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.

Current state of tumour necrosis factor α blockade in Wegener’s granulomatosis

Abstract: Tumour necrosis factor α (TNFα) is likely to be involved in the pathogenesis of Wegener’s granulomatosis. This paper reviews published clinical trials of the anti-TNFα agents etanercept and infliximab with regard to their efficacy and safety in the treatment of Wegener’s granulomatosis. On the basis of the high rate of adverse events, particularly an increased incidence of cancers, the use of etanercept in the management of Wegener’s granulomatosis is not justified. However, the potential role for infliximab or the as yet untested adalimumab cannot be discounted. The development of novel approaches focusing on blockade of specific molecules including TNFα in the treatment of Wegener’s granulomatosis is awaited.

The morphological basis of increased stiffness of rabbit tibialis anterior muscles during surgical limb-lengthening.

Abstract: When the tibialis anterior muscle of the rabbit is progressively stretched during surgical limb distraction, the muscle fibres lengthen by addition of new serial sarcomeres, provided that stretch is carried out at an appropriate rate. However, in spite of the apparent adaptation to the new functional length, range of joint movement is greatly decreased. In this study we have first, made measurements of the passive tension developed by distracted muscles over the range of joint movement and secondly made quantitative measurements of endomysial and perimysial connective tissue content. It was found that at all ankle joint angles greater than 90°, the passive tension developed by the distracted muscles was greater than both contralateral and sham-operated controls. Image analysis showed that the ratio of collagen to contractile material was increased in distracted muscles compared with muscles from sham-operated controls, due to increased deposition of collagen type III. Scanning electron microscopy showed the presence of a dense perimysial weave surrounding the distracted muscle fibres. These quantitative and qualitative changes in the connective tissue component could account for the increased stiffness demonstrated by the physiological measurements. It would seem that in distracted muscle the connective tissue element adapts less readily than the contractile component, with prolonged stretch leading to damage to the perimysial and endomysial network, with subsequent fibrosis and loss of muscle compliance. Such changes could help explain the loss of range of movement noted in the distracted limbs of patients undergoing surgical limb-lengthening and in other conditions that result in muscle contractures.

The biomechanical effectiveness of the Boston brace in the management of adolescent idiopathic scoliosis.

Abstract: The present study assesses the biomechanical effectiveness of the Boston brace on a group of 14 patients with adolescent scoliosis. Interface pressure measurements were performed at the appropriate compression pads within the brace when it was first applied and on two further sessions within the 6-m

Evaluation of Internet use by paediatric orthopaedic outpatients and the quality of information available

Abstract: Parents use the Internet increasingly for information about their children's medical problems. There is no quality control for medical information content. The goals of our study were to assess Internet awareness by families seen in paediatric orthopaedic outpatients departments and the type, quality and reliability of information available, using clubfoot as an example. Parents accompanying children to the outpatient's clinic were surveyed regarding the use of the Internet for medical information. They were asked about their ability to use the Internet, and whether this helped the consultation. To assess the quality of information available, the search phrases 'clubfoot' and 'club foot' were placed in the five most commonly used World Wide Web search engines. Web sites were evaluated for authorship, content and informational value using our own agreed scoring system, ranging from 0-100 points. Sixty-one percent of the questionnaires were completed, the mothers completed 67%. Eighty-four percent reported access to the Internet. Most found their searches useful and 26% were reminded of questions to ask at consultation. When a search for 'clubfoot' was carried out we found 11% of web sites were affiliated to academic institutions. There was a significant difference when the terms 'clubfoot' or 'club foot' were searched. Twenty-eight percent offered conventional information. Thirty-six percent of web sites were not related to congenital talipes equinovarus. The average information value was 26 points (0-98). Parents frequently use the Internet for information about paediatric orthopaedic consultations, prior to consultation. The quality of clubfoot information on the Internet is variable. The development of academic-based websites should be encouraged, as these offer the most useful information.