A Prospective Observational Cohort Study for Newly Diagnosed Osteosarcoma Patients in the UK: ICONIC Study Initial Results.

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.

The feasibility, acceptability, safety, and effects of early weight bearing in humeral fractures - a scoping review.

Purpose: Non-weight bearing is often recommended after humeral fractures. This review aims to summarise the extent and nature of the evidence for the feasibility, acceptability, safety, and effects of early weight bearing (EWB) in people with humeral fractures, treated operatively or non-operatively. .

Early and Intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): protocol of the process evaluation.

Introduction: People with spinal cord injury receive physical rehabilitation to promote neurological recovery. Physical rehabilitation commences as soon as possible when a person is medically stable. One key component of physical rehabilitation is motor training.

Opening up conversations: Collaborative working across sociomaterial contexts in nursing in London.

Aim: To discuss nurses' use of networks to address nursing recruitment and retention in London, UK.

Design: Qualitative evaluation of the Capital Nurse programme reporting on 30 narrative interviews with executive, clinical and student nurses in 2019.

Results: Executive nurses within the Capital Nurse programme recognized the importance of sociomaterial contexts in the health and social care system in London and worked strategically across these contexts to achieve change.

Early and intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): description of the intervention.

Study Design: Descriptive.

Objectives: The primary objective is to describe the intervention that will be provided in a large multi-centre randomised controlled trial titled: Early and Intensive Motor Training for people with Spinal Cord Injuries (the SCI-MT Trial). The secondary objective is to describe the strategies that will be used to operationalise and standardise the Motor Training provided to participants while keeping the intervention person-centred.

Early and intensive motor training to enhance neurological recovery in people with spinal cord injury: trial protocol.

Study Design: Protocol for a multi-centre randomised controlled trial (the SCI-MT trial).

Objectives: To determine whether 10 weeks of intensive motor training enhances neurological recovery in people with recent spinal cord injury (SCI).

Setting: Fifteen spinal injury units in Australia, Scotland, England, Italy, Netherlands, Norway, and Belgium.

Current solutions for the treatment of chronic articular cartilage defects in the knee.

Chondral and osteochondral defects in the knee are common and may lead to degenerative joint disease if treated inappropriately.Conventional treatments such as microfracture often result in fibrocartilage formation and are associated with inferior results. Additionally, microfracture is generally unsuitable for the treatment of defects larger than 2-4 cm.

A novel ceramic coating for reduced metal ion release in metal-on-metal hip surgery.

An ovine total hip arthroplasty model was developed to evaluate metal ion release, wear, the biological response and adverse tissue reaction to metal-on-metal (MoM) bearing materials. The performance of an advanced superlattice ceramic coating (SLC) was evaluated as a bearing surface and experimental groups divided into; (1) MoM articulating surfaces coated with a SLC coating (SLC-MoM), (2) uncoated MoM surfaces (MoM), and (3) metal on polyethylene (MoP) surfaces. Implants remained in vivo for 13 months and blood chromium (Cr) and cobalt (Co) metal ion levels were measured pre and postoperatively.

Determining the porous structure for optimal soft-tissue ingrowth: An in vivo histological study.

The success of osseointegrated transcutaneous prostheses depends on a soft-tissue seal forming at the skin-implant interface in order to prevent infection. Current designs include a flange with drilled holes or a subdermal barrier with a porous coating in an attempt to promote soft-tissue attachment. However, the soft-tissue seal is not reliably achieved despite these designs and infection remains a significant problem.

Supraspinatus detachment causes musculotendinous degeneration and a reduction in bone mineral density at the enthesis in a rat model of chronic rotator cuff degeneration.

Background: To evaluate biological strategies that enhance tendon-bone healing in humans, it is imperative that suitable animal models accurately reproduce the pathological changes observed in the clinical setting following a tear. The purpose of the present study was to investigate rotator cuff degeneration in a rat, as well as assess the development of osteopenia at the enthesis following tendon detachment.

Methods: Eighteen female Wistar rats underwent unilateral detachment of the supraspinatus tendon.

The effectiveness of demineralized cortical bone matrix in a chronic rotator cuff tear model.

Background: The purpose of this study was to assess the effect of demineralized bone matrix (DBM) on rotator cuff tendon-bone healing. The hypothesis was that compared with a commercially available dermal matrix scaffold, DBM would result in a higher bone mineral density and regenerate a morphologically superior enthesis in a rat model of chronic rotator cuff degeneration.

Methods: Eighteen female Wistar rats underwent unilateral detachment of the supraspinatus tendon.

Tendon Reattachment to Bone in an Ovine Tendon Defect Model of Retraction Using Allogenic and Xenogenic Demineralised Bone Matrix Incorporated with Mesenchymal Stem Cells.

Background: Tendon-bone healing following rotator cuff repairs is mainly impaired by poor tissue quality. Demineralised bone matrix promotes healing of the tendon-bone interface but its role in the treatment of tendon tears with retraction has not been investigated. We hypothesized that cortical demineralised bone matrix used with minimally manipulated mesenchymal stem cells will result in improved function and restoration of the tendon-bone interface with no difference between xenogenic and allogenic scaffolds.

Are all metal-on-metal hip revision operations contributing to the National Joint Registry implant survival curves? : a study comparing the London Implant Retrieval Centre and National Joint Registry datasets.

Aims: The National Joint Registry for England, Wales and Northern Ireland (NJR) has extended its scope to report on hospital, surgeon and implant performance. Data linkage of the NJR to the London Implant Retrieval Centre (LIRC) has previously evaluated data quality for hip primary procedures, but did not assess revision records.

Methods: We analysed metal-on-metal hip revision procedures performed between 2003 and 2013.

Augmentation of Rotator Cuff Repair With Soft Tissue Scaffolds.

Background: Tears of the rotator cuff are one of the most common tendon disorders. Treatment often includes surgical repair, but the rate of failure to gain or maintain healing has been reported to be as high as 94%. This has been substantially attributed to the inadequate capacity of tendon to heal once damaged, particularly to bone at the enthesis.

Shoulder linked arthroplasty in patients with obstetric brachial plexus palsy can improve quality of life and function at short-term follow-up.

Background: Patients with obstetric brachial plexus palsy (OBPP) are prone to develop degenerative shoulder disease at a younger age than the general population. To date, no reports have been published on the complexities or outcome of shoulder arthroplasty (SA) in this unique patient group.

Methods: We reviewed of 9 SAs in 9 patients (3 men and 6 women) with OBPP with mean follow-up 5.

Resurfacing hip arthroplasty in neuromuscular hip disorders - A retrospective case series.

Background: Management of the degenerate hip in patients with neuromuscular conditions should be aimed at improving quality of life and ease of nursing care. Arthroplasty poses a significant challenge with predisposition to dislocation and loosening due to anatomical abnormalities, soft tissue contractures and impaired muscle tone.

Methods: We present a series of 11 hips (9 patients) following total hip resurfacing arthroplasty for painful osteoarthritis in patients with differing neuromuscular conditions.

In vivo roughening of retrieved total knee arthroplasty femoral components.

Background: Joint registry data highlights the higher rates of cumulative revision for younger patients undergoing TKR. One of the reasons associated with this higher revision rate may be due to the wear of the UHMWPE leading to loosening. Alternate bearing surfaces have been developed to address this problem; however, roughening of the metal bearing surface has not been demonstrated in vivo.

Two malignant peripheral nerve lesions of non-neurogenic origin.

The imaging features and histology of two cases of non-neurogenic intraneural malignancy--an epithelioid sarcoma and myeloma--are described. These cases are important reminders that not all nerve tumours are of neural origin and also show the crucial importance of a robust multidisciplinary approach to achieve the correct diagnosis and management.

Development of a hydroxyapatite coating containing silver for the prevention of peri-prosthetic infection.

We hypothesized that the electrochemical deposition of hydroxyapatite (EHA) can be used to incorporate silver (Ag), providing a controlled and sustained release of Ag ions at a bactericidal concentration. Six groups were investigated: electrochemical co-precipitation of HA and Ag (EHA/Ag); EHA pre-coated discs treated in AgN0(3) (EHA/AgN0(3)); plasma sprayed HA (PHA) pre-coated discs treated in AgN0(3) (PHA/AgN0(3)); EHA with 2 "layers" of Ag (EHA/Ag/2 layers); EHA coating only; and PHA coating only. Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) and X-ray diffraction (XRD) analyses quantified coating thickness, calcium/phosphorous ratio, and % atomic silver content, respectively.

The prevalence of symptomatic posterior tibialis tendon dysfunction in women over the age of 40 in England.

Background: To investigate the prevalence of posterior tibial tendon dysfunction (PTTD) in women over the age of 40.

Methods: A validated survey was posted to a random sample of 1000 women (over 40 years) from a GP group practice in Hertfordshire, England. Survey positive women were telephoned and when indicated, a detailed examination was performed.

Custom-made endoprosthetic reconstruction of the distal humerus for non-tumorous pathology.

Eight patients underwent custom-made endoprosthetic elbow reconstruction between 1989 and 2006 either for failed primary total elbow replacements or following complex fracture complications. A functional assessment using the Toronto Extremity Salvage (TES) score was performed. Patients were followed for a mean of 46.

Imaging of painful scoliosis.

Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful.

Use of mesenchymal stem cells to enhance bone formation around revision hip replacements.

Tissue engineering approaches to regenerate bone stock in revision total hip replacements could enhance the longevity of the implant and benefit the quality of the patient's life. This study investigated the impaction of allograft with mesenchymal stem cells in an ovine hip hemiarthroplasty model. In total, 10 sheep were divided into two groups with 5 sheep in each group.