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Conference paperSugand K, Boyer N, Sarraf K, et al., 2015,
Using online mutlimedia to teach orthopaedic trauma emergencies
, Annual Meeting of the Society-of-Academic-and-Research-Surgery (SARS(, Publisher: WILEY-BLACKWELL, Pages: 34-34, ISSN: 0007-1323 -
Conference paperStephen JM, Halewood C, Kittl C, et al., 2015,
The influence of posterior medial meniscocapsular lesions on tibiofemoral joint laxity in ACL deficient and reconstructed knees
, British Association of Surgery of the Knee -
Journal articleAkhtar K, Sugand K, Wijendra A, et al., 2015, , Patient Safety in Surgery, Vol: 9, ISSN: 1754-9493
BACKGROUND: Simulation allows training without posing risk to patient safety. It has developed in response to the demand for patient safety and the reduced training times for surgeons. Whilst there is an increasing role of simulation in orthopaedic training, the perception of patients and the general public of this novel method is yet unknown. Patients and the public were given the opportunity to perform a diagnostic knee arthroscopy on a virtual reality ARTHRO Mentor simulator. After their practice session, participants answered a validated questionnaire based on a 5-point Likert Scale assessing their opinions on arthroscopic simulation. Primary objective was observing perception of patients on orthopaedic virtual reality simulation. FINDINGS: There were a total of 159 respondents, of which 86% were of the opinion that simulators are widely used in surgical training and 94% felt that they should be compulsory. 91% would feel safer having an operation by a surgeon trained on simulators, 87% desired their surgeon to be trained on simulators and 72% believed that additional simulator training resulted in better surgeons. Moreover, none of the respondents would want their operation to be performed by a surgeon who had not trained on a simulator. Cronbach's alpha was 0.969. CONCLUSIONS: There is also a clear public consensus for this method of training to be more widely utilised and it would enhance public perception of safer training of orthopaedic surgeons. This study of public perception provides a mandate to increase investment and infrastructure in orthopaedic simulation as part of promoting clinical governance.
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Journal articleCampbell IC, Coudrillier B, Mensah J, et al., 2015, , JOURNAL OF THE ROYAL SOCIETY INTERFACE, Vol: 12, ISSN: 1742-5689
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- Citations: 35
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Journal articleKawaguchi Y, Kondo E, Takeda R, et al., 2015, , ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol: 31, Pages: 435-444, ISSN: 0749-8063
PurposeThe purpose was to clarify the load-bearing functions of the fibers of the femoral anterior cruciate ligament (ACL) attachment in resisting tibial anterior drawer and rotation.MethodsA sequential cutting study was performed on 8 fresh-frozen human knees. The femoral attachment of the ACL was divided into a central area that had dense fibers inserting directly into the femur and anterior and posterior fan-like extension areas. The ACL fibers were cut sequentially from the bone: the posterior fan-like area in 2 stages, the central dense area in 4 stages, and then the anterior fan-like area in 2 stages. Each knee was mounted in a robotic joint testing system that applied tibial anteroposterior 6-mm translations and 10° or 15° of internal rotation at 0° to 90° of flexion. The reduction of restraining force or moment was measured after each cut.ResultsThe central area resisted 82% to 90% of the anterior drawer force; the anterior fan-like area, 2% to 3%; and the posterior fan-like area, 11% to 15%. Among the 4 central areas, most load was carried close to the roof of the intercondylar notch: the anteromedial bundle resisted 66% to 84% of the force and the posterolateral bundle resisted 16% to 9% from 0° to 90° of flexion. There was no clear pattern for tibial internal rotation, with the load shared among the posterodistal and central areas near extension and mostly the central areas in flexion.ConclusionsUnder the experimental conditions described, 66% to 84% of the resistance to tibial anterior drawer arose from the ACL fibers at the central-proximal area of the femoral attachment, corresponding to the anteromedial bundle; the fan-like extension fibers contributed very little. This work did not support moving a single-bundle ACL graft to the side wall of the notch or attempting to cover the whole attachment area if the intention was to mimic how the natural ACL resists tibial displacements.Clinical RelevanceThere is ongoing debate about ho
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Journal article, 2015, , Br J Hosp Med (Lond), Vol: 76, ISSN: 1750-8460
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Journal articleMacmull S, Gupte CM, 2015, , Orthopaedics and Trauma, Vol: 29, Pages: 6-11, ISSN: 1877-1327
Knee arthroscopy has proved to be a useful tool in the diagnosis of common knee intra-articular pathologies and has become a mainstay of treatment for meniscal, cruciate and chondral disorders of the knee. The aim of this article is to give a brief history of arthroscopic surgery, explain the safe positioning of the patient on the operating table and how to navigate the knee with an arthroscope, and cover the potential complications.
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Journal articleKittl C, Halewood C, Stephen JM, et al., 2015, , American Journal of Sports Medicine, Vol: 43, Pages: 354-362, ISSN: 0363-5465
Background:Lateral extra-articular soft tissue reconstructions in the knee may be used as a combined procedure in revision anterior cruciate ligament surgery as well as in primary treatment for patients who demonstrate excessive anterolateral rotatory instability. Only a few studies examining length change patterns and isometry in lateral extra-articular reconstructions have been published.Purpose:To determine a recommended femoral insertion area and graft path for lateral extra-articular reconstructions by measuring length change patterns through a range of knee flexion angles of several combinations of tibial and femoral insertion points on the lateral side of the knee.Study Design:Controlled laboratory study.Methods:Eight fresh-frozen cadaveric knees were freed of skin and subcutaneous fat. The knee was then mounted in a kinematics rig that loaded the quadriceps muscles and simulated open-chain knee flexion. The length changes of several combinations of tibiofemoral points were measured at knee flexion angles between 0° and 90° by use of linear variable displacement transducers. The changes in length relative to the 0° measurement were recorded.Results:The anterior fiber region of the iliotibial tract displayed a significantly different (P < .001) length change pattern compared with the posterior fiber region. The reconstructions that had a femoral insertion site located proximal to the lateral epicondyle and with the grafts passed deep to the lateral collateral ligament displayed similar length change patterns to each other, with small length increases during knee extension. These reconstructions also showed a significantly lower total strain range compared with the reconstruction located anterior to the epicondyle (P < .001).Conclusion:These findings show that the selection of graft attachment points and graft course affects length change pattern during knee flexion. A graft attached proximal to the lateral femoral epicondyle and running deep
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Journal articleBrewer P, Hand SJ, Archer M, et al.,
New genus of primitive wombat (Vombatidae,Marsupialia) from Miocene deposits in the RiversleighWorld Heritage Area (Queensland, Australia)
, Palaeontologia Electronica -
Conference paperGeraldes D, Hansen U, Amis A, 2015,
Parametric analysis of glenoid implant design
, European Society of Biomechanics 2015 -
Book chapterAkhtar K, Standfield NJ, Gupte CM, et al., 2015, , Effective Training of Arthroscopic Skills, Pages: 71-80
Virtual reality(VR) is defined as the computer-generated simulation of a three-dimensional image or environment that can be interacted with in a seemingly real or physical way by a person using special electronic equipment (Oxford English Dictionary 2014).
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Conference paperCoudrillier B, Geraldes D, Nghia V, et al., 2015,
A novel micro-computed tomography method to measure IOP-induced deformation of the lamina cribrosa.
, The Annual Meeting of the Association for Research in Vision and Ophthalmology 2015 -
Conference paperCoudrillier B, Geraldes D, Nghia V, et al., 2015,
Phase-contrast micro-tomography measurements of intraocular pressure-induced deformation of the porcine lamina cribrosa
, Biomechanics, Bioengineering and Biotransport Conference 2015 -
Journal articleYu AW, Duncan JM, Daurka JS, et al., 2015, , ADVANCES IN ORTHOPEDICS, Vol: 2015, ISSN: 2090-3464
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- Citations: 30
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Conference paperSpulber I, Chen Y-M, Papi E, et al., 2015,
Live demonstration: Wearable electronics for a smart garment aiding rehabilitation
, Pages: 1912-1912 -
Journal articleWilson H, Shah I, Abel P, et al., 2015,
Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture
, Central European Journal of Urology, Vol: 68, Pages: 165-168 -
Book chapterKeller R, Amis AA, 2015,
Anatomy and Biomechanics of the Natural Knee and After TKR
, The Unhappy Total Knee Replacement, Editors: Hirschmann, Becker, Publisher: Springer, Pages: 3-15, ISBN: 978-3-319-08098-7This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.
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Journal articleChen A, Balogun-Lynch J, Aggarwal K, et al., 2014, , SpringerPlus, Vol: 3, Pages: 1-5, ISSN: 2193-1801
The aims of this study were to: [1] Assess the number of patients with suspected knee osteoarthritis that underwent repeat weight-bearing(WB) knee radiographs in the orthopaedic clinic following initial non-WB radiograph requested by their general practitioner (GP). [2] Confirm whether repeating WB knee views changed radiology reports. [3] Determine the number of London trusts with protocols for routinely performing WB views. A Retrospective cohort study of 1968 patients aged >40 years referred to a London teaching hospital for knee radiographs over 12 months. Radiographs were identified as WB/non-WB. Subsequent repeat WB views performed in those that went on to have an orthopaedic consultation were also documented. A consultant musculoskeletal radiologist reported both images. A proforma containing a likert scale of severity for commonly reported abnormalities in knee osteoarthritis and criteria from the Kellgren and Lawrence scale was used for reporting. London NHS Trusts were surveyed to identify if protocols were in place for performing WB views. A total of 1,968 patients underwent knee radiographs, of which 1922 (97.7%) had initial non-WB radiographs. Of the 56 patients in this group that underwent required repeat WB radiographs, joint space narrowing was reported as more severe on WB versus non-WB radiographs (p = 0.035). Only 54% of departments routinely performed WB radiographs. Few patients (2.3%) referred by GPs have WB radiographs requested. Some of those referred for a specialist opinion required repeat WB views. Nearly half of London hospitals do not routinely perform WB radiographs. This represents a significant financial burden to the NHS, increased radiation exposure and wasted patient/clinician time. We propose that all GP requested knee radiographs be performed as WB unless otherwise stated.
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Journal articlePuthumanapully PK, Harris SJ, Leong A, et al., 2014, , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 22, Pages: 2891-2899, ISSN: 0942-2056
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- Citations: 31
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Journal articleHunt NC, Ghosh KM, Athwal KK, et al., 2014, , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 22, Pages: 3100-3112, ISSN: 0942-2056
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- Citations: 40
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