Institution
Nuffield Orthopaedic Centre
Healthcare•Oxford, United Kingdom•
About: Nuffield Orthopaedic Centre is a healthcare organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Population & Arthroplasty. The organization has 2082 authors who have published 2920 publications receiving 145718 citations.
Papers published on a yearly basis
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TL;DR: Detailed genetic and functional data are presented indicating that the LRP5 gene and the Wnt signalling pathway are key players in bone formation and the risk of osteoporosis, and that L RP5 signalling is essential for normal morphology, developmental processes and bone health.
77 citations
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TL;DR: This is the first study showing that DAIR is better than a two‐stage revision regarding functional outcome, and emphasises the need for exchange of modular components for improved chances of eradication of infection.
Abstract: Aims Advocates of debridement, antibiotics and implant retention (DAIR) in hip periprosthetic joint infection (PJI) argue that a procedure not disturbing a sound prosthesis-bone interface is likely to lead to better survival and functional outcome compared with revision. This case-control study aims were to compare outcome of DAIRs for infected primary total hip arthroplasty (THA) with outcomes following primary THA and two-stage revision of infected primary THAs.
Patients and Methods We retrospectively reviewed all DAIRs, performed for confirmed infected primary hip arthropasty (n = 82) at out institution, between 1997 and 2013. Data recorded included full patient information and type of surgery. Outcome measures included complications, mortality, implant survivorship and functional outcome. Outcome was compared with two control groups matched for gender and age; a cohort of primary THAs (n = 120) and a cohort of two-stage revisions for infection (n = 66).
Results Mean age at DAIR was 69 years (33 to 87) and mean follow-up was eight years (2 to 17; standard deviation (sd) 5). A total of 52 (63%) of DAIRs were for early PJI (less than six weeks). Greater success in the eradication of infection with DAIR was identified with early PJI, comprising an interval less than a week between onset of symptoms and exchange of modular components with the DAIR procedure. Eradication of infection, complications and re-operation rates were similar in the DAIR and two-stage revision groups. For hips with successful eradication of infection with DAIR, the five-year survival (98%; 95% confidence interval (CI) 94 to 100) was similar to the primary THA group (98%; 95% CI 95 to 100) (n = 43; p = 0.3). The DAIR group had inferior mean Oxford Hip Scores (OHS) (38; 12 to 48) compared with the primary THA group (42; 15 to 48) (p = 0.02) but a significantly better mean OHS compared with the two-stage revision group (31; 0 to 48) (p = 0.008). Patients who required only one DAIR for eradication of infection had a similar mean OHS (41; 20 to 48) to the primary THA group (p = 0.2).
Conclusion The DAIR procedure is associated with a similar complication rate and ability to eradicate infection as two-stage revision. This study emphasises the need for exchange of modular components for improved chances of eradication of infection. This is the first study showing that DAIR is better than a two-stage revision regarding functional outcome.
Cite this article: Bone Joint J 2017;99-B:614–22.
77 citations
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University of Queensland1, Hanyang University2, Eulji University3, Cedars-Sinai Medical Center4, National Institutes of Health5, University of Texas Health Science Center at Houston6, French Institute of Health and Medical Research7, Sir Charles Gairdner Hospital8, University of Western Australia9, Oslo University Hospital10, King Abdulaziz University11, Danube University Krems12, National Institute for Health and Welfare13, Second Military Medical University14, Ghent University Hospital15, National Autonomous University of Mexico16, University of California17, University of Otago18, Toronto Western Hospital19, Central University, India20, Nuffield Orthopaedic Centre21, Norfolk and Norwich University Hospital22, University of Cambridge23, University of Toronto24, University Health Network25, Memorial University of Newfoundland26, University of Alberta27, VU University Medical Center28, National Yang-Ming University29, Taipei Veterans General Hospital30, Military University Nueva Granada31, Universidade Nova de Lisboa32, Spanish National Research Council33, University of Bristol34, National Institute for Health Research35
Abstract: The association of endoplasmic reticulum aminopeptidase 2 (ERAP2) with ankylosing spondylitis (AS) was recently described in the large International Genetics of AS Consortium Immunochip study. Variants in ERAP2 have also been associated with inflammatory bowel disease, psoriasis, acute anterior uveitis and birdshot chorioretinopathy. Subsequent investigation demonstrated an association of ERAP2 with AS which was present when one conditioned on one of the two independent haplotypes of ERAP1 associated with AS or when HLA-B27-negative patients were analysed separately. These two analyses provide analogous evidence for the association of ERAP2 with AS in HLA-B27-negative cases because of the genetic interaction between HLA-B27 and the AS-associated ERAP1 variants in AS cases. ERAP1 and ERAP2 are located on chromosome 5q15 in the opposite orientation. The locus is challenging to analyse because of the strong linkage disequilibrium (LD) across the locus and the epistasis between ERAP1 and HLA-B alleles associated with AS. We therefore sought to investigate the association of ERAP2 with AS in HLA-B27-positive patients. This is of clinical importance because functional studies have demonstrated that the strongly AS-protective variant rs2248374 causes a functional ERAP2 protein knockout, because its G allele causes a loss of ERAP2 protein expression. There is also a variant of ERAP2 which changes its enzyme catalytic activity and specificity (rs2549782, K392A). Because this is in almost complete LD with rs2248374 (1000 Genomes D′=1.00, r2=0.90), it is almost never translated in vivo. Further, the very strong LD between these markers means that analysis of rs2549782 for association would yield results almost identical to the results for rs2248374 presented below. Therefore, it is of relevance to determine whether the association of ERAP2 with HLA-B27-negative disease is also found in HLA-B27-positive cases, since ERAP inhibition may offer a novel therapeutic for AS...
77 citations
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TL;DR: In this paper, a study of two hundred and sixty-nine shoulder patients with a diagnosis of primary frozen shoulder was conducted, where the main outcome measure was the Oxford shoulder score.
Abstract: Two-hundred and sixty-nine shoulders in 223 patients with a diagnosis of primary frozen shoulder were studied. The main outcome measure was the Oxford shoulder score. The mean follow-up from symptom onset was 4.4 years (range, 2-20 years). The mean age at symptom onset was 53.4 years; with women affected more commonly than men (1.6:1.0).Twenty percent of patients reported bilateral symptoms, but there were no recurrent cases. In the long term, 59% of patients had normal or near normal shoulders and 41% reported some ongoing symptoms. The majority of these persistent symptoms were mild (94%), with pain being the most common complaint. Only 6% had severe symptoms with pain and functional loss.Those with the most severe symptoms at condition onset had the worst long-term prognosis, P
77 citations
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TL;DR: This work has developed a non-invasive measurement technique which can ultimately be used to quantify three-dimensional patellar kinematics of human subjects for a range of static positions of loaded flexion and assessed its accuracy.
77 citations
Authors
Showing all 2120 results
Name | H-index | Papers | Citations |
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Douglas G. Altman | 253 | 1001 | 680344 |
George Davey Smith | 224 | 2540 | 248373 |
Cyrus Cooper | 204 | 1869 | 206782 |
James J. Collins | 151 | 669 | 89476 |
Richard J.H. Smith | 118 | 1308 | 61779 |
Andrew Carr | 111 | 842 | 54974 |
Paul Dieppe | 105 | 618 | 53529 |
Matthew A. Brown | 103 | 748 | 59727 |
David W. Murray | 97 | 699 | 43372 |
Ray Fitzpatrick | 95 | 477 | 40322 |
Derrick W. Crook | 92 | 474 | 29885 |
Richard W Morris | 91 | 519 | 35165 |
Richard J. K. Taylor | 91 | 1543 | 43893 |
Sharon J. Peacock | 90 | 494 | 33352 |
Derick T Wade | 90 | 398 | 37413 |