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 radiographic classification of medial gonarthrosis. Correlation with operation methods in 200 knees.

Abstract: Ahlback's classification of gonarthrosis can be applied with improved precision by careful interpretation of anteroposterior varus stress and lateral radiographs of the knee. The tibial lesion in early gonarthrosis is located in the anterior and middle part of the medial plateau. In more advanced disease, when the anterior cruciate ligament is invariably damaged, the lesion extends to the posterior margin of the medial tibial plateau.We studied the preoperative radiographs of 200 knees with arthrosis. We were able to predict the integrity of the anterior cruciate ligament (and the use of unicompartmental arthroplasty) with 95 percent accuracy and rupture or damage to the anterior cruciate ligament (and the use of total condylar arthroplasty) with 100 percent accuracy.We believe that the Ahlback classification reflects the anatomic and pathologic progression of medial compartment gonarthrosis, and is of value in allowing more accurate comparisons to be made of different methods of treatment.

Avascular necrosis of the femoral head. An anatomical study.

Abstract: Since the recent publication of studies of the vascular pattern of the proximal femoral epiphysis in man by Tucker (1949), Trueta and Harrison (1953), Judet, Judet, Lagrange and Dunoyer (1955), and Trueta (1957) there has been a renewed interest in the mechanism of capital necrosis after fractures of the femoral neck. The literature on the subject is so extensive that no effort will be made here to quote even the most outstanding work, for the aim of this paper is to report the results of an investigation into the vascular damage caused by fractures of the femoral neck in the adult.

An assessment of the histological criteria used to diagnose infection in hip revision arthroplasty tissues.

Abstract: AIM: To characterise the number and nature of the inflammatory cells seen in cases of septic or aseptic loosening of hip arthroplasty, and to establish reliable histological criteria to distinguish between these two conditions. METHODS: Histological examination of paraffin sections of periprosthetic tissues (pseudocapsule, femoral and acetabular pseudomembranes) of 523 cases of aseptic loosening and 79 cases of microbiology culture proven septic loosening. The cellular composition of the inflammatory cell infiltrate was determined semiquantitatively. RESULTS: The finding of a 2+ or greater neutrophil polymorph infiltrate (one or more cells per high power field (x400) on average after examination of 10 fields) in arthroplasty tissues correlated strongly with the microbiological diagnosis of septic loosening: diagnostic sensitivity 100%, specificity 97%, accuracy 99%, positive predictive value 92%, negative predictive value 100%. The finding of a 3+ neutrophil polymorph infiltrate (five or more cells on average per high power field) had a diagnostic sensitivity of 72%, specificity 100%, accuracy 98%, positive predictive value 100%, and negative predictive value 97%. In some cases of septic loosening the finding of a heavy lymphocytic and plasma cell infiltrate was of low diagnostic sensitivity. A neutrophil polymorph infiltrate (generally less than one cell per 10 high power fields) was also seen in cases of aseptic loosening. CONCLUSIONS: The presence of 2+ or more (more than one neutrophil polymorph per high power field (x400) on average after examination of at least 10 high power fields) in periprosthetic tissues provides the most sensitive and accurate histopathological criterion for distinguishing between septic and aseptic loosening of hip arthroplasty.

Microfibrils, elastin fibres and collagen fibres in the human intervertebral disc and bovine tail disc.

Abstract: The distribution of microfibrils was studied immunohistochemically in intervertebral discs taken from young normal human surgical cases and from the bovine tail. Co-localization of microfibrils and elastin fibres was examined by dual immunostaining of fibrillin-1 and elastin. Collagen fibre network orientation was studied by using polarized filters. A similar microfibrillar network was seen in both bovine and human discs with network organization being completely different from region to region. In the outer annulus fibrosus (OAF), abundant microfibrils organized in bundles were mainly distributed in the interterritorial matrix. In addition, the microfibril bundles were orientated parallel to each other and co-localized highly with elastin fibres. Within each lamella, co-localized microfibrils and elastin fibres were aligned in the same direction as the collagen fibres. In the interlamellar space, a dense co-localized network, staining for both microfibrils and elastin fibres, was apparent; immunostaining for both molecules was noticeably stronger than within lamellae. In the inner annulus fibrosus, the microfibrils were predominantly visible as a filamentous mesh network, both in the interterritorial matrix and also around the cells. The microfibrils in this region co-localized with elastin fibres far less than in the OAF. In nucleus pulposus, filamentous microfibrils were organized mainly around the cells where elastin fibres were hardly detected. By contrast, sparse elastin fibres, with a few of microfibrils, were visible in the interterritorial matrix. The results of this study suggest the microfibrillar network of the annulus may play a mechanical role while that around the cells of the nucleus may be more involved in regulating cell function.