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.

The X-chromosome and susceptibility to ankylosing spondylitis.

Abstract: Objective. Ankylosing spondylitis (AS) affects 0.25-1.0% of the population, and its etiology is incompletely understood. Susceptibility to this highly familial disease (lambda(s) = 58) is primarily genetically determined. There is a significant sex bias in AS, and there are differences in recurrence risk to the offspring of affected mothers and fathers, suggesting that there may be an X-linked recessive effect. We undertook an X-chromosome linkage study to determine any contribution of the X-chromosome to AS susceptibility.Methods. A linkage study of the X-chromosome using 234 affected sibling pairs was performed to investigate this hypothesis.Results. No linkage of the X-chromosome with susceptibility to AS was found. Model-free multipoint linkage analysis strongly excluded any significant genetic contribution (lambda greater than or equal to 1.5) to AS susceptibility encoded on the X-chromosome (logarithm of odds [LOD] < -2.0). Smaller genetic effects (lambda greater than or equal to 1.3) were also found to be unlikely (LOD < -1.0).Conclusion. The sex bias in AS is not explained by X-chromosome-encoded genetic effects. The disease model best explaining the sex bias in occurrence and transmission of AS is a polygenic model with a higher susceptibility threshold in females.

Functional and oncological outcomes after limb-salvage surgery for primary sarcomas of the upper limb.

Abstract: The surgical treatment of upper limb sarcoma poses an oncological and reconstructive challenge. Limb-salvage surgery aims to balance adequate excision margins for disease control and preservation of all important structures to retain maximum function. Reported here is an assessment of the functional and oncological outcomes of limb salvage surgery for primary sarcoma of the upper limb and limb girdle in 72 patients referred to a specialist musculoskeletal tumour unit over 9 years. All patients underwent excision of the sarcoma with reconstruction and adjuvant treatment as needed. Functional outcome was assessed using the Toronto Extremity Salvage Score (TESS) after discharge from hospital. The upper limb sarcomas treated by limb-salvage surgery achieved planned margins of excision in 85% of cases with primary surgery. This increased to 100% with re-excision, resulting in local recurrence in 15% and survival of 75% among those at 5 years or more after surgery, while retaining good to excellent function (TESS mean of 87 out of 100). A total of 38 patients completed TESS questionnaires and, as a single group, had a mean TESS of 87. Patient age, anatomical site of tumour and adjuvant treatment made no significant difference to TESS. Liposarcomas had a significantly better TESS than leiomyosarcomas, chondrosarcomas and malignant peripheral nerve sheath tumours. Oncological outcome was assessed in terms of excision margins achieved, local recurrence, re-excision and disease-free survival. Eight patients died of disease, all with high-grade primary tumours. Fourteen had local recurrence, four low-grade disease and the remaining high-grade disease. All four low-grade recurrences were successfully re-excised, as were five of the high-grade recurrences. The remaining five died of disease, with or without further recurrences. Consistently good functional results as measured by TESS were reported by responders, but high-grade disease and early recurrence were identified as predictors of recurrence and death from disease, respectively.

Biomechanics of Rowing

Abstract: A new control model for the study of biomechanical simulation of human movement was investigated using rowing as an example. The objectives were to explore biological and mechanical alternatives to optimal control methods. The simulation methods included simple control mechanisms based on proportional and derivative (PD) control, consideration of a simple neural model, introduction of an inverse dynamics system for feedback, and computational adjustment of control parameters by using an evaluative criterion and optimization method. By using simulation, appropriate rowing motions were synthesized. The generated rowing motion was periodic, continuous, and adaptable so that the pattern was stable against the mechanical force and independent of the initial condition. We believe that the simulation model is not only practical as a computational research tool from a biomechanical-engineering viewpoint but also significant from the point of view of fundamental biological theories of movement.