G. Blundell Jones

Bio: G. Blundell Jones is an academic researcher from British Orthopaedic Association. The author has contributed to research in topics: Dislocation & Penicillin. The author has an hindex of 6, co-authored 7 publications receiving 173 citations.

Massive osteolysis: disappearing bones.

Abstract: 1. The clinical and pathological features are given of an example of the rare syndrome of progressive and massive osteolysis associated with haemangiomatous changes in the bones affected. 2. Twenty-six cases have been previously reported, but this is only the second from Britain. Only one other patient is considered to have died as a direct result of the disease.

Paralytic dislocation of the hip

Abstract: 1. Forty-eight paralytic dislocations of the hip have been studied and twenty-seven operations for correction of valgus deformity of the femoral neck have been done. 2. The differing features of dislocations occurring in poliomyelitis, cerebral palsy and meningomyelocoele are considered in relation to management after operation. 3. Early recognition of subluxation is essential to a successful varus osteotomy. An angle of 105 degrees rather than the 120 degrees previously recommended is advisable for children under the age of five. 4. Redislocation is most likely to occur in meningomyelocoele in which muscular imbalance is greatest, and in later cases where the acetabulum has become shallow by growth without the femoral head within it. It has not occurred as a late complication after weight bearing has been established, from a recurrence of valgus deformity.

Arthroplasty of the knee by the walldlus prosthesis

Abstract: 1. Forty-five arthroplasties of the knee with the Walldius prosthesis are reported in forty-two patients, thirty-seven with rheumatoid arthritis and five with osteoarthritis. 2. There has been no structural failure of the prosthesis. 3. Sepsis required removal of the prosthesis in three cases, but arthrodesis was obtained in two of the three. 4. Serious loosening of the prosthesis occurred in one case only. Varus deformity occurred in one patient. 5. Radiological evidence of some movement of the prosthesis was present in six other cases but this did not seem to affect function. 6. It is concluded that this operation has a place in the treatment of the more seriously disabled patient, but should not be used when heavy demands are likely to be made on the joint.

The stability of the hip in children. A radiological study of the results of muscle surgery in cerebral palsy

Abstract: (1980). The Stability of the Hip in Children: A Radiological Study of the Results of Muscle Surgery in Cerebral Palsy. Acta Orthopaedica Scandinavica: Vol. 51, No. sup184, pp. 1-100.

Two-Stage Reimplantation for the Salvage of Infected Total Knee Arthroplasty

Abstract: The results of eleven two-stage reimplantations to salvage eleven infected total knee arthroplasties in ten women (seven with osteoarthritis and three with rheumatoid arthritis) were evaluated after an average follow-up of thirty-four months. The staged procedures included removal of all of the components of the prosthesis and all cement, then six weeks of parenteral antibiotic therapy (monitored by maintaining serum bactericidal levels at a peak dilution of 1:8), and finally reimplantation with a total condylar-type prosthesis. All antibiotics were discontinued after reimplantation. At follow-up, no patient had had a recurrence of the original infection, but one had a hematogenous infection with a different organism secondary to an infected bunion. The results after reimplantation were rated excellent in five knees, good in four, and fair in two. Weakness of the extensor mechanism with an extension lag was the most frequent complication. We do not believe that antibiotic therapy alone is adequate for the management of an infection around a prosthesis. The method described appears to be effective but it is costly and time-consuming. The surgical procedures and medical management are technically difficult, often special equipment and a custom-made prosthesis are required, and there are no shortcuts.

Femoral fractures in conjunction with total hip replacement.

Abstract: We reviewed thirty-eight cases, in thirty-six patients, of fracture of the femur distal to the base of the neck incurred in conjunction with total hip replacement. There were thirteen preoperative, eighteen intraoperative, and seven postoperative fractures. The cases were contributed by thirteen surgeons. We found that the preoperative fractures with pre-existing disease in the hip joint were effectively treated by primary total hip replacement using custom-made femoral components with long necks or long stems, or both. The intraoperative femoral fractures usually occurred while the surgeon was reaming the canal, seating the femoral component, or manipulating the femur in patients who were predisposed to fracture. Theoretically these lesions can be treated like preoperative fractures, but this demands immediate access to custom-made femoral components with long necks or long stems, or both, along with an appreciation of the extent and significance of the fracture. Inadequate fixation was found to lead to painful non-union or late loosening of the femoral component in four of eighteen patients. Postoperative fractures occurred too rarely for us to draw any definite conclusions about management, except to say that surgical treatment can be hazardous and traction has been successful in this series and in other reports. Prophylactic measures, however, may help to prevent postoperative femoral fractures. Most of these fractures occur through a cortical defect near the tip of the femoral component. A long-stem femoral component may help to prevent postoperative fractures whenever a proximal cortical defect of the femur is present preoperatively or is created at surgery.

Classification and management of carpal dislocations.

Abstract: A classification and plan of management for carpal dislocations are presented, based upon the following basic premises: perilunate and lunate dislocations are different stages of the same injury and are therefore managed identically; displacement may be either dorsal or volar; anatomic restoration of the 3 key elements (scaphoid, lunate, and capitate) is essential. Following initial closed reduction, rotary subluxation of the scaphoid and intercalary segment instability must be specifically looked for and corrected in the patient with perilunate or lunate dislocation without fracture of the scaphoid. In transcaphoid perilunate dislocation, anatomic reduction of the scaphoid fracture and maintenance of that reduction is necessary to prevent nonunion of the fracture and/or late dorsiflexion instability of the carpus. As with all ligamentous injuries, early diagnosis and treatment are essential. Failure to obtain or maintain anatomic position by closed methods is an indication for open reduction and internal fixation. Combined dorsal and volar approaches are recommended for perilunate and lunate dislocations. In some cases of transscaphoid perilunate dislocation, a limited Russe approach to stabilize the scaphoid fracture may be sufficient. Frequent concomitant injuries include median nerve damage, osteochondral fractures of the carpal bones, and fracture of the radial styloid. Isolated rotary subluxation of the scaphoid without perilunate dislocation is a more subtle injury which may require special radiographic views, and also demands early diagnosis and treatment.

Interleukin-6: a potential mediator of the massive osteolysis in patients with Gorham-Stout disease.

Abstract: Gorham-Stout disease (GSD) or massive osteolysis, is an extremely rare osteolytic condition that involves extensive locally aggressive resorption of bone. The etiology and pathophysiology are unknown, and the role of the osteoclast in GSD is unclear. We studied a patient with GSD who had massive resorption of his mandible, which extended to his maxilla, zygoma, right parietal region, and cranium. To investigate the cause of the extensive resorption, we tested the effects of the patient's serum, sampled early in the course of treatment and later after the osteolysis was stabilized, on the formation of osteoclast-like multinucleated cells (MNC) in cultures of normal human marrow. GSD serum (10%, vol/vol) markedly increased the number of MNC formed in these cultures compared to that in normal serum as well as stimulated the formation of resorption pits by these MNC on dentine slices. GSD serum, collected after further therapy, did not enhance the number of MNC formed in marrow cultures compared to that in normal serum. Elevated levels of interleukin-6 (IL-6) were detected in the earlier GSD serum that were 7 times the upper limit of the normal range, and after further treatment, IL-6 levels fell to one quarter the pretreatment value. The levels of IL-1 beta, tumor necrosis factor-alpha, transforming growth factor-alpha, PTH, and PTH-related peptide in pretreatment GSD serum were not increased. Moreover, the addition of neutralizing antibodies to IL-6 to the normal human bone marrow cultures effectively blocked the increase in MNC formation induced by active GSD serum. These data suggest that bone resorption in GSD patients is due to enhanced osteoclast activity, and that IL-6 may play a role in the increased bone resorption in GSD.