Carbon footprint of tonsillectomy.

Background And Purpose: Healthcare is responsible for 5.4% of greenhouse gas emissions in the UK. Emissions in surgery is a relatively unexplored area; in particular, this hasn't yet been looked at as a whole in ENT in the UK.

To flex or not to flex: oesophageal soft food bolus obstruction in the modern age.

Background: Oesophageal soft food bolus obstruction is a common presentation to emergency departments. Often these patients are given medication with little evidence of efficacy. Although many cases self-resolve, some require removal of the obstruction.

Total knee arthroplasty reduces knee extension torque in-vitro and patellofemoral arthroplasty does not.

Patients often have difficulty recovering knee extension strength post total knee arthroplasty (TKA), and that may reflect alteration of the mechanics including geometry and rollback kinematics, so the purpose of this work was to explore this by comparing the knee extension torque (KET) of the native knee, TKA and patellofemoral arthroplasty (PFA) in response to quadriceps tension. Eight fresh-frozen knees were mounted in a knee extension rig with quadriceps loading and tibial extension torque measurement. Each knee was subject to four conditions: native knee, PFA, cruciate-retaining (CR) and posterior-stabilized (PS) TKA.

Intratympanic Gentamicin Versus Labyrinthectomy: Inner Ear Sensitivity to Gentamicin and Impact on the Contralateral Labyrinth.

Objectives: To investigate the impact of labyrinthectomy and intratympanic (IT) gentamicin injections on the contralateral labyrinth, we also assessed the response of each individual semicircular canal to each IT gentamicin application.

Methods: We performed a pilot observational study on tertiary, referral, academic settings. Thirteen patients with unilateral vestibular pathology were organized into two groups, group I (seven patients) receiving IT gentamicin and group II undergoing labyrinthectomy (six patients).

Gaucher disease: outcome following total hip replacements and effect of enzyme replacement therapy in a cohort of UK patients.

Only a limited number of reports of total hip replacements (THRs) in patients with Gaucher disease (GD) have been published, with the majority showing high rates of early aseptic loosening as well as an increased number of peri-operative complications. We present a series of twelve THRs in nine affected patients, with a mean age of 39 years at the time of surgery (median 37 years; range 27-60 years). We examine the medium- to long-term results and present the outcome scores, survival, and assess the effect of enzyme replacement therapy (ERT).

Management of anticoagulation therapy in the perioperative patient.

With the increasing use of oral anticoagulation therapy the appropriate management of perioperative anticoagulation is of surgical importance. There is a delicate balance between the risk of a perioperative thromboembolic event and the risk of operative bleeding from anticoagulation. Whilst there are a range of options available to the clinician, there appears to be no precise agreement about how to best manage this problem.

Sources of adult mesenchymal stem cells and their applicability for musculoskeletal applications.

There is significant potential for the use of adult mesenchymal stem cells in regenerating musckuloskeletal tissues. The sources of these stem cells discussed in this review are bone marrow, blood, adipose tissue, synovium, periosteum & cartilage. Adult mesenchymal stem cells of bone marrow origin are the cells which are heavily investigated in many studies and have been shown capable of producing a variety of connective tissues especially cartilage and bone.

Regulation of differentiation of mesenchymal stem cells into musculoskeletal cells.

Mesenchymal stem cells (MSCs) are multipotent cells that have the capability of differentiating into several different cells such as osteoblasts (bone), chondrocytes (cartilage), adipocytes (fat), myocytes (muscle) and tenocytes (tendon). In this review we highlight the different regulators which determine the lineage a particular MSC will differentiate into. Mesenchymal stem cells are increasingly being used in tissue regeneration and repair.

Advances and developments in the use of human mesenchymal stem cells - a few considerations.

One less visited area in musculoskeletal stem cell research is the effects of donor age on quality of stem cells. The prevalence of degenerative orthopaedic conditions is large, and the older population is likely to receive great benefit from stem cell therapies. There are many known growth factors involved in controlling and influencing stem cell growth which are also related to cell senescence.

The use of growth factors and mesenchymal stem cells in orthopaedics.

Stem cell therapy is an exciting and upcoming branch of tissue engineering with application in the field of orthopaedics. The most commonly used type of stem cells, mesenchymal stem cells (MSCs), can be easily isolated from bone marrow or synovium and cultured in vitro. Newer techniques using tissue engineering to regenerate musculoskeletal tissue by using biomimetic materials are now being studied.

Bearing couples in total hip arthroplasty.

Total hip arthroplasty is a well-established treatment for arthritis of the hip. The choice of bearing couple used for articulation should be tailored to the patient. This article reviews the history of different bearing surfaces, and outlines the advantages and disadvantages that may influence their use.