Tsoukas Dimitrios, MD

Director Orthopaedic Clinic Athens Euroclinic

Director Minimally Invasive Orthopaedic and Sports Medicine Surgery Center MIOSMED Center



            Full thickness articular cartilage lesions of the knee are among the important problems in current orthopaedic surgery.  Cartilage lesions can be managed with a wide spectrum of treatment modalities.  Articular repair procedures such as abrasion chondroplasty microfracturing and articular reconstructive procedures with autologous chondrocyle implantation and mosaicplasty have been preferred.


·       Defects ≤ 2-2,5cm2

·       Stable knee normally aligned

·       Less than 60 years old


The rehabilitation program after microfracture is crucial to optimize the success of the technique.  For chondral defects on the femur or tibia the patient is started on a continuous passive motion machine almost immediately.  In a range of motion of 300 to 700 for 6 hours per day and this is increased as tolerated by 100 to 200 until full range of motion is obtained.  Partial weight bearing 20%-30% of their body weight for 6-8 weeks.  Return to sports after 4-6 months (protocol according to Richard Steadman).

·       Second look arthroscopyand biopsy materials: healing tissue was of intermediate histologic structure between laginous fibrocarti and hyaline cartilage tissue.

·       Best functional results:

Ø     Age younger than 35 years

Ø     size of defect ≤2cm2

Ø     BMI ≤ 25kgr/m2

Ø     surgery as soon as possible (within 12 months)

Ø     lesions on the femoral condyles

The microfracture technique is appropriate in patients performing high-level activities

There are reports of microfracture being used in the shoulder, hip and ankle.  The long term effectiveness of the technique in these joints is unknown.

Recent Announcements

Monday, 20 Feb 2017

5th Congress of ECOSEP & 2nd UAE FA Football Medicine Update 25th-27th November 2017 Dubai

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Monday, 05 Sep 2016


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Recent Articles

Platelet Rich Plasma (PRP)

An innovative treatment, for  Musculoskeletal Pathologies , PRP uses your own blood for healing muscle, tendon and ligament injuries. 

A common form of healing is scarring which affects function . Most of the Current therapies  treating sports Injuries  do not change the intrinsically poor healing properties. Given this situation, biologically based strategies involving the stimulation of cell activities through the delivery of Growth Factors have attracted considerable interest. 

Platelet Rich Plasma is derived by placing a small amount of your blood in a filtration system which separates red blood cells from platelets. The high concentration of platelets (containing a high level of Growth Factor) is then injected into the injured tissue which initiates the body’s natural healing response.

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Extra Shockwave Therapy & Treatment

At European SportsCare, Extracorporeal Shockwave Therapy (ECSWT) is available for the treatment of musculoskeletal softtissue pathology such as Tendon, Ligament, Muscle and bone. Shockwave Therapy is a non-invasive treatment provided by fully trained Consultants providing this treatment for more than 15 years. It is available as an out-patient treatment in one of our comfortable consultation rooms at 68 Harley Street.

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Acute Lateral Ankle Sprains In Track & Field Athletes: A Proposal Of An Expanded Classification

We present a longitudinal observational study on classification of acute lateral ankle ligament injuries in track & field athletes, based on objective criteria. These very common and sometimes troublesome sports injuries are treated functionally but there is a lack in international literature in predicting the time needed for full recovery.

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Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

Objective: To compare long term outcome of highly active patients with anterior cruciate ligament ruptures treated operatively versus non-operatively.

Design: We reviewed high level athletes with an anterior cruciate ligament rupture on either MRI or arthroscopic evaluation more than 10 years previously, who were treated conservatively. They were pair-matched with patients who had had an anterior cruciate ligament reconstruction with bone-patella-tendon-bone, with respect to age, gender and Tegner activity score before injury.Participants: In total 50 patients were pair-matched.

Results: We found no statistical difference between the patients treated conservatively or operatively with respect to osteoarthritis or meniscal lesions of the knee, as well as activity level, objective and subjective functional outcome. The patients who were treated operatively had a significantly better stability of the knee at examination.

Conclusion: We conclude that the instability repair using

a bone-patella-tendon-bone anterior cruciate ligament reconstruction is a good knee stabilising operation. Both treatment options however show similar patient outcome at 10 year follow up.

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ACL injuries. Diagnosis, treatment and rehabilitation

The ability to recognize the ACL deficient knee is lacking, even among orthopaedic surgeons. The history of an acute ACL tear is remarkably constant, because the injury is often non contact, and patients usually report a twist on the flexed knee, turning to the same side as the injured knee, although hyperextension or direct injury is the cause in some sports. Patients often remember a loud pop, but, because there are no nociceptors in the ACL, pain is not an immediate feature in the isolated lesion. Players may attempt to continue to play, but they usually stop because the knee feels insecure. Pain ensues in association with a hemarthrosis: 70% of acute hemarthroses of the knee are associated with a tear of the ACL. The diagnosis must be confirmed before treatment is offered.

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