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Showing papers by "Nuffield Orthopaedic Centre published in 1976"


Journal ArticleDOI
TL;DR: The odd facet is shown to be a habitual non-contact area and the ridge to be subject to high load, observations which correlate with cartilage lesions described in Part 2 of the paper.
Abstract: Cadaver knee joints were mounted so that life-like forces of weight-bearing were simulated. The patello-femoral contact areas were defined under load throughout the range of movement by the dye method. During movement from extension to 90 degrees of flexion a band of contact sweeps across the patella from inferior to superior pole, but the odd facet makes no contact. At about 135 degrees of flexion separate medial and lateral contact areas form, the medial one limited to the odd facet. From extension to 90 degrees of flexion the patella holds the quadriceps tendon away from the femur, but in further degrees of flexion an extensive "tendo-femoral" contact area forms. Between 90 degrees and 135 degrees of flexion the patella rotates and the ridge between the medial and odd facets engages the femoral condyle. The odd facet is shown to be a habitual non-contact area and the ridge to be subject to high load, observations which correlate with cartilage lesions described in Part 2 of the paper.

337 citations


Journal ArticleDOI
TL;DR: Basal degeneration is a lesion in which there is a fasciculation of collagen in the middle and deep zones of cartilage without, at first, affecting the surface.
Abstract: Two distinct lesions affect the articular cartilage of the patella. Surface degeneration occurs particularly on the odd facet; it is age dependent, often present in youth and it becomes more frequent with increasing age. It probably does not occasion patello-femoral pain in youth, but may predispose to degenerative arthritis in that joint in later years and is regarded as a consequence of habitual disuse. The term "basal degeneration" is used to describe a lesion in which there is a fasciculation of collagen in the middle and deep zones of cartilage without, at first, affecting the surface. It was found astride the ridge separating the medial from the odd facet in twenty-three adolescents who had complained of prolonged patello-femoral pain. They were treated by excision of the disc of affected cartilage, with relief of pain in most cases. The pathogenesis of basal degeneration is related to the functional anatomy of the patella.

310 citations


Journal ArticleDOI
15 Jul 1976-Nature
TL;DR: It is reported that the α2HS-glycoprotein is synthesised by the liver and a proportion is subsequently accumulated in bone tissue, suggesting that its presence in plasma could be a result of synthesis and release by bone tissue.
Abstract: WE have shown previously that a glycoprotein constituent of calcified cortical bone matrix is immunochemically identical to a component of blood plasma1,2. In bone and dentine this specific α-glycoprotein is concentrated in amounts relative to plasma albumin but is not present at greater concentrations than in plasma in various other tissues. This material, although mainly present in extra-vascular sites in bone, could originate from the plasma because it represents a substantial proportion of the radioactivity in bone tissue 12 d after injection of 14C-total plasma glycoprotein1. Rabbit bone α-glycoprotein is analogous to human α2HS-glycoprotein3,4, which is located in mineralising areas in normal human bone matrix5. To our knowledge direct conclusive proof of the tissue origin of the plasma α2HS-glycoprotein is lacking although most of the serum glycoproteins seem to be synthesised by the liver6,7. Nevertheless, its increased concentration in calcified tissues suggests that its presence in plasma could be a result of synthesis and release by bone tissue. We now report that the α2HS-glycoprotein is synthesised by the liver and a proportion is subsequently accumulated in bone tissue.

212 citations


Journal ArticleDOI
TL;DR: It is suggested that the changes in the concentration of branched-chain amino acids after injury indicate decreased uptake by muscle or excessive release due to an imbalance between protein synthesis and protein catabolism in this tissue.
Abstract: 1. Venous blood concentrations of the branched-chain amino acids, valine, leucine and isoleucine, and urinary nitrogen excretion have been measured in sixteen adult males, from 2 h to 7 days after injury, and in four adults after elective skin grafts. 2. In the injured group the concentrations of these amino acids rose significantly 24 h after injury and had doubled at 4 days and remained high; in contrast the skin-graft patients showed no significant change. 3. In those injured patients with initial hyperketonaemia, defined as more than 0·2 mmol/l, the increase in concentrations of branched-chain amino acids at the fourth and seventh days after injury was significantly less than in those with normoketonaemia, and was accompanied by lower urinary nitrogen excretion throughout the whole period. 4. It is suggested that the changes in the concentration of branched-chain amino acids after injury indicate decreased uptake by muscle or excessive release due to an imbalance between protein synthesis and protein catabolism in this tissue.

46 citations


Journal ArticleDOI
TL;DR: The results showed that the incidence of venous reactions was related not only to the duration but also to the cannula material, and those made of fluoroethylene propylene (F.F.E.P.) appeared to cause less overall venous reaction than the other type of ‘Teflon’ used, namely tetrafluoro methylene (T.V.E.)
Abstract: SummaryLocal venous reactions to in-dwelling plastic cannulae have been studied in 477 postoperative patients. The results showed that the incidence of venous reactions was related not only to the duration but also to the cannula material.Cannulae of 4 different types of material were used. Those made of fluoroethylene propylene (F.E.P.) appeared to cause less overall venous reactions than the other type of ‘Teflon’ used, namely tetrafluoroethylene (T.F.E.), and both appeared to be less reactive than either polyvinyl chloride (P.V.C.) or polyethylene (P.E.). The infusion of blood through all cannulae significantly increased the incidence of venous reactions.

38 citations


Journal ArticleDOI
TL;DR: A new method is described which takes advantage of the thiol groups present in Type III collagen which are more predominant in early life than in the other collagens so far described.

33 citations


Journal ArticleDOI
TL;DR: The detailed examination of 121 patients who had suffered from traumatic brain damage seems to suggest scope for developing recovery curves that might prove valuable indicators of the effectiveness of long-term therapy.
Abstract: This paper describes the detailed examination of 121 patients who had suffered from traumatic brain damage. An important feature of the study was that all patients were examined by methods devised by the therapists in the department concerned, and the results subsequently integrated. The patients are described and their ability to return to independent existence is assessed in relation to the duration of unconsciousness and of post-traumatic amnesia (PTA). One method in particular, devised in the physiotherapy department, seems to suggest scope for developing recovery curves that might prove valuable indicators of the effectiveness of long-term therapy.

23 citations


Journal ArticleDOI
TL;DR: The BAOT developed four inter-related forms for recording activities of daily living assessment and distributed them to a large number of hospitals for trial and comment, but most hospitals preferred their own forms to those submitted by the BAOT.
Abstract: THE British Association of Occupational Therapists has recently tried to produce a generally acceptable method of recording the assessment of activities of daily living (ADL). There appeared to be a widespread feeling that a standardised ADL index would facilitate the referral and transfer of patients from one place to another and particularly between hospital and community based staff. It was also felt that such standardisation would save a great deal of time that occupational therapists appeared to be devoting to the repeated design of new forms and new indices of ADL. The BAOT therefore developed four inter-related forms for recording activities of daily living assessment and distributed them to a large number of hospitals for trial and comment. In the event most hospitals preferred their own forms to those submitted by the BAOT. The reasons for this apparently chauvinistic attitude seem to be:

19 citations



Journal ArticleDOI
19 Feb 1976-Nature
TL;DR: The comparative dosimetry of plutonium and radium in man is used, with results broadly in agreement with maximum permissible levels set by the International Commission on Radiological Protection.
Abstract: In the past attempts have been made to deduce plutonium toxicity in man from studies based on animal experimentation. An alternative method is to use the comparative dosimetry of plutonium and radium in man, with results broadly in agreement with maximum permissible levels set by the International Commission on Radiological Protection.

10 citations


Journal ArticleDOI
TL;DR: Results are presented which suggest that a feature of idiopathic adolescent scoliosis is an immaturity of connective tissues.
Abstract: There are many known causes of scoliosis (British Medical Journal, 1975) but together they account for only a small fraction of patients with scoliosis. In most patients who develop scoliosis during the rapid growth of adolescence the cause is obscure. There are, however, some inherited disorders of connective tissue in which marked scoliosis is a feature and in which abnormalities of collagen have been demonstrated (Francis et al., 1973). Here we present results which suggest that a feature of idiopathic adolescent scoliosis is an immaturity of connective tissues.

Journal ArticleDOI
TL;DR: The present studies were designed to examine the relationships between plasma immunoreactive calcitonin (iCT) and bone disease in patients with chronic renal failure.
Abstract: In experimental animals the main effect of calcitonin is to inhibit bone resorption and this property has led to its use in man to suppress excessive bone turnover in Paget's disease and other disorders [3, 7, 8, 9, 10, 14]. Despite considerable work the role of calcitonin of endogenous origin in the pathogenesis of human bone disease has remained unresolved. The present studies were designed to examine the relationships between plasma immunoreactive calcitonin (iCT) and bone disease in patients with chronic renal failure.


Journal ArticleDOI
TL;DR: The problems of management and rehabilitation of the disabled are dealt with, and the importance of taking consideration of the behavioural and social factors in assessing individual needs is emphasised.

Journal ArticleDOI

Journal ArticleDOI
TL;DR: A case is reported of spontaneous subluxation of C.3 on C.4 in a 6-year-old boy due to an upper respiratory infection after surgical treatment for muscular torticollis.
Abstract: A case is reported of spontaneous subluxation of C.3 on C.4 in a 6-year-old boy due to an upper respiratory infection after surgical treatment for muscular torticollis.

Journal ArticleDOI
TL;DR: The present study investigates the combined roles of the adreno-corticosteroids and prolactin in the control of S.L.A. release in rats subjected to perfusion with high levels of bovine growth hormone.
Abstract: McConaghey and Sledge (1970) first demonstrated that the isolated perfused rat liver released a somatomedin-like activity (S.L.A.) when high levels of bovine growth hormone (10/ag/ml) were included in the perfusion medium. Francis and Hill (1975) showed with an improved perfusion system that a similar S.L.A. was released when low levels (50 ng/ml) of ovine prolactin were included in the perfusion medium. The appearance of S.L.A. varied with the time of day at which the perfusion was carried out. The present study investigates the combined roles of the adreno-corticosteroids and prolactin in the control of S.L.A. release.