Institution
Nuffield Orthopaedic Centre
Healthcare•Oxford, 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 published on a yearly basis
Papers
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TL;DR: The effects of growth pre-dispose children with neurological impairments to the sec-ondary problems of muscle contractures, bony deformities, and unusual gait abnormalities.
Abstract: Children with cerebral palsy (CP) are functionally limited to varying degrees because of their decreased central control and coordination of their movements. The effects of growth predispose children with neurological impairments to the secondary problems of muscle contractures, bony deformities, and unusual gait abnormalities. Health care programmes aim to prevent deformities and encourage the development of functional and independent skills and abilities. Orthoses continue to have an important role in many therapeutic regimens for children with CP, however, there have been differences in designs of orthoses prescribed for the common problem of spastic equinus. This is because different treatment paradigms have evolved which advocate different designs of ankle–foot orthoses (AFOs).
108 citations
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TL;DR: MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting, in this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed.
Abstract: Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40 %) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51 %, moderate in 39 % and severe in 10 %. Subluxation was more prevalent in females than males (42 % vs. 37 %) and this was most obvious in the severe group where 68 % were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed.
107 citations
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TL;DR: The responsiveness of the Manchester-Oxford Foot Questionnaire (MOXFQ) was compared with foot/ankle-specific and generic outcome measures used to assess all surgery of the foot and ankle and found that the responsiveness was good compared with the AOFAS.
Abstract: The responsiveness of the Manchester–Oxford Foot
Questionnaire (MOXFQ) was compared with foot/ankle-specific and
generic outcome measures used to assess all surgery of the foot
and ankle. We recruited 671 consecutive adult patients awaiting
foot or ankle surgery, of whom 427 (63.6%) were female, with a mean
age of 52.8 years (18 to 89). They independently completed the MOXFQ,
Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively
and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle
surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS)
scores corresponding to four foot/ankle regions. A transition item measured
perceived changes in foot/ankle problems post-surgery. Of 628 eligible
patients proceeding to surgery, 491 (78%) completed questionnaires
and 262 (42%) received clinical assessments both pre- and post-operatively. The
regions receiving surgery were: multiple/whole foot in eight (1.3%),
ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%), hallux in
196 (31.2%), and lesser toes in 111 (17.7%). Foot/ankle-specific
MOXFQ, AOFAS and EQ-5D domains produced larger effect sizes (> 0.8)
than any SF-36 domains, suggesting superior responsiveness. In analyses
that anchored change in scores and effect sizes to patients’ responses
to a transition item about their foot/ankle problems, the MOXFQ
performed well. The SF-36 and EQ-5D performed poorly. Similar analyses,
conducted within foot-region based sub-groups of patients, found
that the responsiveness of the MOXFQ was good compared with the
AOFAS. This evidence supports the MOXFQ’s suitability for assessing
all foot and ankle surgery.
107 citations
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TL;DR: The radiographic Decision Aid safely and reliably identifies appropriate patients for meniscal-bearing UKA and achieves good results in this population.
Abstract: Aims An evidence-based radiographic Decision Aid for meniscal-bearing
unicompartmental knee arthroplasty (UKA) has been developed and
this study investigates its performance at an independent centre. Patients and Methods Pre-operative radiographs, including stress views, from a consecutive
cohort of 550 knees undergoing arthroplasty (UKA or total knee arthroplasty;
TKA) by a single-surgeon were assessed. Suitability for UKA was
determined using the Decision Aid, with the assessor blinded to
treatment received, and compared with actual treatment received, which
was determined by an experienced UKA surgeon based on history, examination,
radiographic assessment including stress radiographs, and intra-operative
assessment in line with the recommended indications as described
in the literature. Results The sensitivity and specificity of the Decision Aid was 92% and
88%, respectively. Excluding knees where a clear pre-operative plan
was made to perform TKA, i.e. patient request, the sensitivity was
93% and specificity 96%. The false-positive rate was low (2.4%)
with all affected patients readily identifiable during joint inspection
at surgery. In patients meeting Decision Aid criteria and receiving UKA,
the five-year survival was 99% (95% confidence intervals (CI) 97
to 100). The false negatives (3.5%), who received UKA but did not
meet the criteria, had significantly worse functional outcomes (flexion
p < 0.001, American Knee Society Score - Functional p < 0.001,
University of California Los Angeles score p = 0.04), and lower
implant survival of 93.1% (95% CI 77.6 to 100). Conclusion The radiographic Decision Aid safely and reliably identifies
appropriate patients for meniscal-bearing UKA and achieves good
results in this population. The widespread use of the Decision Aid
should improve the results of UKA. Cite this article: Bone Joint J 2016;98-B(10
Suppl B):3–10.
107 citations
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TL;DR: The authors carried out a prospective study of 93 patients undergoing surgery for conditions of the rotator cuff during 1994 and 1995 They were assessed before operation and after six months, and four years, using the patient-based Oxford Shoulder Score (OSS), the SF-36 questionnaire and the Constant shoulder score.
Abstract: We carried out a prospective study of 93 patients undergoing surgery for conditions of the rotator cuff during 1994 and 1995 They were assessed before operation and after six months, and four years, using the patient-based Oxford Shoulder Score (OSS), the SF-36 questionnaire and the Constant shoulder score The response rates were higher for the OSS and SF-36 The correlation coefficients were high (r > 05) between all scores at each stage of the study While all scores improved substantially at six months, the Constant score was reduced significantly at four years This did not correlate with the patients’ judgement of the change in symptoms or of the success of the operation Our study suggests that patient-based measures of pain and function can reliably assess outcomes in the medium term after surgery to the shoulder
107 citations
Authors
Showing all 2120 results
Name | H-index | Papers | Citations |
---|---|---|---|
Douglas G. Altman | 253 | 1001 | 680344 |
George Davey Smith | 224 | 2540 | 248373 |
Cyrus Cooper | 204 | 1869 | 206782 |
James J. Collins | 151 | 669 | 89476 |
Richard J.H. Smith | 118 | 1308 | 61779 |
Andrew Carr | 111 | 842 | 54974 |
Paul Dieppe | 105 | 618 | 53529 |
Matthew A. Brown | 103 | 748 | 59727 |
David W. Murray | 97 | 699 | 43372 |
Ray Fitzpatrick | 95 | 477 | 40322 |
Derrick W. Crook | 92 | 474 | 29885 |
Richard W Morris | 91 | 519 | 35165 |
Richard J. K. Taylor | 91 | 1543 | 43893 |
Sharon J. Peacock | 90 | 494 | 33352 |
Derick T Wade | 90 | 398 | 37413 |