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Book chapterMcGregor AH, 2016, , Sports Innovation Technology and Research, Pages: 31-38
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Journal articleNahas S, Ieong E, Logishetty K, et al., 2016, , MUSCULOSKELETAL CARE, Vol: 14, Pages: 180-184, ISSN: 1478-2189
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- Citations: 1
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Journal articleGrice JE, Willmott H, Halewood C, et al., 2016, , Foot & Ankle Orthopaedics, Vol: 1, ISSN: 2473-0114
<jats:sec> <jats:title>Category:</jats:title> <jats:p>Midfoot/Forefoot</jats:p> </jats:sec> <jats:sec> <jats:title>Introduction/Purpose:</jats:title> <jats:p>Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a commonly performed procedure for the treatment of hallux rigidus. A range of fixation methods have been used. Most recently, the shape-memory staple has been described. Made from an equiatomic alloy, the staple changes its shape when heated to body temperature so as to provide compression across the arthrodesis. We aimed to determine load to failure, cyclic loading and failure characteristics of different staple configurations compared to crossed screws.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>A cadaveric porcine model was used to simulate first MTPJ arthrodesis. Five forms of fixation were tested: single vertical staple; single horizontal staple; paired staples in orthogonal superior-inferior and medial-lateral configuration (0-90° to sagittal plane); paired staples in an oblique orthogonal configuration (45-135° to sagittal plane); two crossed screws. Using a materials-testing machine, specimens were loaded in dorsiflexion to simulate weight bearing. Cyclical loading was performed from 5-40N at a rate of 0.5 Hz for 1000 cycles. Plantar gapping, shear and creep were measured. Specimens were then loaded to failure in order to generate a load-displacement curve. The mechanism of failure was noted for each group.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Single staple configurations failed at very lo
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Conference paperBates AV, Mcgregor AH, Alexander C, 2016, , ESMAC, Publisher: Elsevier, ISSN: 1879-2219
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Journal articleBuckeridge EM, Weinert-Aplin RA, Bull AM, et al., 2016, , Sports Biomechanics, Vol: 15, ISSN: 1752-6116
Strength, technique, and coordination are crucial to rowing performance, but external interventions such as foot-stretcher set-up can fine-tune technique and optimise power output. For the same resultant force, raising the height of foot-stretchers on a rowing ergometer theoretically alters the orientation of the resultant force vector in favour of the horizontal component. This study modified foot-stretcher heights and examined their instantaneous effect on foot forces and rowing technique. Ten male participants rowed at four foot-stretcher heights on an ergometer that measured handle force, stroke length, and vertical and horizontal foot forces. Rowers were instrumented with motion sensors to measure ankle, knee, hip, and lumbar–pelvic kinematics. Key resultant effects of increased foot-stretcher heights included progressive reductions in horizontal foot force, stroke length, and pelvis range of motion. Raising foot-stretcher height did not increase the horizontal component of foot force as previously speculated. The reduced ability to anteriorly rotate the pelvis at the front of the stroke may be a key obstacle in gaining benefits from raised foot-stretcher heights. This study shows that small changes in athlete set-up can influence ergometer rowing technique, and rowers must individually fine-tune their foot-stretcher height to optimise power transfer through the rowing stroke on an ergometer.
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Conference paperJin A, Cobb JP, Hansen U, et al., 2016, , WCO-IOF-ESCEO World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, Publisher: Springer Verlag (Germany), Pages: S490-S490, ISSN: 1433-2965
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Conference paperGeraldes D, Hansen U, Jeffers J, et al., 2016,
Interference fit optimisation for small press-fitted pegs
, International Society for Technology in Arthroplasty 2015, Publisher: BRITISH EDITORIAL SOCIETY OF BONE & JOINT SURGERY, Pages: 150-150, ISSN: 2049-4416 -
Journal articleCoudrillier B, Campbell IC, Read AT, et al., 2016, , INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, Vol: 57, Pages: 2666-2677, ISSN: 0146-0404
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Journal articleGulati V, Simpson AI, Uzoigwe C, et al., 2016, , Journal of the Royal Society of Medicine, ISSN: 1758-1095
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Journal articleKittl C, El-Daou H, Athwal KK, et al., 2016, , American Journal of Sports Medicine, Vol: 44, Pages: NP15-NP18, ISSN: 1552-3365
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Book chapterHalewood C, Amis AA, 2016, , Surgery of the Meniscus, Pages: 35-45
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- Citations: 2
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Journal articleDavda K, Smyth N, Cobb JP, et al., 2016, , ACTA ORTHOPAEDICA, Vol: 87, Pages: 314-317, ISSN: 1745-3674
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Conference paperPapi E, Bo YNJ, McGregor AH, 2016,
KNEE FLEXION MEASURED WITH A FLEXIBLE WEARABLE SENSOR
, European Society of Biomechanics Conference -
Conference paperSymes DR, Najmudin Z, Cole JM, et al., 2016, , Compact EUV & X-ray Light Sources 2016, Publisher: OSA Publishing
Extremely bright coherent femtosecond x-ray pulses are generated in compact laserdriven electron accelerators. Micro-tomography obtained with the Gemini laser indicates the usefulness of these sources in research and clinical applications.
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Journal articleAng WW, Sabharwal S, Johannsson H, et al., 2016, , Annals of Medicine and Surgery, Vol: 7, Pages: 24-29, ISSN: 2049-0801
The National Health Service (NHS) is currently facing a financial crisis with a projected deficit of £2billion by the end of financial year 2015/16. As operating rooms (OR) are one of the costliest components in secondary care, improving theatre efficiency should be at the forefront of efforts to improve health service efficiency. The objectives of this study were to characterize the causes of trauma OR delays and to estimate the cost of this inefficiency. A 1-month prospective single-centre study in St. Mary's Hospital. Turnaround time (TT) was used as the surrogate parameter to measure theatre efficiency. Factors including patient age, ASA score and presence of surgical and anaesthetic consultant were evaluated to identify positive or negative associations with theatre delays. Inefficiency cost was calculated by multiplying the time wasted with staff capacity costs and opportunity costs, found to be £24.77/minute. The commonest causes for increased TT were delays in sending for patients (50%) and problems with patient transport to the OR (31%). 461 min of delay was observed in 12 days, equivalent to loss of £951.58/theatre/day. Non-statistically significant trends were seen between length of delays and advancing patient age, ASA score and absence of either a senior clinician or an anaesthetic consultant. Interestingly, the trend was not as strong for absence of an anaesthetic consultant. This study found delays in operating TT to represent a sizable cost, with potential efficiency savings based on TT of £347,327/theatre/year. Further study of a larger sample is warranted to better evaluate the identified trends.
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Journal articleGill RJ, Smith DB, Raine NE, et al., 2016, , Scientific Reports, Vol: 6, ISSN: 2045-2322
The capacity to explore soft tissue structures in detail is important in understandinganimal physiology and how this determines features such as movement, behaviour and the impactof trauma on regular function. Here we use advances in micro-computed tomography (micro-CT)technology to explore the brain of an important insect pollinator and model organism, thebumblebee (Bombus terrestris). Here we present a method for accurate imaging and exploration 2of insect brains that keeps brain tissue free from trauma and in its natural stereo-geometry, andshowcase our 3D reconstructions and analyses of 19 individual brains at high resolution.Development of this protocol allows relatively rapid and cost effective brain reconstructions,making it an accessible methodology to the wider scientific community. The protocol describes thenecessary steps for sample preparation, tissue staining, micro-CT scanning and 3D reconstruction,followed by a method for image analysis using the freeware SPIERS. These image analysis methodsdescribe how to virtually extract key composite structures from the insect brain, and wedemonstrate the application and precision of this method by calculating structural volumes andinvestigating the allometric relationships between bumblebee brain structures.
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Journal articleSabharwal S, Carter AW, Rashid A, et al., 2016, , Bone & Joint Journal, Vol: 98B, Pages: 249-259, ISSN: 2049-4394
Aims The aims of this study were to estimate the cost of surgical treatment of fractures of the proximal humerus using a micro-costing methodology, contrast this cost with the national reimbursement tariff and establish the major determinants of cost.Methods A detailed inpatient treatment pathway was constructed using semi-structured interviews with 32 members of hospital staff. Its content validity was established through a Delphi panel evaluation. Costs were calculated using time-driven activity-based costing (TDABC) and sensitivity analysis was performed to evaluate the determinants of costResults The mean cost of the different surgical treatments was estimated to be £3282. Although this represented a profit of £1138 against the national tariff, hemiarthroplasty as a treatment choice resulted in a net loss of £952. Choice of implant and theatre staffing were the largest cost drivers. Operating theatre delays of more than one hour resulted in a loss of incomeDiscussion Our findings indicate that the national tariff does not accurately represent the cost of treatment for this condition. Effective use of the operating theatre and implant discounting are likely to be more effective cost containment approaches than control of bed-day costs.Take home message: This cost analysis of fractures of the proximal humerus reinforces the limitations of the national tariff within the English National Health Service, and underlines the importance of effective use of the operating theatre, as well as appropriate implant procurement where controlling costs of treatment is concerned.
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Journal articleBelsi A, Papi E, McGregor AH, 2016, , BMJ Open, Vol: 6, ISSN: 2044-6055
Objectives To identify the impact the use of wearable technology could have in patients with osteoarthritis in terms of communication with healthcare providers and patients’ empowerment to manage their condition.Design Qualitative study using focus groups with patients with osteoarthritis; data from patients’ responses were analysed using Framework Methodology.Participants 21 patients with knee osteoarthritis from the London area (age range 45–65鈥厃ears) participated in a total of four focus groups. Recruitment continued until data saturation.Setting The study was conducted in a university setting.Results Patients’ responses suggested a positive attitude on the impact wearable technology could have on the management of osteoarthritis. It was perceived that the use of wearable devices would benefit patients in terms of feeling in control of their condition, providing them with awareness of their progress, empowering in terms of self-management and improving communication with their clinician.Conclusions This paper suggests positive patient perspectives on the perceived benefits wearable technology could have on the management of osteoarthritis. The data that could be collected with the use of wearable technology could be beneficial both to patients and clinicians. The information obtained from this study suggests that introducing wearable technology into patient-centred care could enhance patient experience in the field of osteoarthritis and beyond.
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Journal articleStephen JM, Halewood C, Kittl C, et al., 2016, , American Journal of Sports Medicine, Vol: 44, Pages: 400-408, ISSN: 0363-5465
Background:Injury to the posteromedial meniscocapsular junction has been identified after anterior cruciate ligament (ACL) rupture; however, there is a lack of objective evidence investigating how this affects knee kinematics or whether increased laxity can be restored by repair. Such injury is often overlooked at surgery, with possible compromise to results.Hypotheses:(1) Sectioning the posteromedial meniscocapsular junction in an ACL-deficient knee will result in increased anterior tibial translation and rotation. (2) Isolated ACL reconstruction in the presence of a posteromedial meniscocapsular junction lesion will not restore intact knee laxity. (3) Repair of the posteromedial capsule at the time of ACL reconstruction will reduce tibial translation and rotation to normal. (4) These changes will be clinically detectable.Study Design:Controlled laboratory study.Methods:Nine cadaveric knees were mounted in a test rig where knee kinematics were recorded from 0° to 100° of flexion by use of an optical tracking system. Measurements were recorded with the following loads: 90-N anterior-posterior tibial forces, 5-N·m internal-external tibial rotation torques, and combined 90-N anterior force and 5-N·m external rotation torque. Manual Rolimeter readings of anterior translation were taken at 30° and 90°. The knees were tested in the following conditions: intact, ACL deficient, ACL deficient and posteromedial meniscocapsular junction sectioned, ACL deficient and posteromedial meniscocapsular junction repaired, ACL patellar tendon reconstruction with posteromedial meniscocapsular junction repair, and ACL reconstructed and capsular lesion re-created. Statistical analysis used repeated-measures analysis of variance and post hoc paired t tests with Bonferroni correction.Results:Tibial anterior translation and external rotation were both significantly increased compared with the ACL-deficient knee after posterior meniscocapsular sectioning (P <
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Journal articleKittl C, El-Daou H, Athwal KK, et al., 2016, , AMERICAN JOURNAL OF SPORTS MEDICINE, Vol: 44, Pages: 345-354, ISSN: 0363-5465
Background:Anterolateral rotatory instability (ALRI) may result from combined anterior cruciate ligament (ACL) and lateral extra-articular lesions, but the roles of the anterolateral structures remain controversial.Purpose:To determine the contribution of each anterolateral structure and the ACL in restraining simulated clinical laxity in both the intact and ACL-deficient knee.Study Design:Controlled laboratory study.Methods:A total of 16 knees were tested using a 6 degrees of freedom robot with a universal force-moment sensor. The system automatically defined the path of unloaded flexion/extension. At different flexion angles, anterior-posterior, internal-external, and internal rotational laxity in response to a simulated pivot shift were tested. Eight ACL-intact and 8 ACL-deficient knees were tested. The kinematics of the intact/deficient knee was replayed after transecting/resecting each structure of interest; therefore, the decrease in force/torque reflected the contribution of the transected/resected structure in restraining laxity. Data were analyzed using repeated-measures analyses of variance and paired t tests.Results:For anterior translation, the intact ACL was clearly the primary restraint. The iliotibial tract (ITT) resisted 31% ± 6% of the drawer force with the ACL cut at 30° of flexion; the anterolateral ligament (ALL) and anterolateral capsule resisted 4%. For internal rotation, the superficial layer of the ITT significantly restrained internal rotation at higher flexion angles: 56% ± 20% and 56% ± 16% at 90° for the ACL-intact and ACL-deficient groups, respectively. The deep layer of the ITT restrained internal rotation at lower flexion angles, with 26% ± 9% and 33% ± 12% at 30° for the ACL-intact and ACL-deficient groups, respectively. The other anterolateral structures provided no significant contribution. During the pivot-shift test, the ITT provided 72% ± 14% of the restraint at 45° for th
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