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Institution

Nuffield Orthopaedic Centre

HealthcareOxford, 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
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Journal ArticleDOI
TL;DR: Smoking and the treatment of post-fracture pain with non-steroidal anti-inflammatory drugs (NSAIDs) put the patient at the greatest risk, while ultrasound therapy appears to be a non-invasive, effective treatment option to reduce the risk of delayed union or non-union.

54 citations

Journal ArticleDOI
TL;DR: It is concluded that mutations in the coding region of noggin are not associated with FOP, and elevated levels of bone morphogenetic protein 4 occur in lymphoblastoid cells and in lesional cells of patients with Fop.
Abstract: Fibrodysplasia ossificans progressiva (FOP) is an extremely rare and disabling genetic disorder characterized by congenital malformation of the great toes and by progressive heterotopic endochondral ossification in predictable anatomical patterns. Although elevated levels of bone morphogenetic protein 4 (BMP4) occur in lymphoblastoid cells and in lesional cells of patients with FOP, mutations have not been identified in the BMP4 gene, suggesting that the mutation in FOP may reside in a BMP4-interacting factor or in another component of the BMP4 pathway. A powerful antagonist of BMP4 is the secreted polypeptide noggin. A recent case report described a heterozygous 42-bp deletion in the protein-coding region of the noggin gene in a patient with FOP. In order to determine if noggin mutations are a widespread finding in FOP, we examined 31 families with 1 or more FOP patients. Linkage analysis with an array of highly polymorphic microsatellite markers closely linked to the noggin gene was performed in four classically-affected multigenerational FOP families and excluded linkage of the noggin locus to FOP (the multipoint lod score was -2 or less throughout the entire range of markers). We sequenced the noggin gene in affected members of all four families, as well as in 18 patients with sporadic FOP, and failed to detect any mutations. Single-strand conformation polymorphism (SSCP) analysis of 4 of these patients plus an additional 9 patients also failed to reveal any mutations. Among the samples analyzed by SSCP and DNA sequencing was an independently obtained DNA sample from the identical FOP patient previously described with the 42-bp noggin deletion; no mutation was detected. Examination of the DNA sequences of 20 cloned noggin PCR products, undertaken to evaluate the possibility of a somatic mutation in the noggin gene which could be carried by a small subset of white blood cells, also failed to detect the presence of the reported 42-bp deletion. We conclude that mutations in the coding region of noggin are not associated with FOP.

54 citations

Journal ArticleDOI
TL;DR: People who experience chronic musculoskeletal pain are at greater risk ofBeing lonely, but at less risk of being socially isolated, according to this study.
Abstract: Introduction:Musculoskeletal pain is a prevalent health challenge for all age groups worldwide, but most notably in older adults Social isolation is the consequence of a decrease in social network

54 citations

Journal ArticleDOI
TL;DR: Severe open tibial fractures covered with free flaps, cause over a year of absenteeism and Infection increases direct cost of treatment over 60 % and roughly doubles LOS and indirect cost in terms of absenteeist and unemployment benefits.
Abstract: Open tibial fractures needing soft tissue cover are challenging injuries. Infection risk is high, making treatment difficult and expensive. Delayed skin closure has been shown to increase the infection rate in several studies. We aimed at calculating the direct and indirect cost of treatment, and to determine the effect of delayed skin closure on this cost. We reviewed all records of patients treated with a free flap in our institution for an open tibial fracture from 2002 to 2013. We calculated direct costs based on length of stay (LOS) and orthopaedic and plastic surgical procedures performed, including medications and intensive care. We analysed indirect cost in terms of absenteeism and unemployment benefits. The primary goal was to establish the extra cost incurred by an infection. We analysed 46 injuries in 45 patients. Infection increased the LOS from 41 to 74 days and increased the cost of treatment from € 49,817 in uninfected fractures to € 81,155 for infected fractures. Employed patients spent 430 days more on unemployment benefits, than a matched cohort in the background population. Achieving skin cover within seven days of injury decreased the infection rate from 60 to 27 %. Severe open tibial fractures covered with free flaps, cause over a year of absenteeism. Infection increases direct cost of treatment over 60 % and roughly doubles LOS. Early soft-tissue cover and correct antibiotics have been shown to improve outcomes—underscoring the need for rapid referral to centres with an ortho-plastic set-up to handle such injuries.

54 citations


Authors

Showing all 2120 results

NameH-indexPapersCitations
Douglas G. Altman2531001680344
George Davey Smith2242540248373
Cyrus Cooper2041869206782
James J. Collins15166989476
Richard J.H. Smith118130861779
Andrew Carr11184254974
Paul Dieppe10561853529
Matthew A. Brown10374859727
David W. Murray9769943372
Ray Fitzpatrick9547740322
Derrick W. Crook9247429885
Richard W Morris9151935165
Richard J. K. Taylor91154343893
Sharon J. Peacock9049433352
Derick T Wade9039837413
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202315
202246
2021138
2020129
2019126
2018110