Nuffield Orthopaedic Centre

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.

Clinical and radiographic analysis of osteochondromas and growth disturbance in hereditary multiple exostoses.

Abstract: Hereditary multiple exostoses (HME) is traditionally described as a skeletal dysplasia. However, the discovery that the EXT family of tumour suppressor genes are responsible for HME suggests that it is more appropriate to classify HME as a familial neoplastic trait. In a clinical and radiographic analysis of paired bone length and exostoses number and dimensions in a HME cohort, the local presence of osteochondromas was consistently associated with growth disturbance. In particular, an inverse correlation between osteochondroma size and relative bone length (p<0.01) was found. These data suggest that the growth retardation in HME may result from the local effects of enlarging osteochondromas rather than a skeletal dysplasia effect. This study provides the first clinical rationale for ablation of rapidly enlarging exostoses to reduce growth disturbance.

A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain

Abstract: The aim of this study was to investigate the effectiveness of pulsed short wave (PSW) in the relief of pain in osteoarthritis of the hip and knee. Ninety-two patients, mean age 63 years, (34 men and 58 women) were randomly allocated to one of three groups: (1) Active PSW, using the dosage found in a pilot study to be non-significantly most effective, (2) Placebo PSW, (3) No treatment control group. Nine sessions of treatment were provided over a 3-week period, each application lasting for 15 min. The machine was modified by the manufacturers so that the therapist was able to administer the treatment and carry out assessments without being aware of the treatment allocation. Outcome measures included sensory and affective pain diary reports averaged over days and weeks, self-reported benefit and the General Health Questionnaire. Analysis of variance with repeated measures over time was used to find out if the active treatment had a specific effect, incremental to the placebo effect. There were no significant differences between the active and placebo groups over time. According to the pain diary reports, both active and placebo groups tended to improve slightly during treatment, but worsened after its withdrawal. Patients who were given the placebo application tended to report more benefit than those who had the active treatment, although this did not quite reach statistical significance (P < 0.06). Patients who were not on a waiting list for surgery did significantly better over time than those who were (P < 0.03). There were no significant differences between the groups over time for the other outcome variables. Any treatment effect on this patient population appears to have been largely placebo-mediated. No evidence was found therefore for the specific effectiveness of PSW for treatment of osteoarthritic hip or knee pain.

Isolation and culture of bone-forming cells (osteoblasts) from human bone.

Abstract: The most conspicuous function of the osteoblast is the formation of bone. During phases of active bone formation, osteoblasts synthesize bone matrix and prime it for subsequent mineralization. Active osteoblasts are plump, cuboidal cells rich in organelles involved in the synthesis and secretion of matrix proteins. Unlike fibroblasts, they are obviously polarized, secreting matrix onto the underlying bony substratum which consequently grows by apposition. Some osteoblasts are engulfed in matrix during bone formation and are entombed in lacunae. These cells are described as osteocytes and remain in the bone matrix in a state of low metabolic activity. At the completion of a phase of bone formation, those osteoblasts which avoided entombment in lacunae lose their prominent synthetic function and become inactive osteoblasts, otherwise known as bone-lining cells. In mature bone, lining cells cover most of the bone surfaces. Osteocytes and bone-lining cells should not be considered as inactive cells since they play a major role in the regulation of bone modeling and remodeling and in calcium homeostasis (1).

Osteoarthritis of the hip

Abstract: 1. A study of normal and osteoarthritic hyaline cartilage has been made with the electron microscope and x-ray diffraction. 2. Normal cartilage consists of a three-dimensional network of collagen fibrils with no preferred orientation, surrounded by a matrix containing polysaccharide. 3. In the osteoarthritic joint the collagen fibrils show definite orientation and a decreased proportion of ground substance. X-ray diffraction confirms this and shows the orientation to be at right angles to the surface of the femoral head. 4. Tensional forces across the joint may explain why osteoarthritic changes first appear in the non-weight-bearing area of the joint.