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.

Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment.

Abstract: It is recommended that in medial compartment osteoarthritis (OA) unicompartmental knee replacement (UKR) should not be undertaken unless there is bone on bone. This recommendation is not evidence based and it is important to know if it is correct as there are many patients with pain and partial thickness cartilage loss (PTCL) who could potentially benefit from UKR. The aim of this study was to determine if the recommendation is valid. From our database of over 1000 patients treated with the Oxford UKR, we identified 29 with medial OA that had PTCL, confirmed at operation, but otherwise satisfied the recommended indications. This group was matched with 29 knees that had bone exposed (BE) on both sides of the medial compartment and 29 knees that had bone loss (BL) on both sides of the medial compartment. There was no significant difference in the demographics or preoperative scores between the three groups. At a mean follow up of 2 years (range 1-6) the Oxford Knee Score (OKS) of the PTCL group (mean 36 SD 10) was significantly (p < 0.001) worse than the OKS of either the bone exposed group (mean 43 SD 4) or the bone loss group (mean 43 SD 5). 21% of those with PTCL did not benefit substantially from the operation (increase in OKS ≤ 6), whereas all patients in the other groups did. We conclude that the results of UKR for PTCL are unpredictable and therefore that UKR should only be done for medial compartment OA if there is bone on bone. There is a need to develop a method to identify which patients with PTCL will do well so that this subgroup could be treated with UKR.

Cytokine receptor profile of arthroplasty macrophages, foreign body giant cells and mature osteoclasts.

Abstract: In the arthroplasty pseudomembrane surrounding a loose prosthesis there is a marked macrophage and foreign body giant cell (FBGC) response to implant-derived wear particles. These cells contribute ...

Cells of the mononuclear phagocyte series differentiate into osteoclastic lacunar bone resorbing cells

Abstract: Although the osteoclast shares several features with other cells of the mononuclear phagocyte system (MPS), its precise cellular ontogeny is unknown, and its membership of the MPS is controversial. This study examined whether various cells of the MPS can be induced to differentiate into cells capable of the highly specialized osteoclastic function of lacunar bone resorption. We isolated mouse and rat monocytes, mouse (liver, peritoneal, alveolar, brain) tissue macrophages, and spleen and marrow haemopoietic cells, as well as foreign body macrophages and macrophage polykaryons derived from subcutaneous granulomas formed by implantation of latex beads and coverslips in mice. When these cells were incubated with UMR106 osteoblast-like cells on glass coverslips and human cortical bone slices in the presence of 1,25-dihydroxy vitamin D3 [1,25(OH)2D3] for 7 and 14 days, numerous tartrate-resistant acid phosphatase-positive cells formed in these co-cultures and scanning electron microscopy revealed extensive lacunar resorption of the bone surface. Bone resorption was seen as early as 4 days after monocytes were co-cultured with UMR106 cells. With the exception of bone marrow-derived cells, lacunar resorption was not seen in the absence of UMR106 cells. These findings show that a bone-derived stromal cell element is necessary for differentiation of monocytes and tissue and inflammatory macrophages into osteoclast-like cells capable of extensive lacunar bone resorption, and would argue in favour of osteoclast membership of the MPS.

The effect of heel pads on the treatment of Achilles tendinitis: A double blind trial:

Abstract: Thirty-three subjects entered a blind-observer, random, prospective study of three forms of conservative treatment of sports-induced Achilles tendinitis, results being assessed by clinical and biomechanical parameters. Two patient groups received heel pads, ultrasound, and exercises, while the third received only ultrasound and exercises. All three groups showed some improvement at both 10 day and 2 month assessment, but the claimed benefit of viscoelastic pads widely used by athletes was not substantiated. The more striking benefit from ultrasound and exercises alone occurred in patients with a shorter history; a comparison of duration of injury in all three groups suggested this was an important factor influencing outcome. The study has highlighted the need for biomechanical outcome measures as well as for more objective clinical outcome measures in the assessment of physical therapy.

The Isolation and Culture of Cells from Explants of Human Trabecular Bone

Abstract: In the early 1980s, investigators working in the Department of Human Metabolism of the University of Sheffield began a systematic study of the phenotypic characteristics of cell populations derived from culture in vitro of washed pieces of adult human trabecular bone. It was soon established that compared with skin fibroblasts from the same donor, these human bone-derived cells (HBDC) proliferated less rapidly, synthesized predominantly type 1 collagen, and expressed high levels of alkaline phosphatase that were stimulated by 1,25(OH)2D3 [1-3]. Furthermore, it was shown that in the presence of this secosteroid the HBDC synthesized the bone/dentine-specific protein osteocalcin [4]. Subsequent studies by investigators in a number of laboratories have confirmed the osteoblast-like nature of the HBDC and shown that they produce all of the major noncoUagenous bone proteins and secrete several proteinases implicated in the regulation of bone turnover [5, 6]. They express receptors for the majority of osteotropic hormones and both produce and respond to a wide variety of cytokines and growth factors [5, 7]. Early attempts to demonstrate that the HBDC expressed osteogenic potential in the diffusion chamber assay proved unsuccessful [8]. We have recently shown, however, that adult HBDC cultured in the continuous presence of physiological concentrations of glucocorticoid and a long-acting ascorbate preparation will both produce an abundant extracellular matrix that mineralizes extensively in vitro, without recourse to the use of f3-glycerophosphate, and will also produce bone when implanted in vivo within diffusion chambers in athymic mice [9]. Figure 1 is a section of the cell layer from such an in vitro culture of HBDC, showing the tissuelike substance formed, and Figure 2 is a section from a diffusion chamber loaded with cultured HBDC and implanted for 11 weeks before recovery and processing. These findings lend weight to the premise that, with appropriate culture conditions, a truly osteogenic population of cells is obtained which may then be used as a reproducible model system for the investigation of bone cell' metabolism. The precise nature of the proliferating cell population in the HBDC method is unknown, but it is reasonable to assume that the cultures are initiated by a small number of