Showing papers by "Nuffield Orthopaedic Centre published in 1985"
304 citations
TL;DR: This study of normal subjects has defined the ranges of voluntary flexion and extension, axial rotation, and lateral bending in the lumbar spines of young males and provided a base line of normal movements to which the movements seen in pathological conditions can be compared.
Abstract: The technique of Biplanar Radiography for the computer analysis of orthogonal radiographs of the human spine enables the calculation of three-dimensional coordinates for anatomical landmarks on the vertebrae. Three-dimensional intervertebral movements are deduced from the changes in the relative orientations of the vertebrae as a subject moves from one position to another. The three-dimensional coordinates of the anatomical landmarks on the vertebrae were found to have an RMS error of less than 1 mm. The RMS errors for translational movements were less than 2 mm and for rotations were less than 1.5 degrees. This study of normal subjects has defined the ranges of voluntary flexion and extension, axial rotation, and lateral bending in the lumbar spines of young males. The range of flexion plus extension at each lumbar intervertebral joint is approximately 14 degrees with the L4/5 level being slightly more mobile than the others. There are approximately 2 degrees of axial rotation at each joint with L3/4 and L4/5 being slightly more mobile. Lateral bending of approximately 10 degrees occurs at the upper three levels while there is significantly less movement of 6 degrees and 3 degrees at L4/5 and L5/S1 respectively. In flexion and extension accompanying axial rotation of 2 degrees or more and lateral bending of 3 degrees or more occurred rarely and any larger accompanying rotation at an intervertebral joint should be considered abnormal. During twisting and side bending axial rotation to the right is accompanied by lateral bending to the left and vice versa at the three upper levels. At L5/S1 axial rotation and lateral bending generally accompany each other in the same direction while L4/5 is a transitional level. During lateral bending there is also generally extension at the upper levels and flexion at L5/S1. The measurement in vivo of the accompanying rotations in the other planes has demonstrated that there is no simple mechanical coupling of the rotations. Finally, this study has provided a base line of normal movements to which the movements seen in pathological conditions can be compared.
225 citations
TL;DR: Eight women with pregnancy-associated osteoporosis were studied for up to ten years and it is suggested that in these patients there may have been a transient failure of the usual changes in calciotropic hormones to prepare the maternal skeleton for the stress of childbirth.
196 citations
TL;DR: The findings question the hypothesis that bone and marrow-derived cells are osteoblasts or osteoblastlike cells, rather than a mixture of cell lines of the bone andBone and marrow stromal system.
116 citations
TL;DR: It is concluded that postmeniscectomy inhibition is not simply due to perceived pain but is due, at least in part, to stimuli from the knee.
Abstract: We have examined the severity and duration of reflex inhibition of quadriceps activation after arthrotomy and meniscectomy, its relationship with pain, and the effect of local anaesthesia on this relationship. Fourteen men, on completion of medial meniscectomy by arthrotomy, received either 10 ml (B10 group) or 15 ml (B15 group) of 0.5% bupivacaine hydrochloride ('Marcaine Plain') into the knee, or no injection (control group). Reflex inhibition of quadriceps was measured as the percentage reduction, from the ipsilateral preoperative value, in the integrated surface electromyogram recorded during maximal voluntary isometric contractions with the knee in extension. Pain during each contraction was recorded on a linear analogue scale. Unoperated limbs showed no evidence of quadriceps inhibition. In the operated limbs, at 1-2 h post-operatively, controls had both severe inhibition (median = 62%) and severe pain on attempting a maximal quadriceps contraction. The B10 group had similar inhibition but less pain (P less than or equal to 0.005, Wilcoxon 2-sample, 1-tailed test). In the B15 group both inhibition (P less than or equal to 0.05) and pain (P less than or equal to 0.01) were less than in the controls. These effects of bupivacaine had been lost by 4-5 h post-operatively. At 3-4 days, inhibition was still severe (median = 75%) in all three groups of patients but pain was only mild or absent. At 10-15 days, median inhibition was still 35%, but there was little or no pain. We conclude that postmeniscectomy inhibition is not simply due to perceived pain but is due, at least in part, to stimuli from the knee.
88 citations
01 Jan 1985
TL;DR: The fixator stiffness is maximized by using the shortest practicable bone pin length and the widest practicable spacing between adjacent pins in the same bone segment; short pins and wide spacing result in the lowest bone/pin interface stresses and minimize the possibility of bone pins loosening.
Abstract: Simple theoretical deflection analysis and experimental data have been used to assess the stiffness of the Oxford External Fixator for a range of fixator configurations. The loading modes comprised...
32 citations
TL;DR: The results demonstrate that bilateral knee arthroplasty can be expected to give good functional results and overall patient satisfaction with the results was good.
Abstract: Thirty-two patients who underwent bilateral bicompartmental Oxford Meniscal Knee arthroplasty have been followed up prospectively for a mean period of 51 months from the time of their first operation. Pain relief was obtained in all but one knee; walking ability was improved in more than two-thirds. Overall patient satisfaction with the results was good. Two knees failed. The results demonstrate that bilateral knee arthroplasty can be expected to give good functional results.
14 citations
TL;DR: Although the beneficial effects of TBI may be short-lived, it can be a useful adjunct to treatment in life-threatening disease where conventional therapy has failed.
Abstract: in a variety of other rheumatic diseases. Risks of carcinogenesis and leukaemogenesis are real, and should be compared to those from cytotoxic therapy (Casciato & Scoci 1979). Bone marrow toxicity is unavoidable and may be potentiated by previous cytotoxic therapy or irradiation, and this may be a life-threatening complication (Morgan et al. 1985) if caution in planning dosage is not observed. Anti-Jo-l-antibody, an autoantibody directed against histidyl-t-RNA synthetase (Matthews & Bernstein 1983), is specific for myositis and was found in 25% of patients with dermatomyositis or polymyositis seen at Hammersmith Hospital. It is not found in childhood or malignancy-associated myositis, but does seem to, 'label' a subset of patients with interstitial lung disease (Bernstein et al. 1984) and mild overlap features such as Raynaud's phenomenon, arthritis and sicca syndrome. Although the beneficial effects of TBI may be short-lived, it can be a useful adjunct to treatment in life-threatening disease where conventional therapy has failed. Acknowledgments: We are grateful to Dr J Cuddigan who referred this patient, and to Dr K E Halnan, Director of the Radiotherapy Department, RPMS, for planning his treatment. We also thank Ms J Coppen for providing myometric data.
13 citations
TL;DR: Some metabolic similarities between Becker's and Duchenne type muscular dystrophy are emphasized and nuclear magnetic resonance spectroscopy may be a useful and objective technique with which to investigate the biochemistry of these and other muscle diseases.
Abstract: The forearm flexor muscles of five patients with Becker's dystrophy were examined by the painless and noninvasive technique of high resolution phosphorus nuclear magnetic resonance spectroscopy. In the mildly affected cases, the ratios of the signals of phosphocreatine to ATP and to inorganic phosphate were normal but they were reduced in the patients with advanced disease. Absolute quantitation under the conditions of the study was not feasible, but it was probable that whereas in advanced Becker's dystrophy the intramyocellular concentration of phosphocreatine was reduced, that of ATP was unchanged. The intramyocellular pH was normal in three of the four patients in whom this could be measured and an additional unidentified signal between those of phosphocreatine and inorganic phosphate was recorded in two patients. This study emphasizes some metabolic similarities between Becker's and Duchenne type muscular dystrophy and suggests that nuclear magnetic resonance spectroscopy may be a useful and objective technique with which to investigate the biochemistry of these and other muscle diseases.
13 citations
01 Jan 1985
TL;DR: Experimental strain gauge data are found to agree very closely with the theoretical analysis for a range of fracture stiffnesses, and to provide a useful measure of progressive bone healing.
Abstract: The increased use of external fracture fixation has brought a need for improved methods of assessing bone healing while the fixator is still in place. In this paper, a method using a strain gauge transducer clamped to the support column of the Oxford External Fixator is considered. Experimental strain gauge data are found to agree very closely with the theoretical analysis for a range of fracture stiffnesses, and to provide a useful measure of progressive bone healing. Bone pin loosening during the course of fracture healing is shown to have a significant effect on the assessment, typically decreasing the strain gauge data by 20 per cent for one loose pin and by 55 per cent for two loose pins. The effects are such that pin loosening could erroneously be interpreted as increased fracture stiffness. Methods are given for correcting the strain gauge data to account for loose pins.
13 citations
TL;DR: Comparison of an in vitro method of assessing interface reactions between bone and ceramic implants with the naturally occurring changes seen in the rat ear model found a gradual chemical change occurred at the calcium silicate surface during the fibrous growth onto the ceramic material.
TL;DR: Posterolateral intertransverse fusion was shown to be capable of fusing the motion segment almost completely, however, the strictly measured fusion rate was only 27%, but this increased to 91% when partial fusions were included.
Abstract: Biplanar radiography was used to assess bony union after intertransverse fusion. The patients were assessed clinically and the fusion status was compared with the clinical result. Posterolateral intertransverse fusion was shown to be capable of fusing the motion segment almost completely. However, the strictly measured fusion rate was only 27%, but this increased to 91% when partial fusions were included. The fusion rate from conventional plain films assessed by the radiologist was 82%, which is similar to other reports. On clinical examination, a satisfactory result was obtained in 82%, but there was no clear correlation with fusion status.
01 Jan 1985
TL;DR: A theoretical and experimental evaluation of the Mark II Oxford External Fixator with sliding clamps has shown that the effective axial stiffness may readily be varied over a wide range.
Abstract: A theoretical and experimental evaluation of the Mark II Oxford External Fixator with sliding clamps has shown that:the effective axial stiffness may readily be varied over a wide range;significant load-bearing may be achieved on the fractured bone while maintaining adequate fracture alignment and stability;the axial sliding facility is likely to be of greatest benefit in the early stages of fracture healing. Sliding decreases rapidly as fracture stiffness increases and ceases altogether at a relatively early stage in the healing process;the effects of bone pin loosening are similar to those previously reported for the fixed-clamp Oxford External Fixator;bone healing assessment using a strain-gauge transducer clamped to the fixator column may become difficult and inaccurate when sliding of the clamps occurs. Temporary locking of the clamps is recommended during the assessment procedure to ensure that sequential tests are strictly comparable.
TL;DR: A large number of the subjects studied had previously been diagnosed with central giant cell granuloma, a type of leukaemia, which can be treated with a single excision.
Abstract: Borg-Constanzi J M, Mohr P D & Lewis D (1981) Postgraduate Medical Journal 57, 228-231 Brown M M, Wade J P H & Marshall J (1985) Brain 108,81-94 Edwards P D, Prosser R & Wells C E C (1975) Journal of Neurology, Neurosurgery and Psychiatry 39, 729-739 Freidmann M, Mumenthaler M & Kummer H (1965) Deutsche Zeitschriftfir Nervenheilkunde 187, 585-594 Gautier-Smith P C & Prankerd T A J (1976) Acta Neurologica Scandinavica 43, 357-364 Harvier P, Lafitte A & Lavarenne G (1950) Paris Medical 139, 277-282 Naville F & Brutsh P (1919) Schweizer Archiv fur Neurologie und Psychiatrie 4, 88-103 Pettit J E, Lewis SM & Goolden A W E (1978) Scandinavian Journal ofHaematology 20, 63-69 Pettit J E, Lewis SM & Nicholas A W (1979) British Journal ofHaematology 43, 167-178 Reinhard E H, Moore C V, Bierbaum 0 S & Moore S (1946) Journal ofLaboratory and Clinical Medicine 3, 107-218 Thomas D J, Marshall L, Ross-Russell RW et at. (1977a) Lancet ii, 161-163 (1977b) Lancet ii, 941-943
TL;DR: A handout given to patients following total hip replacement is based on a handout intended to supplement the information provided by members of the rehabilitation team.
Abstract: This article is based on a handout given to patients following total hip replacement. It is intended to supplement the information provided by members of the rehabilitation team. One problem which may arise from the use of handouts is that the information and instructions given may differ in some way from that provided by members of staff. However, potential misunderstandings can be avoided if the communication between staff members is good, and if it is made clear to the patient that the handout presents general guidelines which may be overruled in individual cases.