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1دورية أكاديمية
المؤلفون: Harry Krishnan, Jonathan D. Eldridge, Damian Clark, Andrew J. Metcalfe, Jarrad M. Stevens, Vipul Mandalia
المصدر: Bone & Joint Open, Vol 3, Iss 3, Pp 268-274 (2022)
مصطلحات موضوعية: knee, stability, patella, TT-TG, osteotomy, tibial tuberosity-trochlear groove (TT-TG) distances, Orthopedic surgery, RD701-811
الوصف: Recognized anatomic variations that lead to patella instability include patella alta and trochlea dysplasia. Lateralization of the extensor mechanism relative to the trochlea is often considered to be a contributing factor; however, controversy remains as to the degree this contributes to instability and how this should be measured. As the tibial tuberosity-trochlear groove (TT-TG) is one of most common imaging measurements to assess lateralization of the extensor mechanism, it is important to understand its strengths and weaknesses. Care needs to be taken while interpreting the TT-TG value as it is affected by many factors. Medializing tibial tubercle osteotomy is sometimes used to correct the TT-TG, but may not truly address the underlying anatomical problem. This review set out to determine whether the TT-TG distance sufficiently summarizes the pathoanatomy, and if this assists with planning of surgery in patellar instability. Cite this article: Bone Jt Open 2022;3(3):268–274.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/2633-1462Test
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2دورية أكاديمية
المؤلفون: Damian Clark, F.R.C.S., Katie Walmsley, PgCert. Surg, Peter Schranz, F.R.C.S., Vipul Mandalia, F.R.C.S.
المصدر: Arthroscopy Techniques, Vol 6, Iss 3, Pp e591-e597 (2017)
مصطلحات موضوعية: Orthopedic surgery, RD701-811
الوصف: The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction. The key features include planning of skin incisions to enable both operations to be undertaken, planning of the screw placement before osteotomy is performed and assessment of the joint through a superolateral portal to assess the need for MPFL reconstruction after tuberosity transfer.
وصف الملف: electronic resource
العلاقة: http://www.sciencedirect.com/science/article/pii/S2212628717300154Test; https://doaj.org/toc/2212-6287Test
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المؤلفون: David J Beard, Loretta Davies, Jonathan A Cook, Jamie Stokes, Jose Leal, Heidi Fletcher, Simon Abram, Katie Chegwin, Akiko Greshon, William Jackson, Nicholas Bottomley, Matt Dodd, Henry Bourke, Beverly A Shirkey, Arsenio Paez, Sarah E Lamb, Karen Barker, Michael Phillips, Mark Brown, Vanessa Lythe, Burhan Mirza, Andrew Carr, Paul Monk, Carlos Morgado Areia, Sean O'Leary, Fares Haddad, Chris Wilson, Andrew Price, Richard Emsley, George Peat, Martyn Snow, Marion Campbell, Tessa Howell, Hilary Johnson, Stephen McDonnell, Thomas Pinkney, Mark Williams, Helen Campbell, Jackie Davies, Jiyang Li, Christina Bagg, Laura Haywood, Anne Nicholson, Joanne Riches, Sean Symons, Mark Vertue, Louay Al Mouazzen, Rachel Bray, Damian Clark, James Coulthard, Tim Holland, Nick Howells, Andrew Jones, Richard Kapur, Alastair Kiszely, Harry Krishnan, Karen MacDonald-Taylor, Jon Manara, James Murray, Corina Negrut, Vishai Pai, Andrew Porteous, Sven Putnis, James Robinson, Shav Rupasinghe, Veenesh Selvaratnam, James Smith, Nick Smith, Jarrad Stevens, Clare Taylor, Anthony Theodorides, Niraj Vetharajan, Helen Vint, Lucy Young, Susan Bullock, Rebecca Cook, Alexander Dodds, Amanda Freeman-Hicks, Paula Hillout, Thomas Cornell, Abbie Coutts, Suzy Dean, Nicki Devooght-Johnson, Emma Ferrell, Eve Fletcher, Chrissie Hall, Benjamin Kent, Sandra Kessly, Robin Kincaid, Mohamed Lazizi, Ahmed Mostafa, Toby Nisbett, Tim Powell, Peter Riddlestone, Andrew Roberton, Jessica Summers, Lucy Whitbread, Belinda Wroath, Emma Fenlon, Andrew Hall, Helen Jeffrey, Raghuram Thonse, Debra Dunne, Andy Metcalfe, Kerri McGowan, Simon Middleton, Feisal Shah, Tim Spalding, Charlie Marie Suddens, Tamar Sweed, Joanna Teuke, Peter Thompson, David Wright, Justine Amero, Emma Brown, Hugh Chissell, Andrea Croucher, Gareth Dickinson, Catherine Hawkes-Blackburn, Alice Peacocke, Graham Smith, Carol Snipe, Kim Dearnley, Reza Mayahi, Barry Andrews, Massimo Barcelona, Hazel Giles, Abdulkerim Gokturk, Paul Harnett, Katie Jeeves, Joyce Kadunyi, Sheena Mendoza, Ines Reichert, Marta Santamaria, Harshinder Virdee, Sanjeev Anand, Nayef Aslam-Pervez, Stephen Draycott, Faye Howarth, Irfan Jina, Niall Maher, Denise Ross, Lindsey Worstenholme, Abdul Baig, Arun Bhaskaran, Daniel Banks, Tracy Brear, Carla Christie, Laura Cowen, Jack Davis, Ross Dixey, Colin Esler, Amirah Essop-Adam, Christina Haines, Linzy Houchen-Wolloff, Husein Varachia, Richard Wood, Glaxy Gray, Jessica Nichols, Alice Panes, Susan Partridge, Lawrie Rogerson, Pankaj Sharma, David Triggs, Ian Venables, Danielle Wilcock, Sarah Buckley, Thelma Darian, Elizabeth Denis, Jo Duncan, Charlotte Hirst, James Newman, Fern Richardson, Jon Smith, Megan Adcode, Megan Cottingham, Eliza Foster, Andrew Kelly, Niamh McKay, Jane Rewbury, Alison Whitcher, James Williams, Esther Zebracki, Llinos Davies, Jayadeep Jayachandran, Alison Tardivel, Victoria Whitehead, Martha Batting, Amy Bond, Marc Deakin, Christopher Dodd, Alison Hudak, Samantha Hynes, Luke Jones, Gail Lang, David McKenna, Susan Morris, Clare Scott-Dempster, Adam Sykes, Iason Vichos, Simon Wood, Rupert Clifton, Stephanie Diaz, Craig Hendy, Nishil Modi, Brendan O'Mahony, Susan O'Sullivan, Nicola Parker, Mira Pecheva, Rowan Rumonovic, Emma McLoughlin, Jeremy Rushbrook, Anna Thornhill, Valerie Parkinson, Rafael Sales, Katja Van De Snepscheut-Jones, David Wilcock, Daniel Wright, Joanna Allison, Simon Baker, Kate Beesley, Gill Ferrari, Benedict Lankester, Alison Lewis, Joanne Lyons, Jamie O'Callaghan, Sarah Sutcliffe, Dianne Wood, Emily Bannister, Chloe Brown, Debbie Burden, Terence Campbell, Emma Craig, Rashmi Easow, Julie Foxton, Alexandra Hazlerigg, Chethan Jayabev, Rosie Murdoch, Georgie Parsons, Harry Brown, Paula Carvelli, Rugaia Montaser, Ali Pepper, Sinduja Sivarajan, Oliver Templeton-Ward, Eva Wilson, Julie Cronin, Sarah Diment, Victoria King, Katharine Shean, Leonidas Vachtsevanos, Katharine Wilcocks, Ben Wilson, Paul McNestry, Joanna Ollerenshaw, James Stoddard, Paul Sutton, Sanjay Anand, Judith Bell, Albert Chikate, Diane Daniel, Timothy Davies, Tom Finnigan, Antonio Frasquet-Garcia, Susan Hopkins, Sharon Kerrison, Angela McGowan, David Sands Johnson, Lara Smith, Philip Turner, Helen Wilkinson, Lynne Allsop, Deborah Anthony, Rebecca Boulton, Sarah Brown, Vikram Desai, Mandy Gill, Cheryl Heeley, Sushrut Kulkarni, Wayne Lovegrove, Dominic Nash, Terri Ann Sewell, Sarah Shelton, Katie Slack, James Cartwright, Lynda Connor, Andrew Davies, Caroline Davies, Glyn Gainard, Dave Graham-Woollard, Carl Murphy, Leanne Quinn, Caradog Thomas, Jenny Travers, Marie Williams, Amanda Bell, Sunny Deo, Katharine Francis, Tracy Jackson, Laura McCafferty, Basalingappa Navadgi, Karan Plank, Venkat Satish, Claire Thelwall, Rachel Knight, Rahul Patel, Bruce Paton, Ashutosh Acharya, Utuman Aland, Miltiades Areirobulos, Pascal de Feyter, Lisa Ditchfield, Hafiz Iqbaz, Daniel Massey, Gareth Stables, Sarah Appleby, Michael Brown, Sarah Cable, Alexander Damen, Joana Da Rocha, Louise Foster, Elizabeth Hamilton, Catriona Hatton, Cassie Honeywell, Kunal Kulkarni, Lucy Markham, Haadiya Mohammed, John O'Grady, Yogesh Joshi, Heather Mclintock, Tania Morgan, Jane Stockport, Pranshu Agrawal, Jo Armstrong, Shannon Briggs, Ben Coupe, Anne Evans, Rob Gilbert, Sandra Latham, Aslam Mohammed
المصدر: Beard, D J 2022, ' Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP) : a pragmatic randomised controlled trial ', The Lancet, vol. 400, no. 10352, pp. 605-615 . https://doi.org/10.1016/S0140-6736Test(22)01424-6
مصطلحات موضوعية: RD32, Treatment Outcome, Anterior Cruciate Ligament Reconstruction, Knee Joint, Anterior Cruciate Ligament Injuries, RM930, Humans, Knee Injuries, General Medicine, R1, RD, State Medicine
الوصف: Background: Anterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability. Methods: We did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367. Findings: Between Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications. Interpretation: Surgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management. Funding: The UK National Institute for Health Research Health Technology Assessment Programme.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1bad1174ff7d024eb039e314d1f44c41Test
https://doi.org/10.1016/s0140-6736Test(22)01424-6 -
4رسالة جامعية
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المؤلفون: Alaa Al-Ahmad, Damian Clark, John Holdsworth, Benjamin Vaughan, Warwick Belcher, Paul Dastoor
المصدر: IEEE Journal of Photovoltaics. 12:521-525
مصطلحات موضوعية: Electrical and Electronic Engineering, Condensed Matter Physics, Electronic, Optical and Magnetic Materials
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::4c4aed0fd5dacb3f113acde7e1a9280bTest
https://doi.org/10.1109/jphotov.2022.3143460Test -
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المؤلفون: Yassin Elsiwy, Domingo J. Tortonese, Jonathan Eldridge, Michael R Whitehouse, Jarrad M Stevens, Damian Clark, Harry Krishnan
المصدر: European Journal of Orthopaedic Surgery & Traumatology. 32:419-425
مصطلحات موضوعية: 030222 orthopedics, medicine.medical_specialty, Mri imaging, business.industry, Patellofemoral joint, Joint contact, 030218 nuclear medicine & medical imaging, Surgery, Surface mapping, 03 medical and health sciences, 0302 clinical medicine, Medicine, Orthopedics and Sports Medicine, Patella, Mri scan, business, Contact area, Joint (geology)
الوصف: In the unstable patellofemoral joint (PFJ), the patella will articulate in an abnormal manner, producing an uneven distribution of forces. It is hypothesised that incongruency of the PFJ, even without clinical instability, may lead to degenerative changes. The aim of this study was to record the change in joint contact area of the PFJ after stabilisation surgery using an established and validated MRI mapping technique. A prospective MRI imaging study of patients with a history of PFJ instability was performed. The patellofemoral joints were imaged with the use of an MRI scan during active movement from 0° through to 40° of flexion. The congruency through measurement of the contact surface area was mapped in 5-mm intervals on axial slices. Post-stabilisation surgery contact area was compared to the pre-surgery contact area. In all, 26 patients were studied. The cohort included 12 male and 14 female patients with a mean age of 26 (15–43). The greatest mean differences in congruency between pre- and post-stabilised PFJs were observed at 0–10 degrees of flexion (0.54 cm2 versus 1.18 cm2, p = 0.04) and between 11° and 20° flexion (1.80 cm2 versus 3.45 cm2; p = 0.01). PFJ stabilisation procedures increase joint congruency. If a single axial series is to be obtained on MRI scan to compare the pre- and post-surgery joint congruity, the authors recommend 11° to 20° of tibiofemoral flexion as this was shown to have the greatest difference in contact surface area between pre- and post-operative congruency.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::bc073aa4f943f38443ef4667543ab42eTest
https://doi.org/10.1007/s00590-021-02980-8Test -
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المؤلفون: Stephanie Parkinson, Maina P. Kava, Cara Schofield, Donna Cross, Klair Bayley, Peter Jacoby, Odette Gaynor, Jenny Downs, Damian Clark, Susan Morris, Kerry Evans, Anita Cairns, Monique M. Ryan, Linda Chiu, Nitamarie Vorster, Aris Siafarikas
المصدر: Journal of Paediatrics and Child Health. 56:1419-1425
مصطلحات موضوعية: Parents, medicine.medical_specialty, Adolescent, Duchenne muscular dystrophy, Walking, Personal Adjustment, 03 medical and health sciences, 0302 clinical medicine, Wheelchair, 030225 pediatrics, Intervention (counseling), medicine, Humans, 030212 general & internal medicine, Child, business.industry, medicine.disease, Mental health, Confidence interval, Muscular Dystrophy, Duchenne, medicine.anatomical_structure, Wheelchairs, Joint pain, Standing Position, Pediatrics, Perinatology and Child Health, Physical therapy, medicine.symptom, Ankle, business
الوصف: Aim Poorer physical and mental health often accompany loss of walking in Duchenne muscular dystrophy. This study assessed the impacts of powered wheelchair standing device (PWSD) use on muscle and joint pain, joint angles when standing and mental health in adolescents with Duchenne muscular dystrophy. Methods Fourteen adolescents and parents participated in a stepped wedge design study over 12 months. During a baseline and intervention period, adolescents described pain and mental health, and parents reported their child's mental health. Video data were collected to measure hip, knee and ankle joint angles in the preferred standing position. Results Compared with baseline and adjusting for covariates, standing wheelchair use was associated with no change in muscle or joint pain or videoed joint angles in standing. Child-reported Strengths and Difficulties total scores decreased (coefficient -3.1, 95% confidence interval -4.6, -1.5); and parent-reported Personal Adjustment and Role Skills Scale total scores increased (coefficient 7.9, 95% confidence interval 3.3-12.5). Conclusions PWSD use was associated with maintenance of musculoskeletal status and advantages to mental health. Long-term observations are necessary to improve understanding of how to support wellbeing in adolescents with Duchenne muscular dystrophy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4e3d558be118fd7c1119d26c44730e2cTest
https://doi.org/10.1111/jpc.14963Test -
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المؤلفون: Damian Clark, Nicole Williams, David Ketteridge, Prajay Patel, Georgia Antoniou
المصدر: Journal of Child Neurology
مصطلحات موضوعية: musculoskeletal diseases, Pediatrics, medicine.medical_specialty, pediatrics, Mucopolysaccharidosis, carpal tunnel syndrome, Physical examination, 03 medical and health sciences, 0302 clinical medicine, decompression surgery, Mucopolysaccharidosis I, Screening method, Medicine, In patient, Carpal tunnel syndrome, 030222 orthopedics, medicine.diagnostic_test, business.industry, Original Articles, medicine.disease, mucopolysaccharidoses, nervous system diseases, body regions, Young age, inborn genetic diseases, Pediatrics, Perinatology and Child Health, Neurology (clinical), High incidence, business, 030217 neurology & neurosurgery
الوصف: Mucopolysaccharidoses (MPSs) are a group of rare lysosomal storage diseases with multisystem manifestations, including carpal tunnel syndrome (CTS). This study comprised a systematic review of literature and hospital guidelines addressing the method and frequency of screening for carpal tunnel syndrome in mucopolysaccharidosis patients and a review of carpal tunnel syndrome in patients seen in the multidisciplinary mucopolysaccharidosis clinic of a pediatric hospital, in order to develop screening recommendations. The literature reported the importance of routine carpal tunnel syndrome screening from early childhood in patients with mucopolysaccharidosis I, II, IV, and VI. Screening methods included physical examination, nerve conduction studies, electromyography, and ultrasonography. Ten of 20 mucopolysaccharidosis patients in our series underwent carpal tunnel syndrome surgery. Given the high incidence of carpal tunnel syndrome at a young age in mucopolysaccharidosis, the authors recommend performing physical examination and obtaining patient and caregiver history for carpal tunnel syndrome every 6 months from the time of mucopolysaccharidosis diagnosis, supplemented by annual nerve conduction studies in cases with poor history or equivocal examination.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e290a49723e5b06039a1e03e8c9e39ecTest
http://europepmc.org/articles/PMC7153223Test -
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المصدر: European Journal of Orthopaedic Surgery & Traumatology. 30:139-145
مصطلحات موضوعية: Adult, Joint Instability, Male, Intra-Articular Fractures, Knee Joint, medicine.medical_treatment, Radiography, Bone Screws, Tibial tuberosity, Bone healing, Osteotomy, Patient Positioning, Screw fixation, Cohort Studies, Arthroscopy, 03 medical and health sciences, Fixation (surgical), 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Registries, Range of Motion, Articular, Superficial Infection, Orthodontics, 030222 orthopedics, Tibia, medicine.diagnostic_test, business.industry, Recovery of Function, 030229 sport sciences, Middle Aged, United Kingdom, Treatment Outcome, Female, Surgery, business, Bone Plates
الوصف: We describe a fixation technique for tibial tuberosity osteotomies (TTO) utilising a plate and screw construct which adheres to established principles of bone healing. We record and discuss the complication profile and benefits of this technique. The technique is outlined, and thirty consecutive case of TTO fixed with this combination of plate and screws were analysed during a study period from January 2018 to October 2018. All patients were followed up clinically to 3 months post-operation for the purpose of identifying early complications of surgery. Radiographic series were reviewed at 2, 6 and 12 weeks post-operation for evidence of fracture, loss of position, hardware failure and union. All cases went on to clinical and radiographic union by 12 weeks. We identified one case of hardware failure, one case of superficial infection and one case of stiffness requiring manipulation. We have found this technique of plate and screw construct to be effective in arthroscopically assisted TTO fixation leading to consistent union without loss of position with a low complication profile.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::456c7a37d9e486be61ed75d62e0128e5Test
https://doi.org/10.1007/s00590-019-02536-xTest -
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المؤلفون: Hywel Davies, James R. Robinson, Jonathan Eldridge, Jonathan Manara, Hashim Al-Musawi, Damian Clark, N. R. Howells, James Murray, Mo Hassaballa, Andrew Porteous
المصدر: Cureus
مصطلحات موضوعية: Response rate (survey), medicine.medical_specialty, Physical Medicine & Rehabilitation, function improvement, business.industry, medicine.medical_treatment, General Engineering, Questionnaire, Knee replacement, Prom, Trauma, oxford knee score, Arthroplasty, Orthopedics, patient reported outcome measures, Orthopedic surgery, medicine, Physical therapy, high demand activities, partial knee replacement, medicine.symptom, business, human activities, Oxford knee score, Balance problems
الوصف: Purpose The purpose of this study was to assess postoperative partial knee replacement (PKR) functional improvement using the postoperative Oxford Knee Score for Activity and Participation Questionnaire (OKS-APQ). PKR includes medial, lateral, and patellofemoral knee arthroplasty. Methods A search of a National Health Service hospital database was made to identify eligible candidates for a survey of Patient-Reported Outcome Measure (PROM). Database records were collected for patients who had medial, lateral, and patellofemoral knee arthroplasty. The first author, an orthopaedic surgery resident, retrospectively reviewed the data and selected 318 patient records for inclusion in a questionnaire survey. The inclusion criteria were: patients who had PKR within three years from the time of the study and patients who don’t have medical problems that may affect their mobility; for example, balance problems. The survey used the postoperative Oxford Knee Score for Activity and Participation Questionnaire (OKS-APQ), Tegner Activity Score (TAS), and four questions were added to the present study, namely, three free-text questions and one visual analogue score (VAS). The survey was sent by post seeking the patients' responses. Results Two-hundred five responded to the survey out of 318; a 64% response rate. The ceiling and floor effects were determined from patients’ answers. Survey questions included: What is the most demanding activity you routinely do every month on your new knee? The patients’ answers were divided into four groups. First, 29% were limited to low functional demand activities, for example, light walking for less than a mile. Second, 43% were involved in domestic work and sports activities, for example, golf, skittles, bowling, squatting, swimming, and gardening. Third, 21% had progressed to higher demand activities, for instance, dancing, racquet sports, cycling, and yoga. Fourth, 7% were performing higher demand activities involving impacts, for example, skiing, heavy gym workout, and marathon running. Conclusion The postoperative questionnaire demonstrated activities ranging from high-impact activities, for example, skiing, and from higher demand activities, for example, dancing to low function activities, for example, light walking.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dee8586e78afd167d410a0d7309f8990Test
https://doi.org/10.7759/cureus.18439Test
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