2,664 results match your criteria: "ROyal National Orthopaedic Hospital[Affiliation]"

Introduction: Osteogenesis imperfecta (OI) is a heritable skeletal disorder and comprises various subtypes that differ in clinical presentation, with Type I considered the least severe and Types III/IV the most severe forms. The study aim was to understand the OI patient diagnostic and treatment journey across Europe.

Methods: We conducted a qualitative, descriptive study to understand the OI patient journey.

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Dupuytren's disease continues to present many challenges for the surgeon. A variety of surgical approaches and their variations have been described in the literature, further complicated by the degree of skin shortage and/or the need for local flap procedures or a full thickness skin graft. In the face of all these decisions - none of which is supported by Level 1 evidence - it can be very difficult to plan the best incision(s).

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Background: Best practice pathways for common surgical procedures, including total knee arthroplasty (TKA), have the potential to improve patient outcomes and reduce carbon emissions. We aimed to estimate the reduction in carbon emissions due to changing trends in the care of patients undergoing TKA in England.

Methods: This was a retrospective analysis of Hospital Episode Statistics data from 1 April 2013 to 31 March 2022 on adults undergoing elective primary TKA in England.

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Article Synopsis
  • Three-dimensional printing is becoming an important method for creating orthopaedic implants, allowing for unique designs and intricate structures.
  • The review aims to create a common vocabulary for 3D printing in orthopaedics by analyzing a specific 3D-printed acetabular cup and discussing its features and potential issues.
  • There is a need for further research on both unused and surgically removed implants to better understand their long-term effects on patients and to refine regulations surrounding this technology.
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Defining accurate terminology for post-injury weightbearing instructions.

Bone Joint J

July 2024

Oxford Trauma and Emergency Care, Kadoorie Centre, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.

Aims: Weightbearing instructions after musculoskeletal injury or orthopaedic surgery are a key aspect of the rehabilitation pathway and prescription. The terminology used to describe the weightbearing status of the patient is variable; many different terms are used, and there is recognition and evidence that the lack of standardized terminology contributes to confusion in practice.

Methods: A consensus exercise was conducted involving all the major stakeholders in the patient journey for those with musculoskeletal injury.

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Article Synopsis
  • Fibrodysplasia ossificans progressiva (FOP) is a rare disorder causing painful flare-ups and abnormal bone growth, known as heterotopic ossification (HO).
  • In a clinical trial, patients receiving the anti-activin A antibody garetosmab experienced fewer severe and lengthy flare-ups compared to those given a placebo, leading to a notable difference in quality of life.
  • The study found that 71% of placebo patients had flare-ups linked to new HO lesions, while garetosmab reduced the severity, duration, and frequency of these flare-ups throughout the trial.
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Cuttlefish Bone-Derived Calcium Phosphate Bioceramics Have Enhanced Osteogenic Properties.

J Funct Biomater

July 2024

Hainan Provincial Fine Chemical Engineering Research Center, Hainan University, Haikou 570228, China.

Cuttlefish bones are byproducts of cuttlefish processing and are readily available in the marine food industry. In this study, calcium phosphate bioceramics were prepared from cuttlefish bones using a two-stage hydrothermal calcination process. The results indicated that all bioceramics derived from cuttlefish bones had a higher degradation capacity, better bone-like apatite formation ability, and higher degree of osteogenic differentiation than commercially available hydroxyapatite.

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This article discusses the recent regulatory restrictions on the use of fluoroquinolones and their impact on treating orthopaedic infections. We focus on the balance between the benefits and risks of fluoroquinolones in scenarios involving severe infections where alternative antibiotics may be less effective. The discussion includes a summary of recent evidence on adverse effects and the implications for clinical practice.

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3D printing is a rapidly growing manufacturing method of medical implants. In orthopedics, this method enables the construction of complex porous structures with the aim of improved bone fixation. A known by-product of the 3D printing process is surface adhered particles which are often challenging to remove from the strut surfaces of the porous region.

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Biomimetic design and integrated biofabrication of an in-vitro three-dimensional multi-scale multilayer cortical model.

Mater Today Bio

October 2024

State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, China.

The lack of accurate and reliable brain models hinders the development of brain science and research on brain diseases. Owing to the complex structure of the brain tissue and its highly nonlinear characteristics, the construction of brain-like tissue models remains one of the most challenging research fields in the construction of living tissues. This study proposes a multi-scale design of a brain-like model with a biomimetic cortical structure, which includes the macroscopic structural features of six layers of different cellular components, as well as micrometer-scale continuous fiber structures running through all layers vertically.

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Objectives: Chronic Recurrent Multifocal Osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis (CNO), is a rare autoinflammatory condition affecting the bones in children and teenagers. The actual incidence of CRMO remains uncertain. The objective of this study is to identify the incidence of CRMO in children and young people under the age of 16 years in the United Kingdom (UK) and Republic of Ireland (ROI).

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To address some challenges facing psychiatrists today we discuss issues of happenstance and fulfilment in psychiatric careers through some of the record and reflections of four psychiatrists since the 1950s. We trace the changes in psychiatry attendant to the transition from the welfare to the neoliberal state and=its contemporary postmodern culture. We highlight the crucial importance of political-cultural as well as technological developments in determining psychiatric service management and provision, and clinical practice and career outcomes.

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What's new in pediatric lower limb reconstruction?

J Child Orthop

August 2024

Paediatric Orthopaedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany.

The last years brought many advances relevant to lower limb reconstruction. It feels like guided growth has been looked at from every angle, and still there are new emerging concepts like rotational guided growth waiting to be validated. New hexapod external devices are more accurate and easier to use, and new unilateral fixators allow for more versatile and stable fixation and lengthening.

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Objective: To assess the yield and clinical impact of image-guided bone biopsy for osteomyelitis of the appendicular skeleton.

Materials And Methods: A literature search of several databases was conducted from inception to August 2023. Eligible studies reported patients who underwent image-guided bone biopsy for investigation of osteomyelitis of the appendicular skeleton.

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Objectives: To evaluate the carbon footprint of the perioperative transurethral resection of bladder tumour (TURBT) pathway from decision to treat to postoperative discharge, and model potential greenhouse gas (GHG) emissions reduction strategies.

Materials And Methods: This process-based attributional cradle-to-grave life-cycle assessment (LCA) of GHG emissions modelled the perioperative TURBT pathway at a hospital in Southwest England. We included travel, energy and water use, all reusable and consumable items, and laundry and equipment sterilisation.

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Wound closure is a critical aspect of medical care, and the choice of closure methods plays a pivotal role in preventing infections. Traditional sutures and staples can introduce foreign material into the wound, increasing the risk of infection. Adhesives offer a potential alternative by providing a physical barrier against microorganisms.

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Detecting HRD in whole-genome and whole-exome sequenced breast and ovarian cancers.

medRxiv

July 2024

Department of Cellular and Molecular Medicine, UC San Diego, La Jolla, CA, 92093, USA.

Breast and ovarian cancers harboring homologous recombination deficiency (HRD) are sensitive to PARP inhibitors and platinum chemotherapy. Conventionally, detecting HRD involves screening for defects in , , and other relevant genes. Recent analyses have shown that HRD cancers exhibit characteristic mutational patterns due to the activities of HRD-associated mutational signatures.

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Objectives: The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls.

Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.

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Unlabelled: We assessed multiple components of muscle function in ten adults with X-linked hypophosphatemia (XLH) receiving burosumab treatment. Lower limb power (+ 9%), short physical performance battery (SPPB) score (+ 1.2 points), and physical activity (+ 65%) increased following 6 months of treatment, and hand grip increased (+ 10%) between 6 and 12 months of treatment.

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There has been little change to the standard treatment for osteosarcoma (OS) over the last 25 years and there is an unmet need to identify new biomarkers and novel therapeutic approaches if outcomes are to improve. Furthermore, there is limited evidence on the impact of OS treatment on patient-reported outcomes (PROs). ICONIC (Improving Outcomes through Collaboration in Osteosarcoma; NCT04132895) is a prospective observational cohort study recruiting newly diagnosed OS patients across the United Kingdom (UK) with matched longitudinal collection of clinical, biological, and PRO data.

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Background: Sarcomas are diverse neoplasms with highly variable histological appearances in which diagnosis is often challenging and management options for metastatic/unresectable disease limited. Many sarcomas have distinctive molecular alterations, but the range of alterations is large, variable in type and rapidly increasing, meaning that testing by limited panels is unable to capture the broad spectrum of clinically pertinent genomic drivers required. Paired whole genome sequencing (WGS) in contrast allows comprehensive assessment of small variants, copy number and structural variants along with mutational signature analysis and germline testing.

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Large acetabular bone defects are challenging in hip revision surgery. Clinical assessment is crucial to evaluate modern technologies in surgical reconstruction. We aimed to better understand the bone remodeling that occurs following acetabular reconstruction.

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Major depressive disorder (MDD) affects a substantial portion of the population; however, much is still unknown about the pathophysiology of this disorder. Treatment resistance highlights the heterogeneous nature of MDD and the need for treatments to target more than monoamine neurotransmission. This review summarizes research into the new and emerging targets of MDD.

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Background: This pilot study assessed text messaging as an early intervention for preventing pressure ulcers (PrUs) in individuals with spinal cord injury (SCI) post-hospital discharge.

Method: Thirty-nine wheelchair-users discharged after acquiring a SCI, underwent randomisation into an intervention group (n = 20) with text messages and a control group (n = 19). All participants received standard post-discharge care and completed a skincare questionnaire before and 6-month after discharge.

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