Platelet-Rich Plasma Injections as a Treatment for Refractory Patellar Tendinosis: A Meta-Analysis of Randomised Trials

( Leanne Dupley ),( Charalambos P. Charalambous ) 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.3

Purpose: Patellar tendinosis (PT) is a common condition amongst athletes. In this study, we perform a meta-analysis on randomised controlled trials (RCTs) to evaluate the use of platelet-rich plasma (PRP) for refractory PT. Methods: A literature search was undertaken in various databases from their year of inception to October 2015. The primary outcome measure was the Victorian Institute of Sports Assessment-Patella (VISA-P) score. Results: We identified 2 RCTs comparing PRP injections to alternative treatment options (extracorporeal shockwave therapy [ESWT] and dry needling of the tendon). Meta-analysis showed no significant difference in mean VISA-P scores between PRP injection and control at early assessment (2 or 3 months; estimated difference in means, 11.9; standard error [SE], 7.4; 95% confidence interval [CI], -2.7 to 26.4; p=0.109). However, PRP was statistically better than control with regards to VISA-P scores at longer follow-up (6 months or longer; estimated difference in means, 12.7; SE, 4.4; 95% CI, 4.1 to 21.3; p=0.004). Conclusions: There is a paucity of RCTs evaluating the role of PRP in PT. Our results suggest that, based on limited evidence, PRP is superior over other established non-surgical treatments (dry needling and ESWT) for refractory PT. Larger RCTs may allow better characterisation of the role of PRP in this condition.

Alternative practices of achieving anaesthesia for dental procedures: a review

Angelo, Zavattini,Polyvios, Charalambous The Korean Dental Society of Anesthsiology 2018 Journal of Dental Anesthesia and Pain Medicine Vol.18 No.2

Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.

Information Freshness and Packet Drop Rate Interplay in a Two-User Multi-Access Channel

Emmanouil Fountoulakis,Themistoklis Charalambous,Nikolaos Nomikos,Anthony Ephremides,Nikolaos Pappas 한국통신학회 2022 Journal of communications and networks Vol.24 No.3

In this work, we combine the two notions of timelydelivery of information to study their interplay; namely, deadlineconstrainedpacket delivery due to latency constraints andfreshness of information. More specifically, we consider a twousermultiple access setup with random access, in which user 1is a wireless device with a buffer and has external bursty trafficwhich is deadline-constrained, while user 2 monitors a sensorand transmits status updates to the destination. We provideanalytical expressions for the throughput and drop probabilityof user 1. For user 2, we derive in closed form the age ofinformation distribution, the average age of information (AoI),and the probability the AoI to be larger than a certain valuefor each time slot. The relations reveal a trade-off between theaverage AoI of user 2 and the drop rate of user 1: the lower theaverage AoI, the higher the drop rate, and vice versa. Simulationscorroborate the validity of our theoretical results.

Mechanical Reinforcement of Lime Pastes by Electrospun Cellulose Acetate Polymer Fibers

Nikolaos Chousidis,Orestis Charalambous,Meropi Zymaride,Christos N. Christou,Alexandra Christophi,Ioanna Savva,Loucas Kyriakou,Ioannis Ioannou,Theodora Krasia-Christoforou 한국섬유공학회 2021 Fibers and polymers Vol.22 No.3

Lime-based composites have been extensively used throughout the years as plasters/renders and jointing mortarsin building construction. However, the low flexural strength and tensile ductility of these composite building materials, thatare currently still used in the structural and thermal upgrading of existing structures of high cultural and architecturalsignificance, have been a significant drawback. Therefore, researchers have been focusing on the development of novelcomposites involving the use of additives to enhance the tensile and flexural capacity of lime-based materials. For the firsttime in this study, naturally-derived polymer fibers produced by electrospinning have been successfully introduced asadditives in lime pastes aiming to investigate their effect on the mechanical performance of the end composites. Moreprecisely, the introduction of electrospun cellulose acetate (CA) microfibers within lime pastes resulted to a tremendousimprovement of the mechanical properties of the latter. Consequently, the present study paves the pathway towards the use ofelectrospun fibrous additives in the development of advanced composite lime-based building materials, which is currently anunexplored area.

Availability of Total Knee Arthroplasty Implants for Metal Hypersensitivity Patients

( Sanil Harji Ajwani ),( Charalambos P. Charalambous ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.4

Purpose: To provide information on the type of “hypersensitivity-friendly” components available for primary total knee arthroplasty (TKA) in the current market. Materials and Methods: Implant manufactures were identified using the 2013 National Joint Registries of the United Kingdom and Sweden and contacted to obtain information about the products they offer for patients with metal hypersensitivity. Results: Information on 23 TKA systems was provided by 13 implant manufacturers. Of these, 15 systems had options suitable for metal hypersensitivity patients. Two types of “hypersensitivity-friendly” components were identified: 10 implants were cobalt chrome prostheses with a “hypersensitivity-friendly” outer coating and 5 implants were made entirely from non-cobalt chrome alloys. Conclusions: The results of this study suggest that several hypersensitivity TKA options exist, some of which provide the same designs and surgical techniques as the conventional implants. The information in this study can guide TKA surgeons in making informed choices about implants and identifying implants that could be examined in future controlled studies comparing outcomes between “hypersensitivity-friendly” and conventional implants.

Metal Allergy Screening Prior to Joint Arthroplasty and Its Influence on Implant Choice: A Delphi Consensus Study Amongst Orthopaedic Arthroplasty Surgeons

( Arif Razak ),( Ananthan Dave Ebinesan ),( Charalambos Panayiotou Charalambous ) 대한슬관절학회 2013 대한슬관절학회지 Vol.25 No.4

Purpose: This study was undertaken to obtain a consensus amongst joint arthroplasty experts with regards to metal allergy screening prior to joint arthroplasty and the choice of implant in patients with potential metal allergy. Materials and Methods: A web based Delphi consensus study was used including orthopaedic surgeons that had previously published on the topic of knee, hip or shoulder arthroplasty. Two rounds of questionnaires were sent via electronic mail. Consensus was considered reached if agreement was 60% or higher. Results: Eighteen surgeons responded to the first and 17 to the second round of questionnaires. There was consensus that patients having metal arthroplasty surgery should not be routinely questioned about metal allergy prior to surgery. There was consensus that patch testing is not necessary even if metal allergy is suspected. Most respondents agreed in proceeding with cobalt chromium or stainless steel implant in patients suspected of metal allergy regardless of the results of cutaneous patch testing. Conclusions: This consensus study suggests that routine metal allergy screening prior to joint arthroplasty is not essential. The use of traditional cobalt chromium/stainless steel implants is recommended regardless of the patient`s metal allergy status based on expert opinion through this study.

Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

Adam Daniel Gerrard,Charalambos P. Charalambous 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.4

Purpose: A meta­analysis was performed to assess the outcomes following surgical intervention for medial knee plica.Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient­reported postoperative scores of “good” and “excellent”. Meta­analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta­analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8–91.4). In those cases that had non­surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1–87).Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first­line treatment or when symptoms have not responded to non­surgical interventions.Level of Evidence: IV

In Vitro Study on the Antioxidant Activity of a Polyphenol-Rich Extract from Pinus brutia Bark and Its Fractions

Elena Cretu,Maarit Karonen,Juha-Pekka Salminen,Cornelia Mircea,Adriana Trifan,Christiana Charalambous,Andreas I. Constantinou,Anca Miron 한국식품영양과학회 2013 Journal of medicinal food Vol.16 No.11

A crude hydromethanolic extract from Pinus brutia bark and its fractions (diethyl ether, ethyl acetate, n-butanol, and aqueous fractions) were studied with regard to their phenolic content and antioxidant activities. The total phenolics and proanthocyanidins in each extract were quantified by spectrophotometric methods; the polyphenolic profile was analyzed by RP-HPLC-DAD-ESI-MS. All extracts were tested with regard to their ability to scavenge free radicals (ABTS radical cation, superoxide and hydroxyl radicals), reduce ferric ions, and inhibit 15-lipoxygenase. P. brutia bark extracts had high phenolic contents (303.79±7.34–448.90±1.39 mg/g). Except diethyl ether extract, all other extracts contained proanthocyanidins ranging from 225.79±3.94 to 250.40±1.44 mg/g. Several polyphenols were identified by RP-HPLC-DAD-ESIMS: taxifolin in diethyl ether extract, a taxifolin-O-hexoside, catechin, procyanidin dimers, and trimers in ethyl acetate extract. Except diethyl ether extract, all other extracts were effective scavengers of superoxide and hydroxyl radicals (EC50 = 33.5±1.1–54.93±2.85 lg/mL and 0.47±0.06–0.6±0.0 mg/mL, respectively). All extracts had noticeable 15-lipoxygenase inhibitory effects (EC50 = 22.47±0.75–34.43±2.25 lg/mL). We conclude that P. brutia bark is very promising for the dietary supplements industry due to its high free radical scavenging and 15-lipoxygenase inhibitory effects.

Case Report : Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw

( Yogesh V. Joshi ),( Deepu Bhaskar ),( Padmanabh M. Phaltankar ),( Charalambos P. Charalambous ) 대한슬관절학회 2015 대한슬관절학회지 Vol.27 No.4

Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction.

Case Report : Pseudogout: A Rare Cause of Acute Arthritis Following Arthroscopic Anterior Cruciate Ligament Reconstruction

( Mahvash Zaman Mbchb ),( Numaera Sabir Mbchb ),( Simon Peter Mill Mbchb ),( Charalambos P Charalambous Frcs ) 대한슬관절학회 2015 대한슬관절학회지 Vol.27 No.3