple external loads. Our main findings revealed very large correlations for maximal mechanical power output (Pmax) (r=0.72), as well as for performance variables between the sprinting and jumping tasks (r=-0.81) and large correlations for maximal velocity (V0) (r=0.66). The maximal force (F0) and the slope of the F-v relationship (F-v slope) were not significantly correlated between both tasks. These results suggest that both testing procedures should be performed in order to gain a deeper insight into the maximal mechanical properties and function of the lower-body muscles in high-level sprinters

DIFFERENCES IN MAXIMAL STRENGTH CAPACITY BETWEEN ISOMETRIC SQUAT AND MID-THIGH PULL TESTS IN ELITE TRACK AND FIELD ATHLETES.

The aim of this study was to compare the vertical peak force (PF) generated during the isometric mid-thigh pull (IMTP) and isometric squat (ISqT) performed at the same knee and hip angles. Fourteen elite track and field athletes performed 3 maximal efforts of isometric IMTP and ISqT tests. The vertical PF was measured by a force platform (Kistler 9290CD, AG Winterthur, Switzerland). Our findings revealed significant higher PF and relative PF during ISqT than IMTP (Mean difference: 953 ± 224 N, p \u3c 0.001, d = 1.62 and 14.6 ± 2.4 N.kg-1, p \u3c 0.001, d = 3.8, respectively). The results of this study suggest that ISqT may be more appropriate testing procedure for identifying athletes’ maximum isometric strength capacities in elite track and field athletes

Popliteal artery damage during total knee arthroplasty

AbstractInjury of popliteal artery during total knee arthroplasty is a relatively rare complication. We report on one case of transverse semi-dissection of the popliteal artery during the tibial cut and one case of popliteal pseudoaneurysm formation caused by Hohmann retractors. Diagnosis was made early in the first case but it was delayed in the second due to misdiagnosis of deep vein thrombosis. Both injuries were managed eventually by open surgery. Postoperative clinical examination and ultrasound imaging confirmed the successful restoration of the blood flow. This case report also describes the classification system of the type of vascular damage and describes the mechanism, the clinical presentation, diagnostic modalities and treatment options for these rare complications of total knee arthroplasty surgery

Advanced trauma life support course for medical students. A new era?

IntroductionTrauma represents a major public health issue and is one of the leading causes of death and disability worldwide. A systematic approach toward dealing with trauma patients was facilitated through the ATLS program, which has become a milestone in trauma care. Our new ATLS course for medical students was set in motion in 2015. Our aim was to make medical students familiar with trauma patients interactively, through a program like ATLS, and here we present the results of this endeavor.MethodsA two-day ATLS-Medical Student (MS) course was offered from November 2015 to July 2018, and analysis was performed retrospectively on the data gathered over a three-month period through online questionnaires. Before graduating, 261 newly qualified medical doctors were interviewed and evaluated as part of the ATLS course.ResultsAfter the course, the vast majority of medical students (251 MSs; 96.16%) felt more capable of managing severely injured patients and 58% of students felt that the medical services they offered were better due to the ATLS training. Regarding the educational fee for the course, 56.7% of the students reported that they felt the fee of 100 euros was fair.DiscussionThe interactive format of the course, which differs from more traditional methods of teaching, has been endorsed by medical students. Though they lack clinical experience, that does not prohibit them from acquiring more specialized or specific knowledge, enabling them to excel. Most of the students improved their skillset either in theoretical knowledge, practical skills, or even in the emotional component of the course, i.e., dealing with treating a severely injured patient. It was decided that the program would be re-evaluated and extended to all Greek Medical Schools.ConclusionThe advantage of providing doctors with trauma training at the beginning of their careers is evident. For that reason, it was decided that the program would be re-evaluated and extended to all Greek Medical Schools

Preoperative planning and operation of custom made total HIP arthroplasty

Aim: The aim of this study is to describe the detailed preoperative planning and the operation of custom made total hip arthroplasty for patients with neglected and severe distorted anatomy hips. Materials-Methods: There were 42 patients - 36 female, 6 male - with 52 hips. The mean age was 47.4 years (22-69) and the mean follow-up was 45.4 months (26-72). The protocol consisted of:pelvis-lateral x-rays, CT of pelvis and lower limps and CAD-CAM using special software, which stimulates the operation. Then the last step was the design of custom prosthesis based on the CT and CAD-CAM study. The mean preoperative clinical score according to Aubigne - Postel was 10.02 Results: The postoperative mean clinical score was 17.04. There were 5(9.6%) intraoperative complications, one fracture which was dealt with wires, one dislocation which was dealt with revision of head, one paresis of peroneal nerve which was recovered 14 months later, one injury of femoral vein which was dealt with sutures and in one patient with severe sclerosis of the femoral canal a bonewindow was done to open it. Postoperatively there were five (9.6%) compications. Two patients hadseptic loosening, one patient had an osteolytic lesion without clinical symptoms, one patient had mechanical failure of the cup and one patient had ectopic ossification III. Conclusions: There were two revisions for septic loosening. There was one fracture intraoperatively that it was due to planning of the implant. There was an osteolytic area in one patient without clinical symptoms. It is believed that only the intraoperative fracture was due to the implant design. Although there is no long follow-up the custom-made prosthesis Symbios has very good clinical results regarding the severe distorted anatomy of these hips. Also the use of CT and CAD-CAM made the procedure very accurate, easier for the surgeon and safer for the patient.ΣΚΟΠΟΣ: Η μελέτη αυτή περιγράφει την προ εγχειρητική μελέτη, τον σχεδιασμό και την εκτέλεση εξατομικευμένων ολικών αρθροπλαστικών ισχίων σε 42 ασθενείς -5 2 ισχία - με βαριά και παραμελημένη διαταραχή της ανατομίας. ΥΛΙΚΟ - ΜΕΘΟΔΟΣ: Στην Πανεπιστημιακή Ορθοπαιδική Κλινική Ιωαννίνων από τον Μάρτιο 1999 έως τον Ιούλιο 2004 και μελετήθηκαν με αξονική τομογραφία 165 ασθενείς και 185 ισχία. Από αυτούς τους ασθενείς 120 υπεβλήθησαν - λόγω διαταραχής της ανατομίας - σε μελέτη CAD-CAM, και από αυτούς τους ασθενείς 42 (36 γυναίκες - 6 άνδρες, μέση ηλικία 47.4 έτη) 52 ισχία, 10 ασθενείς είχαν αμφοτερόπλευρο ΣΕΙ- υπεβλήθησαν μετά από μελέτη και σχεδιασμό σε επέμβαση εξατομικευμένης ολικής αρθροπλαστικής ισχίου. Ο μέσος χρόνος παρακολούθησης ήταν 45.4 μήνες(26-72). Η κύρια ένδειξη για την χειρουργική επέμβαση σε όλους τους ασθενείς ήταν ο πόνος που δεν παρουσίασε ύφεση παρόλο την αυστηρή συντηρητική και φαρμακευτική αγωγή που είχε προηγηθεί. ΑΠΟΤΕΛΕΣΜΑΤΑ: Η κλινική αξιολόγηση έγινε με την κλίμακα Aubigne-Postel. Το προεγχειρητικό σκορ ήταν 10.08(6-12) και το μετεγχειρητικό ήταν 17.04(12-18). Υπήρξαν 5(9.6%) διεγχειρητικές επιπλοκές, ένα κάταγμα που αντιμετωπίστηκε με σύρμα, ένα εξάρθρημα που αντιμετωπίστηκε με αλλαγή κεφαλής, δημιουργία οστικού παραθύρου για την διάνοιξη του μηριαίου αυλού, μία πάρεση περονιαίου νεύρου που επανήλθε 14 μήνες μετά, και ένας τραυματισμός μηριαίας φλέβας όπου έγινε συρραφή. Μετεγχειρητικά υπήρξαν 5(9.6%) επιπλοκές, δύο σηπτικές χαλαρώσεις, μία οστεολυτική εστία χωρίς κλινικά σημεία, μία έκτοπη οστεοποίηση III όπου έγινε χειρουργική αφαίρεση, μία επιπολής φλεγμονή που αντιμετωπίστηκε με αντιβιοτικά και μία αποτυχία κυπελλίου που έγινε αντικατάσταση. ΣΥΜΠΕΡΑΣΜΑΤΑ: Από τις 52 προθέσεις σήμερα 45.4 μήνες μετά το χειρουργείο έχουν αντικατασταθεί δύο λόγω σηπτικής χαλάρωσης και διατηρούνται οι 50. Μία ασθενής έχει εμφανίσει μία οστεολυτική εστία αλλά συνεχίζει να φέρει την πρόθεση μιας και δεν υπάρχουν κλινικά συμπτώματα. Όλοι οι ασθενείς εκτός από μία έχουν αναπτύξει υψηλό κλινικό σκορ 17.04 από τον πρώτο χρόνο. Αν και ο χρόνος παρακολούθησης είναι μικρός - 45.4 μήνες (26-72) - η πρόθεση έχει παρουσιάσει πολύ καλά αποτελέσματα αναλογιζόμενοι πάντα την βαριά παραμόρφωση της ανατομίας των ισχίων και την αδυναμία πλήρης εφαρμογής πρόθεσης χωρίς τσιμέντο. Τέλος τα αποτελέσματα της μελέτης πιστεύουμε ότι δικαιολογούν πλήρως την χρήση της αξονικής τομογραφίας και μελέτης CAD-CAM σε παρόμοιες περιπτώσεις. Με τον τρόπο αυτό η επέμβαση είναι πιο ακριβής, ευκολότερη για τον χειρουργό και ασφαλέστερη για τον ασθενή

Incidence of Heterotopic Ossification in Patients Receiving Radiation Therapy following Total Hip Arthroplasty

Heterotopic ossification (HO) is a frequent complication of hip surgery. In this study the incidence of HO is analyzed in high risk patients who received radiation therapy (RT) after total hip replacement (THA) with regular and miniposterolateral hip approach. Two hundred and thirty five high risk patients received a single dose of 700 rad after THA. The incidence of HO was 15.7%. The incidence of HO in the high risk subgroup with the miniincision was lower (5.7%) but not significantly different (P=0.230). Hypertrophic osteoarthritis was demonstrated to be the consistent predisposing factor for HO formation (P=0.005)

Leg Length Discrepancy Due to Loss of Femoral Antecurvatum After Elastic Stable Intramedullary Nailing of Diaphyseal Fractures of the Femur in Children

Limb length discrepancy (LLD) is a frequent complication after elastic stable intramedullary nailing (ESIN) of femoral shaft fractures in children. It is the result of either shortening or lengthening of the affected limb. A shorter limb is usually observed when there is no strict adherence to the main indication of the technique, which is a transverse or short oblique fracture of the diaphysis. A longer limb may be the result of either improper reduction and significant dissociation of fracture fragments, or stimulation of growth of the fractured bone of the child, known as overgrowth. We describe a potential third cause of limb lengthening after treating femoral shaft fractures with the ESIN technique. LLD may be the result of acute femur lengthening due to the loss of normal femoral antecurvatum

Isolated Avulsion Fracture of Patellar Attachment of Medial Patellotibial and Medial Patellomeniscal Ligaments in the Presence of Trochlear Dysplasia: An Indication for Acute Surgical Repair

We present the case of a 13-year-old female athlete with acute traumatic lateral patellar dislocation. Patella reduced spontaneously with knee extension. Clinical examination revealed pain and tenderness at the middle/inferior part of the medial patellar border. An MRI showed an avulsion fracture at the middle/inferior part of the medial patellar border along with type C dysplastic trochlea and medial femoral condyle hypoplasia. On examination under anesthesia, the patella was stable in extension, indicating intact medial patellofemoral ligament (MPFL), but dislocated beyond 30 degrees of knee flexion. Surgical repair of the common patellar attachment of medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML) by means of strong nonabsorbable transosseous sutures was performed, in order to allow healing of MPTL/MPML with the patella centered on the trochlear groove. The follow-up was uncomplicated. It is concluded that isolated acute traumatic insufficiency of MPTL/MPML with coexisting trochlear dysplasia, even with intact MPFL, is an indication for acute surgical MPTL/MPML repair in order to compensate for the inherent osseous instability of the patellofemoral joint

Current Concepts on the Application, Pharmacokinetics and Complications of Antibiotic-Loaded Cement Spacers in the Treatment of Prosthetic Joint Infections

Prosthetic joint infection (PJI) is a devastating complication of total joint replacement surgery. It affects about 2% of primary total joint replacements. Treatment aims at infection eradication and restoration of patient’s mobility. Two-stage revision arthroplasty with an interim application of an antibiotic-loaded cement spacer (ALCS) is the widely accepted treatment for PJI. Spacers are powerful local carriers of antibiotics at the site of infection, effective against biofilm-protected microbes. On the other hand, spacers permit some mobility of the patient and facilitate final prosthesis implantation. ALCS’s are either commercially available or prepared intraoperatively on prefabricated or improvised molds. Antibiotic elution from the spacer depends on the amount of the antibiotic used for cement impregnation, at the expense of mechanical stiffness of the spacer. The antibiotic should not exceed 4g per 40g of bone cement to preserve the mechanical properties of the cement. Spacers are frequently accompanied by local or systemic complications. The spacer may break, dislocate and compress vessels or nerves of the limb. Systemic complications are the result of excess elution of antibiotic and include nephrotoxicity, hepatotoxicity, ototoxicity, allergic reactions or neutropenia. Elderly patients with comorbidities are at risk to present such complications. Microbial resistance is a potential risk of long-lasting spacer retention. Persisting infection may require multiple spacer replacements

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Mutational Pattern in the Fourth Pandemic Phase in Greece

The aim of this study is to investigate the circulating variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from Athens and from rural areas in Greece during July and August 2021. We also present a rapid review of literature regarding significant SARS-CoV-2 mutations and their impact on public health. A total of 2500 nasopharyngeal swab specimens were collected from suspected COVID-19 cases (definition by WHO 2021b). Viral nucleic acid extraction was implemented using an automatic extractor and the RNA recovered underwent qRT-PCR in order to characterize the specimens as positive or negative for SARS-CoV-2. The positive specimens were then used to identify specific Spike gene mutations and characterize the emerging SARS-CoV-2 variants. For this step, various kits were utilized. From the 2500 clinical specimens, 220 were tested positive for SARS-CoV-2 indicating a prevalence of 8.8% among suspected cases. The RT-PCR Ct (Cycle threshold) Value ranged from 19 to 25 which corresponds to medium to high copy numbers of the virus in the positive samples. From the 220 positive specimens 148 (67.3%) were from Athens and 72 (32.7%) from Greek rural areas. As far as the Spike mutations investigated: N501Y appeared in all the samples, D614G mutation appeared in 212 (96.4%) samples with a prevalence of 87.2% in Athens and 98.6% in the countryside, E484K had a prevalence of 10.8% and 12.5% in Athens and the rural areas, respectively. K417N was found in 18 (12.2%) samples from Athens and four (5.6%) from the countryside, P681H was present in 51 (34.5%) Athenian specimens and 14 (19.4%) specimens from rural areas, HV69-70 was carried in 32.4% and 19.4% of the samples from Athens and the countryside, respectively. P681R had a prevalence of 87.2% in Athens and 98.6% in rural areas, and none of the specimens carried the L452R mutation. 62 (28.2%) samples carried the N501Y, P681H, D614G and HV69-70 mutations simultaneously and the corresponding variant was characterized as the Alpha (UK) variant (B 1.1.7). Only six (2.7%) samples from the center of Athens had the N501Y, E484K, K417N and D614G mutations simultaneously and the virus responsible was characterized as the Beta (South African) variant (B 1.351). Our study explored the SARS-CoV-2 variants using RT-PCR in a representative cohort of samples collected from Greece in July and August 2021. The prevalent mutations identified were N501Y (100%), D614G (96.4%), P681R (90.1%) and the variants identified were the Delta (90.1%), Alpha (28.2%) and Beta (2.7%)