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Richardson E, Krishnan N, Stafford F, Yeates L, Nowak N, McGaughran J, Wildschutt J, Smith J, Turner C, Kevin L, Davis A, Macciocca I, Connell V, Ma A, Semsarian C, Bagnall R, Siggs O, Skinner J, MacArthur D, Ingles J. The Elusive Hearts Study: Seeking Genetic Diagnoses in Gene-elusive Cases of Rare Monogenic Cardiovascular Diseases. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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2
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Fitzgerald N, Skinner J, Asakai H, Turner C. Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) – The paediatric experience in New South Wales (NSW). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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3
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Nahdi S, Skinner J, Neubeck L, Freedman B, Gwynn J, Lochen M, Poppe K, Rambaldini B, Rolleston A, Stavrakis S, Gwynne K. One size does not fit all – a realist review of screening for asymptomatic atrial fibrillation in Indigenous communities in Australia, Canada, New Zealand and United States. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it is increasing in prevalence and incidence globally. True prevalence is underestimated because silent/asymptomatic AF is frequent and under-detected, but can cause stroke. Guidelines recommend opportunistic screening for AF in patients aged ≥65 years old. A growing body of evidence from hospital and community-based studies in Australia, New Zealand, Canada and United States indicates this age limit is lower for Indigenous people. Screening for AF meets the World Health Organisation (WHO) criteria for successful routine screening, yet little is known about successful implementation of AF screening in Indigenous communities in developed countries.
Purpose
The aim of this study is to use a realist approach to identify what works, how, for whom and under what circumstances for AF screening of Indigenous communities in Australia, Canada, New Zealand and United States.
Methods
In the realist review, eight databases were searched for studies targeted at AF screening in Indigenous communities. Realist analysis was used to identify context-mechanism-outcome configurations across 11 included records (reporting on 5 studies). Snowball referencing and grey literature were used to iteratively incorporate evidence to enhance the refined programme theory that was the product of the realist analysis.
Results
The realist review included studies using multiple screening strategies such as using tools to increase screening, using different screening environments and training screeners to provide culturally centred care. The realist analysis identified a number of mechanisms that can improve AF screening in Indigenous communities. The contextual factors enabling AF screening programs in Indigenous communities include wider community engagement, opportunistic non-clinical settings, using portable and easy to use devices, increasing knowledge, motivation and confidence in screening amongst Indigenous healthcare workers as well as improving follow-up protocols for abnormal results tailored to screen setting. Barriers to effective AF screening include time-poor working environments, conflicting cultural issues, navigating communication of abnormal results and logistical issues with device use (Figure 1).
Conclusion(s)
Since the life-course risk for AF in Indigenous population is different, a modified screening strategy needs to be put in place. This realist review provides lessons learned for successful implementation of AF screening programs for Indigenous communities. In order to tackle the gap in cardiovascular burden in Indigenous people, this study calls for action to develop AF screening guidelines for Indigenous populations and provides a guide for policy makers about timely and effective AF screening programs for Indigenous communities.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Nahdi
- University of Sydney, Sydney, Australia
| | - J Skinner
- University of Sydney, Poche Centre for Indigenous Health, Sydney, Australia
| | - L Neubeck
- Edinburgh Napier University, Edinburgh, United Kingdom
| | - B Freedman
- Heart Research Institute, Sydney, Australia
| | - J Gwynn
- University of Sydney, Poche Centre for Indigenous Health, Sydney, Australia
| | - M.L Lochen
- UiT The Arctic University of Norway, Community Medicine, Tromso, Norway
| | - K Poppe
- The University of Auckland, Auckland, New Zealand
| | - B Rambaldini
- University of Sydney, Poche Centre for Indigenous Health, Sydney, Australia
| | - A Rolleston
- The University of Auckland, Auckland, New Zealand
| | - S Stavrakis
- University of Oklahoma Health Sciences Center, Cardiovascular research, Oklahoma City, United States of America
| | - K Gwynne
- University of Sydney, Poche Centre for Indigenous Health, Sydney, Australia
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4
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Bracamonte-Baran W, Gilotra N, Won T, Rodriguez K, Talor M, Oh B, Grifin J, Skinner J, Johns R, Russell S, Anders R, Zhu Q, Halushka M, Brandacher G, Cihakova D. Endothelial Stromal PD-L1 Modulates CD8+ T Cell Infiltration after Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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5
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Holden A, Nanayakkara S, Skinner J, Spallek H, Sohn W. What do Australian health consumers believe about commercial advertisements and testimonials? a survey on health service advertising. BMC Public Health 2021; 21:74. [PMID: 33413201 PMCID: PMC7791787 DOI: 10.1186/s12889-020-10078-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Abstract
Background There has been little examination of consumer attitudes towards the commercial advertising of healthcare services in Australia and how marketing is used by consumers in their health decision-making. In this research, we examined how consumers reported commercial advertising helped them to understand the health services available to them and the influence that marketing had upon their choices. Methods A survey instrument using a Likert scale to indicate agreement or disagreement with 21 questions was developed using qualitative interviews before being distributed online within Australia. Sampling of participants was stratified by age, gender and location. The results were subjected to statistical analysis with Spearman Rank Correlation test being used for bivariate analysis. Results One thousand five hundred sixty-four complete surveys were collected. The results revealed certain consumer beliefs, for example; the title of ‘Dr’ was believed to indicate skill and high levels of training (81.0%), with 80.3% agreeing incorrectly that use of the title was strictly regulated. Participants reported to have a higher confidence in their own abilities (71.2%) than the public (52.8%) in assessing health advertising. The level of self-confidence increased with higher education level and decreased by age (p < 0.05). Testimonials were reported to be lacking in reliability (67.7%) and that they should not be used in healthcare in the same manner as they are used in other industries. Only 44.8% of participants reported that they felt confident to spot a review that was not written by a genuine user of a service. Conclusions The data demonstrated that many health consumers felt that while commercial health advertising was helpful, it was also confusing, with many participants also holding mistaken beliefs around other elements of commercial health advertising. While the advertising of healthcare services might have educational effects and be superficially empowering, advertising is primarily intended to sell, not educate. This research demonstrates that there is significant potential for healthcare advertising to mislead. Future developments in regulatory health advertising policy, and the related ethical frameworks developed by professional healthcare associations, need to consider how the consumers of healthcare services might be better protected from misleading and predatory advertising practices. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10078-9.
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Affiliation(s)
- Acl Holden
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, 2-18 Chalmers Street, Sydney, NSW, 2010, Australia. .,The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia.
| | - S Nanayakkara
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, 2-18 Chalmers Street, Sydney, NSW, 2010, Australia
| | - J Skinner
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, 2-18 Chalmers Street, Sydney, NSW, 2010, Australia.,The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - H Spallek
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, 2-18 Chalmers Street, Sydney, NSW, 2010, Australia
| | - W Sohn
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, 2-18 Chalmers Street, Sydney, NSW, 2010, Australia
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6
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Earle N, Winbo A, Crawford J, Wheeler M, Stiles R, Donoghue T, Stiles M, Hayes I, Marcondes L, Martin A, Skinner J. Significance of the Carriage of Sarcomeric Mutations in Hypertrophic Cardiomyopathy in New Zealand. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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Fenton S, Burrows TL, Skinner JA, Duncan MJ. The influence of sleep health on dietary intake: a systematic review and meta-analysis of intervention studies. J Hum Nutr Diet 2020; 34:273-285. [PMID: 33001515 DOI: 10.1111/jhn.12813] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/28/2020] [Accepted: 08/22/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Poor dietary intake increases disease risk, and poor sleep influences diet. This systematic review and meta-analysis of intervention studies aimed to evaluate the effect of sleep health on dietary intake in adults. METHODS Five online databases were used to identify studies published between 1970 and 2019. Included studies were interventions that modified sleep and reported dietary outcomes. RESULTS Fifty four full texts were assessed and 24 publications were included. Following risk of bias appraisal, data were narratively summarised and a sub-group of studies (n = 15) was meta-analysed to determine the effect of sleep on dietary intake. One intervention modified sleep timing and 23 modified duration. Sleep duration was partially restricted (≤5.5 h night-1 ) (n = 16), totally restricted (n = 4), partially and totally restricted (n = 1), and extended (n = 2). Dietary outcomes were energy intake (n = 24), carbohydrate, fat, protein intake (n = 20), single nutrient intake (n = 5), diet quality (n = 1) and food types (n = 1). Meta-analysis indicated partial sleep restriction results in higher energy intake in intervention compared with control [standardised mean difference (SMD) = 0.37; 95% confidence interval (CI) = 0.21-0.52; P < 0.001], with a mean difference of 204 kcal (95% CI = 112-295; P < 0.001) in daily energy intake, and a higher percentage of energy from fat, protein, carbohydrate (fat: SMD = 0.33; 95% CI = 0.16-0.51; P < 0.001; protein: SMD = 0.30, 95% CI = 0.12-0.47, P = 0.001; carbohydrate: SMD = 0.22, 95% CI = 0.04-0.39, P = 0.014). CONCLUSIONS Partial sleep restriction with duration of ≤5.5 h day-1 increases daily energy intake, as well as fat, protein and carbohydrate intake. Further research is needed to determine the relationship between other dimensions of sleep health and dietary intake.
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Affiliation(s)
- S Fenton
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - T L Burrows
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - J A Skinner
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - M J Duncan
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
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8
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Welch AA, Jennings A, Kelaiditi E, Skinner J, Steves CJ. Cross-Sectional Associations Between Dietary Antioxidant Vitamins C, E and Carotenoid Intakes and Sarcopenic Indices in Women Aged 18-79 Years. Calcif Tissue Int 2020; 106:331-342. [PMID: 31813016 PMCID: PMC7072069 DOI: 10.1007/s00223-019-00641-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022]
Abstract
The prevalence of sarcopenia is increasing in aging populations, so prevention is critical. Vitamins (A, C, E and carotenoids) modify skeletal muscle via protein and collagen synthesis and anti-inflammatory activities. Previous studies have not investigated intake of these vitamins in relation to sarcopenic indices in both younger and older-aged women. Indices of skeletal muscle mass (as fat-free mass (FFM) relative to body size) were measured using DXA and leg explosive power (LEP) using the Nottingham Power Rig in 2570 women aged 18-79 years. Adjusted measures of skeletal muscle were calculated according to quintiles of vitamin C, E, retinol and carotenoid intake, derived from Food Frequency Questionnaires, after stratification by age. Higher vitamin C intake was associated with significantly higher indices of FFM and LEP, (Q5-Q1 = 2.0-12.8%, P < 0.01-0.02). Intakes of total and individual carotenoids were significantly associated with indices of FFM and LEP (Q5-Q1 = 1.0-7.5%). Vitamin E was significantly associated with FFM% and FFMBMI only. In mutually adjusted analysis with vitamin C, total carotene, vitamin E and protein in the model, the strongest associations were with vitamin C. These associations were stronger in younger women (< 65 years). For the first time, our research shows higher dietary intakes of antioxidant vitamins, particularly vitamin C, is associated with higher skeletal muscle mass and power in free-living women. These findings have relevance for the treatment and prevention of frailty and sarcopenia throughout adulthood.
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Affiliation(s)
- A A Welch
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK.
| | - A Jennings
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - E Kelaiditi
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
- Faculty of Sport, Health and Applied Science, St Mary's University, Waldegrave Road, Twickenham, London, TW1 4SX, UK
| | - J Skinner
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - C J Steves
- Department of Twin Research and Genetic Epidemiology, King's College, London, UK
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9
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Isbister J, Yeates L, Hunyor I, McGaughran J, Semsarian C, Skinner J, van Spaendonck-Zwarts K, Raju H, Ingles J. 588 Seek and You Shall Find: A Case Highlighting the Importance of Multisystem Assessment in Arrhythmogenic Cardiomyopathy. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Youssef D, Singh A, Ayer J, Skinner J, Turner C, Christoff A. 648 A Single Centre Experience of the Incidence and Rhythm Characteristics of Paediatric Out of Hospital Cardiac Arrest Survivors Over a 11-Year Period. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Singh A, Turner C, Skinner J, Ayer J. 206 Contemporary Outcomes in Neonates Presenting With Congenital Complete Heart Block Presenting as Neonates- a 22 Year Series. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Arnone R, Romano G, Skinner J, Watt S, Poenicke C, Hoestergard D, Chiaramonte G. Improving the operational skills of the health personnel working in the emergency departments. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In December 2013 the European Commission approved the project promoted by CEFPAS, The Centre for Training and Research in Public Health within the programme PROGRESS, “Improving the operational skills of health personnel working in the emergency departments. A useful tool to give concrete answers to EU policies on patients’ safety and to create new working opportunities”.
This project aimed to combine the need to find innovative solutions in the field of healthcare with the objective of increasing the safety of patients in emergency departments, while also covering the need to promote worker mobility within the European Union. The key tool for implementing this goal is the exchange of experience and best practices.
The project partners included: the Edinburgh University of Medicine, the Napier University (again in Edinburgh), the Dresden University of Technology, the Herlev Hospital (in Copenhagen) through the DIMS or the Danish Institute for Medical Simulation at the University of Copenhagen, as well as ISMETT and CREAM (the Research Centre of the University of Medicine) in Palermo.
Every partner, during the planning, has provided the know how developed in the area of emergency. Specifically it has been analyzed the possibility to compare and visit the simulation Centres of Edinburgh, Dresden and Palermo, and to study the use, in each country, of innovative methodology during the training of the health personnel.
The partner, during the planning of the project, studied also how to help people to find easier jobs opportunities in the health sector (so they thought to create a specific data base of the emergency departments operating in Italy, Scotland and Germany where to find a job or a chance for an internship).
The project has lasted for one year and has provided research activities and the exchange of experience and best practices.
Key messages
There is a huge difference regarding the way in which the emergency system is organized within single countries around Europe. Comparing high-level organisations we have benefited in terms of ideas, projects and potential objectives to be set in order to improve our work and to improve results for patients.
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Affiliation(s)
| | | | - J Skinner
- Edinburgh University of Medicine, Edinburgh, UK
| | - S Watt
- Napier University, Edinburgh, UK
| | - C Poenicke
- Dresden University of technology, Dresden, Germany
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13
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Botha S, Martin-Garcia J, Hu H, Weierstall U, Fuchs M, Shi W, Andi B, Skinner J, Bernstein H, Fromme P, Zatsepin N. Single-wavelength anomalous dispersion phasing for serial millisecond snapshot crystallography. Acta Crystallogr A Found Adv 2019. [DOI: 10.1107/s0108767319098970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Zatsepin N, Botha S, Martin-Garcia J, Hu H, Weierstall U, Shi W, Andi B, Skinner J, Bernstein H, Fromme P, Fuchs M. Optimizing data quality in injector-based serial millisecond crystallography. Acta Crystallogr A Found Adv 2019. [DOI: 10.1107/s0108767319096259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Key S, Scott G, Stammers JG, Freeman MAR, Pinskerova V, Field RE, Skinner J, Banks SA. Does lateral lift-off occur in static and dynamic activity in a medially spherical total knee arthroplasty? A pulsed-fluoroscopic investigation. Bone Joint Res 2019; 8:207-215. [PMID: 31214333 PMCID: PMC6548977 DOI: 10.1302/2046-3758.85.bjr-2018-0237.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives The medially spherical GMK Sphere (Medacta International AG, Castel San Pietro, Switzerland) total knee arthroplasty (TKA) was previously shown to accommodate lateral rollback while pivoting around a stable medial compartment, aiming to replicate native knee kinematics in which some coronal laxity, especially laterally, is also present. We assess coronal plane kinematics of the GMK Sphere and explore the occurrence and pattern of articular separation during static and dynamic activities. Methods Using pulsed fluoroscopy and image matching, the coronal kinematics and articular surface separation of 16 well-functioning TKAs were studied during weight-bearing and non-weight-bearing, static, and dynamic activities. The closest distances between the modelled articular surfaces were examined with respect to knee position, and proportions of joint poses exhibiting separation were computed. Results Overall, 1717 joint poses were analyzed. At a 1.0 mm detection threshold, 37 instances of surface separation were observed in the lateral compartment and four medially (p < 0.001). Separation was activity-dependent, both laterally and medially (p < 0.001), occurring more commonly during static deep flexion in the lateral compartment, and during static rotation in the medial compartment. Lateral separation occurred more frequently than medial during kneeling (7/14 lateral vs 1/14 medial; p = 0.031) and stepping (20/1022 lateral vs 0/1022 medial; p < 0.001). Separation varied significantly between individuals during dynamic activities. Conclusion No consistent association between closest distances of the articular surfaces and knee position was found during any activity. Lift-off was infrequent and depended on the activity performed and the individual knee. Lateral separation was consistent with the design rationale. Medial lift-off was rare and mostly in non-weight-bearing activities. Cite this article: S. Key, G. Scott, J.G. Stammers, M. A. R. Freeman†, V. Pinskerova, R. E. Field, J. Skinner, S. A. Banks. Does lateral lift-off occur in static and dynamic activity in a medially spherical total knee arthroplasty? A pulsed-fluoroscopic investigation. Bone Joint Res 2019;8:207–215. DOI: 10.1302/2046-3758.85.BJR-2018-0237.R1.
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Affiliation(s)
- S Key
- Royal London Hospital, London, UK
| | - G Scott
- Royal London Hospital, London, UK
| | | | - M A R Freeman
- †M.A.R Freeman has deceased since the submission of this manuscript
| | - V Pinskerova
- First Orthopaedic Clinic, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - R E Field
- St George's, University of London, London, UK; Director of Research, South West London Elective Orthopaedic Centre, Epsom, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Stanmore, UK
| | - S A Banks
- University of Florida, Gainesville, Florida, USA
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16
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Koochekpour S, Maresh GA, Katner A, Parker-Johnson K, Lee TJ, Hebert FE, Kao YS, Skinner J, Rayford W. Correction: Establishment and characterization of a primary androgen‐responsive African‐American prostate cancer cell line, E006AA. Prostate 2004;60(2):145‐152. Prostate 2019; 79:815. [PMID: 31416301 DOI: 10.1002/pros.23800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Abstract
Objectives The Attune total knee arthroplasty (TKA) has been used in over 600 000 patients worldwide. Registry data show good clinical outcome; however, concerns over the cement-tibial interface have been reported. We used retrieval analysis to give further insight into this controversial topic. Methods We examined 12 titanium (Ti) PFC Sigma implants, eight cobalt-chromium (CoCr) PFC Sigma implants, eight cobalt-chromium PFC Sigma rotating platform (RP) implants, and 11 Attune implants. We used a peer-reviewed digital imaging method to quantify the amount of cement attached to the backside of each tibial tray. We then measured: 1) the size of tibial tray thickness, tray projections, peripheral lips, and undercuts; and 2) surface roughness (Ra) on the backside and keel of the trays. Statistical analyses were performed to investigate differences between the two designs. Results There was no evidence of cement attachment on any of the 11 Attune trays examined. There were significant differences between Ti and CoCr PFC Sigma implants and Attune designs (p < 0.05); however, there was no significant difference between CoCr PFC Sigma RP and Attune designs (p > 0.05). There were significant differences in the design features between the investigated designs (p < 0.05). Conclusion The majority of the earliest PFC Sigma designs showed evidence of cement, while all of the retrieved Attune trays and the majority of the RP PFC trays in this study had no cement attached. This may be attributable to the design differences of these implants, in particular in relation to the cement pockets. Our results may help explain a controversial aspect related to cement attachment in a recently introduced TKA design.Cite this article: A. Cerquiglini, J. Henckel, H. Hothi, P. Allen, J. Lewis, A. Eskelinen, J. Skinner, M. T. Hirschmann, A. J. Hart. Analysis of the Attune tibial tray backside: A comparative retrieval study. Bone Joint Res 2019;8:136-145. DOI: 10.1302/2046-3758.83.BJJ-2018-0102.R2.
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Affiliation(s)
- A Cerquiglini
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - J Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - H Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - P Allen
- Princess Alexandra NHS Trust, Harlow, UK
| | - J Lewis
- BMI Goring Hall Hospital, Goring-by-Sea, West Sussex, UK
| | - A Eskelinen
- The Coxa Hospital for Joint Replacement, Tampere, Finland
| | - J Skinner
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - M T Hirschmann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, Switzerland; University of Basel, Basel, Switzerland
| | - A J Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
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18
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Abstract
Objectives Previous studies have suggested that metal-on-metal (MoM) Pinnacle (DePuy Synthes, Warsaw, Indiana) hip arthroplasties implanted after 2006 exhibit higher failure rates. This was attributed to the production of implants with reduced diametrical clearances between their bearing surfaces, which, it was speculated, were outside manufacturing tolerances. This study aimed to better understand the performance of Pinnacle Systems manufactured before and after this event. Methods A total of 92 retrieved MoM Pinnacle hips were analyzed, of which 45 were implanted before 2007, and 47 from 2007 onwards. The ‘pre-2007’ group contained 45 implants retrieved from 21 male and 24 female patients, with a median age of 61.3 years (interquartile range (IQR) 57.1 to 65.5); the ‘2007 onwards’ group contained 47 implants retrieved from 19 male and 28 female patients, with a median age of 61.8 years (IQR 58.5 to 67.8). The volume of material lost from their bearing and taper surfaces was measured using coordinate and roundness measuring machines. These outcomes were then compared statistically using linear regression models, adjusting for potentially confounding factors. Results There was no significant difference between the taper and bearing wear rates of the ‘pre-2007’ and ‘2007 onwards’ groups (p = 0.67 and p = 0.39, respectively). Pinnacles implanted from 2007 onwards were revised after a mean time of 50 months, which was significantly earlier than the ‘pre-2007’ hips (96 months) (p < 0.001). A reduction in the time to revision was present year on year from 2003 to 2011. Conclusion We found no difference in the wear rate of these implants based on the year of implantation. The ‘pre-2007’ hips had a two-fold greater time to revision than those implanted after 2007; this may be due to the increased surveillance of MoM hips following UK regulatory advice and several high-profile failures. Interestingly, we observed a decreasing trend in the mean time to revision every year from 2003 onwards. Cite this article: S. Bergiers, H. S. Hothi, J. Henckel, A. Eskelinen, J. Skinner, A. Hart. Wear performance of retrieved metal-on-metal Pinnacle hip arthroplasties implanted before and after 2007. Bone Joint Res 2018;7:595–600. DOI: 10.1302/2046-3758.711.BJR-2018-0143.R1.
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Affiliation(s)
- S Bergiers
- Institute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - H S Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - J Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - A Eskelinen
- Orthopaedic Surgeon, The Coxa Hospital for Joint Replacement, Tampere, Finland
| | | | - A Hart
- Limb Reconstruction Unit, Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK; The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
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19
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George A, Villarosa AR, Patterson Norrie T, Hoolsema J, Dahlen HG, Ajwani S, Bhole S, Blinkhorn A, Srinivas R, Yaacoub A, Milat A, Skinner J, Johnson M. Process evaluation of the midwifery initiated oral health-dental service program: perceptions of pregnant women. Aust Dent J 2018; 64:55-65. [PMID: 30375645 DOI: 10.1111/adj.12660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pregnant women in Australia seldom seek dental care and are unaware of its importance. To address these gaps the midwifery-initiated oral health dental service (MIOH-DS) program was comprehensive trialled and found effective. The aim of this study was to undertake a process evaluation of the MIOH-DS using the perspectives of pregnant women who participated in the trial. METHODS A qualitative research design was utilized, whereby content analysis was undertaken on data from 11 semi-structured interviews with women who participated in the program. RESULTS All participants were receptive of the MIOH-DS intervention, and found it to be an acceptable intervention that met their needs, and encouraged future positive oral health practices and health-seeking behaviours. They expressed that midwives were an appropriate professional to conduct oral health assessments, education and referrals to affordable dental services. Although some participants were initially apprehensive towards receiving treatment during pregnancy, dental staff members were able to appropriately educate and reassure them during treatment. CONCLUSIONS The MIOH-DS represents a promising and acceptable intervention strategy for pregnant women to promote their oral health. Findings merit further investigation on whether positive outcomes achieved can be sustained when implemented in other national or international settings similar to the study setting.
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Affiliation(s)
- A George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Liverpool, New South Wales, Australia.,Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, New South Wales, Australia
| | - A R Villarosa
- COHORT, Western Sydney University, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
| | - T Patterson Norrie
- COHORT, Western Sydney University, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
| | - J Hoolsema
- COHORT, Western Sydney University, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
| | - H G Dahlen
- School of Nursing & Midwifery, Ingham Institute Applied Medical Research, Western Sydney University, Parramatta, New South Wales, Australia
| | - S Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, Sydney Research, University of Sydney, Sydney, New South Wales, Australia
| | - S Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, Sydney Research, University of Sydney, Sydney, New South Wales, Australia
| | - A Blinkhorn
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - R Srinivas
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Liverpool, New South Wales, Australia.,Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, New South Wales, Australia
| | - A Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Penrith, New South Wales, Australia
| | - A Milat
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - J Skinner
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - M Johnson
- Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia.,Faculty of Health Sciences, Australian Catholic University, Sydney, New South Wales, Australia
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20
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Cohen AT, Phillips MJ, Edmondson RA, Skinner JA, Das SK, Cooper DJ, Thomas EM, Melissari E, Kakkar VV. A Dose Ranging Study to Evaluate Dermatan Sulphate in Preventing Deep Vein Thrombosis following Total Hip Arthroplasty. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryDermatan sulphate catalyses thrombin inhibition by heparin cofactor II; it has a lower haemorrhagic to antithrombotic ratio than that of heparin in animal models. Consecutive patients aged forty years or more, electively undergoing total hip replacement under general anaesthesia, were randomly allocated to one of three dosage regimens of dermatan sulphate (MF701, Mediolanum Farmaceutici) given intramuscularly. These were 200 mg once daily (n = 50), 200 mg twice daily (n = 52) and 300 mg twice daily (n = 51), administered from twenty-four hours pre-operatively until the tenth postoperative day. The overall incidence of DVT assessed by bilateral venography was 53%, 51% and 34% respectively (Chi-square test for trend p = 0.06). The incidence of major proximal DVT was 10.6%, 8.5% and 2.1% respectively. Pulmonary embolism (PE) and bleeding were assessed in all 153 patients. There was one case of PE in each dose group. The incidence of bleeding episodes, volume of blood lost and blood transfusion requirements were low and showed no increase with increasing dose. The patients were followed up 4-8 weeks after discharge.We conclude that the two lower doses were subtherapeutic in this population, however dermatan sulphate given 300 mg twice daily, proved to be efficacious with an incidence of proximal major DVT of 2.1% and a low incidence of bleeding complications. A trial of dermatan sulphate 300 mg twice daily compared to standard prophylactic agents is needed.
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Affiliation(s)
- A T Cohen
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - M J Phillips
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - R A Edmondson
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - J A Skinner
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - S K Das
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - D J Cooper
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - E M Thomas
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - E Melissari
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
| | - V V Kakkar
- The Thrombosis Research Institute, Emmanuel Kaye Building, London, UK
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21
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Panagiotopoulou VC, Davda K, Hothi HS, Henckel J, Cerquiglini A, Goodier WD, Skinner J, Hart A, Calder PR. A retrieval analysis of the Precice intramedullary limb lengthening system. Bone Joint Res 2018; 7:476-484. [PMID: 30123497 PMCID: PMC6076355 DOI: 10.1302/2046-3758.77.bjr-2017-0359.r1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The Precice nail is the latest intramedullary lengthening nail with excellent early outcomes. Implant complications have led to modification of the nail design. The aim of this study was to perform a retrieval study of Precice nails following lower-limb lengthening and to assess macroscopical and microscopical changes to the implants and evaluate differences following design modification, with the aim of identifying potential surgical, implant, and patient risk factors. METHODS A total of 15 nails were retrieved from 13 patients following lower-limb lengthening. Macroscopical and microscopical surface damage to the nails were identified. Further analysis included radiology and micro-CT prior to sectioning. The internal mechanism was then analyzed with scanning electron microscopy and energy dispersive x-ray spectroscopy to identify corrosion. RESULTS Seven male and three female patients underwent 12 femoral lengthenings. Three female patients underwent tibial lengthening. All patients obtained the desired length with no implant failure. Surface degradation was noted on the telescopic part of every nail design, less on the latest implants. Microscopical analysis confirmed fretting and pitting corrosion. Following sectioning, black debris was noted in all implants. The early designs were found to have fractured actuator pins and the pin and bearings showed evidence of corrosive debris. The latest designs showed evidence of biological deposits suggestive of fluid ingress within the nail but no corrosion. CONCLUSION This study confirms less internal corrosion following modification, but evidence of titanium debris remains. We recommend no change to current clinical practice. However, potential reuse of the Precice nail, for secondary limb lengthening in the same patient, should be undertaken with caution.Cite this article: V. C. Panagiotopoulou, K. Davda, H. S. Hothi, J. Henckel, A. Cerquiglini, W. D. Goodier, J. Skinner, A. Hart, P. R. Calder. A retrieval analysis of the Precice intramedullary limb lengthening system. Bone Joint Res 2018;7:476-484. DOI: 10.1302/2046-3758.77.BJR-2017-0359.R1.
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Affiliation(s)
- V. C. Panagiotopoulou
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK and The Royal National Orthopaedic Hospital, Stanmore, UK
| | - K. Davda
- Limb Reconstruction Unit, The Royal National Orthopaedic Hospital, Stanmore, UK
| | - H. S. Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
| | - J. Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK and The Royal National Orthopaedic Hospital and Stanmore, UK
| | - A. Cerquiglini
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
| | - W. D. Goodier
- Limb Reconstruction Unit, The Royal National Orthopaedic Hospital, Stanmore, UK
| | - J. Skinner
- Limb Reconstruction Unit, Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK and The Royal National Orthopaedic Hospital, Stanmore, UK
| | - A. Hart
- Limb Reconstruction Unit, Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK and The Royal National Orthopaedic Hospital, Stanmore, UK
| | - P. R. Calder
- Limb Reconstruction Unit, The Royal National Orthopaedic Hospital, Stanmore, UK
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22
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Affiliation(s)
- J A Skinner
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - F S Haddad
- The Bone & Joint Journal, 22 Buckingham Street, London, WC2N 6ET and NIHR University College London Hospitals Biomedical Research Centre, UK
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23
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Burrows T, Kay-Lambkin F, Pursey K, Skinner J, Dayas C. Food addiction and associations with mental health symptoms: a systematic review with meta-analysis. J Hum Nutr Diet 2018; 31:544-572. [DOI: 10.1111/jhn.12532] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- T. Burrows
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - F. Kay-Lambkin
- Faculty Health and Medicine; NHMRC Centre for Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre; University of Newcastle; Newcastle NSW Australia
| | - K. Pursey
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - J. Skinner
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - C. Dayas
- School of Biomedicine and Pharmacy; Faculty of Health and Medicine; University of Newcastle; Newcastle NSW Australia
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24
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Sabah SA, Moon JC, Jenkins-Jones S, Morgan CL, Currie CJ, Wilkinson JM, Porter M, Captur G, Henckel J, Chaturvedi N, Kay P, Skinner JA, Hart AJ, Manisty C. The risk of cardiac failure following metal-on-metal hip arthroplasty. Bone Joint J 2018; 100-B:20-27. [PMID: 29305446 PMCID: PMC6424145 DOI: 10.1302/0301-620x.100b1.bjj-2017-1065.r1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS The aim of this study was to determine whether patients with metal-on-metal (MoM) arthroplasties of the hip have an increased risk of cardiac failure compared with those with alternative types of arthroplasties (non-MoM). PATIENTS AND METHODS A linkage study between the National Joint Registry, Hospital Episodes Statistics and records of the Office for National Statistics on deaths was undertaken. Patients who underwent elective total hip arthroplasty between January 2003 and December 2014 with no past history of cardiac failure were included and stratified as having either a MoM (n = 53 529) or a non-MoM (n = 482 247) arthroplasty. The primary outcome measure was the time to an admission to hospital for cardiac failure or death. Analysis was carried out using data from all patients and from those matched by propensity score. RESULTS The risk of cardiac failure was lower in the MoM cohort compared with the non-MoM cohort (adjusted hazard ratio (aHR) 0.901; 95% confidence interval (CI) 0.853 to 0.953). The risk of cardiac failure was similar following matching (aHR 0.909; 95% CI 0.838 to 0.987) and the findings were consistent in subgroup analysis. CONCLUSION The risk of cardiac failure following total hip arthroplasty was not increased in those in whom MoM implants were used, compared with those in whom other types of prostheses were used, in the first seven years after surgery. Cite this article: Bone Joint J 2018;100-B:20-7.
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Affiliation(s)
- S A Sabah
- Royal National Orthopaedic Hospital, Stanmore, Middlesex and University College London, London, UK
| | - J C Moon
- Institute of Cardiovascular Sciences, University College London and Barts Heart Centre, London, UK
| | - S Jenkins-Jones
- Division of Surgery and Interventional Sciences, University College London, UK and Global Epidemiology and Medical Statistics, Pharmatelligence, Cardiff, UK
| | - C Ll Morgan
- Division of Surgery and Interventional Sciences, University College London, UK and Global Epidemiology and Medical Statistics, Pharmatelligence, Cardiff, UK
| | - C J Currie
- Global Epidemiology and Medical Statistics, Pharmatelligence, Cardiff, UK and Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - J M Wilkinson
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK and National Joint Registry for England, Wales and Northern Ireland
| | - M Porter
- Centre for Hip Surgery, Wrightington Hospital, Wigan, UK
| | - G Captur
- Institute of Cardiovascular Sciences, University College London, UK and Department of Cardiology, Barts Heart Centre, London, UK
| | - J Henckel
- Royal National Orthopaedic Hospital, Stanmore, UK and Division of Surgery and Interventional Sciences, University College London, UK
| | - N Chaturvedi
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - P Kay
- Wrightington Hospital, Wigan, UK
| | - J A Skinner
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - A J Hart
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - C Manisty
- Institute of Cardiovascular Sciences, University College London, UK and Department of Cardiology, Barts Heart Centre, London, UK
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25
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Skinner JA, Haddad FS. A new year, but the spectre of metal-on-metal lives on. Bone Joint J 2018; 100-B:1-3. [PMID: 29305442 DOI: 10.1302/0301-620x.100b1.bjj-2017-1462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J A Skinner
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - F S Haddad
- The Bone & Joint Journal, 22 Buckingham Street, London, WC2N 6ET and NIHR University College London Hospitals Biomedical Research Centre, UK
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26
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Patel KH, Gikas PD, Pollock RC, Carrington RW, Cannon SR, Skinner JA, Briggs TW, Aston WJS. Pigmented villonodular synovitis of the knee: A retrospective analysis of 214 cases at a UK tertiary referral centre. Knee 2017; 24:808-815. [PMID: 28442184 DOI: 10.1016/j.knee.2017.03.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/15/2017] [Accepted: 03/22/2017] [Indexed: 02/08/2023]
Abstract
AIMS Pigmented villonodular synovitis (PVNS) is a rare, locally aggressive and potentially recurrent synovial disease. We present the largest single-centre experience of knee PVNS. Our aim was to evaluate our tertiary hospital's experience in the management of knee PVNS. PATIENTS AND METHODS Retrospective data collection of consecutive cases of knee PVNS from 2002 to 2015. RESULTS In total, 214 cases of knee PVNS were identified which represented 53.4% of all PVNS (12.1% were recurrent at presentation). 100 were localised PVNS (LPVNS), 114 diffuse PVNS (DPVNS) and two malignant PVNS. Knee PVNS was more likely to occur in females with a mean age of 39. Following surgery, 47.6% had recurrence with DPVNS as opposed to 8.6% with LPVNS. In LPVNS, there was no significant difference in recurrence between open and arthroscopic synovectomy (8.7% vs 9.1%, P>0.05). However, in DPVNS, there was a significantly higher risk of recurrence with arthroscopic compared to open synovectomy (83.3% vs 44.8%, RR=1.86 95% CI 1.32-2.62, P=0.0004). CONCLUSION PVNS can be difficult to treat. We found no difference in local recurrence rates between open and arthroscopic treatment of LPVNS but significantly increased rates of recurrence for DPVNS following arthroscopic treatment. We would therefore recommend open synovectomy for DPVNS.
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Affiliation(s)
- K H Patel
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom.
| | - P D Gikas
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - R C Pollock
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - R W Carrington
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - S R Cannon
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - J A Skinner
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - T W Briggs
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
| | - W J S Aston
- Bone Tumour Unit, Royal National Orthopaedic Hospitral NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom
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27
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Burrows T, Skinner J, Joyner MA, Palmieri J, Vaughan K, Gearhardt AN. Food addiction in children: Associations with obesity, parental food addiction and feeding practices. Eat Behav 2017; 26:114-120. [PMID: 28236739 DOI: 10.1016/j.eatbeh.2017.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/11/2017] [Accepted: 02/13/2017] [Indexed: 11/28/2022]
Abstract
Food addiction research in children is limited, and to date addictive-like eating behaviors within families have not been investigated. The aim of this study is to understand factors associated with addictive-like eating in children. The association between food addiction in children with obesity, parental food addiction, and parental feeding practices (i.e., restriction, pressure to eat, monitoring) was investigated. Parents/primary caregivers (aged≥18years) of children aged 5-12years, recruited and completed an online cross-sectional survey including demographics, the Yale Food Addiction Scale (YFAS), and the Child Feeding Questionnaire (CFQ). Parents, reporting on themselves and one of their children, were given a food addiction diagnosis and symptom score according to the YFAS predefined criteria. The total sample consisted of 150 parents/primary caregivers (48% male) and 150 children (51% male). Food addiction was found to be 12.0% in parents and 22.7% in children. In children, food addiction was significantly associated with higher child BMI z-scores. Children with higher food addiction symptoms had parents with higher food addiction scores. Parents of FA children reported significantly higher levels of Restriction and Pressure to eat feeding practices, but not Monitoring. Children with elevated YFAS-C scores may be at greater risk for eating-related issues.
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Affiliation(s)
- T Burrows
- Nutrition and Dietetics, School of Health Sciences, University of Newcastle, NSW, Australia
| | - J Skinner
- Nutrition and Dietetics, School of Health Sciences, University of Newcastle, NSW, Australia
| | - M A Joyner
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - J Palmieri
- Nutrition and Dietetics, School of Health Sciences, University of Newcastle, NSW, Australia
| | - K Vaughan
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - A N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
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28
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Burrows T, Skinner J, Joyner M, Palmieri J, Vaughan K, Gearhardt A. Food addiction in children: Associations with obesity, parental food addiction and feeding practices. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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29
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Di Laura A, Hothi H, Henckel J, Swiatkowska I, Liow MHL, Kwon YM, Skinner JA, Hart AJ. Retrieval analysis of metal and ceramic femoral heads on a single CoCr stem design. Bone Joint Res 2017; 6:345-350. [PMID: 28566326 PMCID: PMC5457640 DOI: 10.1302/2046-3758.65.bjr-2016-0325.r1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/01/2017] [Indexed: 11/08/2022] Open
Abstract
Objectives The use of ceramic femoral heads in total hip arthroplasty (THA) has increased due to their proven low bearing wear characteristics. Ceramic femoral heads are also thought to reduce wear and corrosion at the head-stem junction with titanium (Ti) stems when compared with metal heads. We sought to evaluate taper damage of ceramic compared with metal heads when paired with cobalt chromium (CoCr) alloy stems in a single stem design. Methods This retrieval study involved 48 total hip arthroplasties (THAs) with CoCr V40 trunnions paired with either CoCr (n = 21) or ceramic (n = 27) heads. The taper junction of all hips was evaluated for fretting/corrosion damage and volumetric material loss using a roundness-measuring machine. We used linear regression analysis to investigate taper damage differences after adjusting for potential confounding variables. Results We measured median taper material loss rates of 0.210 mm3/year (0.030 to 0.448) for the metal head group and 0.084 mm3/year (0.059 to 0.108) for the ceramic group. The difference was not significant (p = 0.58). Moreover, no significant correlation between material loss and implant or patient factors (p > 0.05) was found. Conclusions Metal heads did not increase taper damage on CoCr trunnions compared with ceramic heads from the same hip design. The amount of material released at the taper junctions was very low when compared with available data regarding CoCr/Ti coupling in metal-on-metal bearings. Cite this article: A. Di Laura, H. Hothi, J. Henckel, I. Swiatkowska, M. H. L. Liow, Y-M. Kwon, J. A. Skinner, A. J. Hart. Retrieval analysis of metal and ceramic femoral heads on a single CoCr stem design. Bone Joint Res 2017;6:–350. DOI: 10.1302/2046-3758.65.BJR-2016-0325.R1.
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Affiliation(s)
- A Di Laura
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - H Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - J Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - I Swiatkowska
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - M H L Liow
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Y-M Kwon
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - J A Skinner
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - A J Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
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Hothi H, Henckel J, Shearing P, Holme T, Cerquiglini A, Laura AD, Atrey A, Skinner J, Hart A. Assessment of the equivalence of a generic to a branded femoral stem. Bone Joint J 2017; 99-B:310-316. [PMID: 28249969 PMCID: PMC5358204 DOI: 10.1302/0301-620x.99b3.bjj-2016-1208.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 12/20/2016] [Indexed: 11/15/2022]
Abstract
Aims The aim of this study was to compare the design of the generic
OptiStem XTR femoral stem with the established Exeter femoral stem. Materials and Methods We obtained five boxed, as manufactured, implants of both designs
at random (ten in total). Two examiners were blinded to the implant
design and independently measured the mass, volume, trunnion surface
topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal
(CCD) angle, femoral offset, stem length, neck length, and the width
and roughness of the polished stem shaft using peer-reviewed methods.
We then compared the stems using these parameters. Results We found that the OptiStems were lighter (p < 0.001), had
a rougher trunnion surface (p < 0.001) with a greater spacing
and depth of the machined threads (p < 0.001), had greater trunnion
cone angles (p = 0.007), and a smaller radius at the top of the
trunnion (p = 0.007). There was no difference in stem volume (p
= 0.643), CCD angle (p = 0.788), offset (p = 0.993), neck length
(p = 0.344), stem length (p = 0.808), shaft width (p = 0.058 to
0.720) or roughness of the polished surface (p = 0.536). Conclusion This preliminary investigation found that whilst there were similarities
between the two designs, the generic OptiStem is different to the
branded Exeter design. Cite this article: Bone Joint J 2017;99-B:310–16.
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Affiliation(s)
- H Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - J Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - P Shearing
- University College London, Torrington Place, London, UK
| | - T Holme
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - A Cerquiglini
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - A Di Laura
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - A Atrey
- University of Toronto and St Michael's Hospital, Toronto, Canada
| | - J Skinner
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - A Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
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Crawford S, Skinner J, Coombes E, Jones A. Cancer of Unknown Primary: a Cancer Registry Study of Factors Affecting Access to Diagnosis. Clin Oncol (R Coll Radiol) 2017; 29:e39-e46. [DOI: 10.1016/j.clon.2016.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 08/11/2016] [Accepted: 08/23/2016] [Indexed: 11/15/2022]
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Hothi HS, Kendoff D, Lausmann C, Henckel J, Gehrke T, Skinner J, Hart A. Clinically insignificant trunnionosis in large-diameter metal-on-polyethylene total hip arthroplasty. Bone Joint Res 2017; 6:52-56. [PMID: 28108481 PMCID: PMC5301900 DOI: 10.1302/2046-3758.61.bjr-2016-0150.r2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 10/21/2016] [Indexed: 12/13/2022] Open
Abstract
Objectives Mechanical wear and corrosion at the head-stem junction of total hip arthroplasties (THAs) (trunnionosis) have been implicated in their early revision, most commonly in metal-on-metal (MOM) hips. We can isolate the role of the head-stem junction as the predominant source of metal release by investigating non-MOM hips; this can help to identify clinically significant volumes of material loss and corrosion from these surfaces. Methods In this study we examined a series of 94 retrieved metal-on-polyethylene (MOP) hips for evidence of corrosion and material loss at the taper junction using a well published visual grading method and an established roundness-measuring machine protocol. Hips were retrieved from 74 male and 20 female patients with a median age of 57 years (30 to 76) and a median time to revision of 215 months (2 to 324). The reasons for revision were loosening of both the acetabular component and the stem (n = 29), loosening of the acetabular component (n = 58) and infection (n = 7). No adverse tissue reactions were reported by the revision surgeons. Results Evidence of corrosion was observed in 55% of hips. The median Goldberg taper corrosion score was 2 (1 to 4) and the annual rate of material loss at the taper was 0.084 mm3/year (0 to 0.239). The median trunnion corrosion score was 1 (1 to 3). Conclusions We have reported a level of trunnionosis for MOP hips with large-diameter heads that were revised for reasons other than trunnionosis, and therefore may be clinically insignificant. Cite this article: H. S. Hothi, D. Kendoff, C. Lausmann, J. Henckel, T. Gehrke, J. Skinner, A. Hart. Clinically insignificant trunnionosis in large-diameter metal-on-polyethylene total hip arthroplasty. Bone Joint Res 2017;6:52–56. DOI: 10.1302/2046-3758.61.BJR-2016-0150.R2.
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Affiliation(s)
- H S Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | - D Kendoff
- Orthopaedic Department, HELIOS, Endo-Klinik Hamburg, Hamburg, Germany
| | - C Lausmann
- Orthopaedic Department, HELIOS, Endo-Klinik Hamburg, Hamburg, Germany
| | - J Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | - T Gehrke
- Orthopaedic Department, HELIOS, Endo-Klinik Hamburg, Hamburg, Germany
| | - J Skinner
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | - A Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
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Skinner J, Byun R, Blinkhorn A. Utilization of public oral health services by New South Wales teenagers, 2004-05 to 2014-15. Aust Dent J 2016; 61:514-520. [PMID: 27377809 DOI: 10.1111/adj.12438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 11/30/2022]
Affiliation(s)
- J Skinner
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales Australia
- Centre for Oral Health Strategy NSW; New South Wales Australia
| | - R Byun
- Centre for Oral Health Strategy NSW; New South Wales Australia
| | - A Blinkhorn
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales Australia
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Kelaiditi E, Jennings A, Steves CJ, Skinner J, Cassidy A, MacGregor AJ, Welch AA. Measurements of skeletal muscle mass and power are positively related to a Mediterranean dietary pattern in women. Osteoporos Int 2016; 27:3251-3260. [PMID: 27417218 PMCID: PMC5409925 DOI: 10.1007/s00198-016-3665-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/08/2016] [Indexed: 01/18/2023]
Abstract
The age-related loss of skeletal muscle and function are risk factors for osteoporosis and fractures. We found that higher adherence to the Mediterranean diet score was significantly associated with greater fat-free mass and leg explosive power suggesting a role for the Mediterranean Diet in prevention of loss of muscle outcomes. INTRODUCTION The loss of skeletal muscle mass, strength, and function with age are contributing risk factors for the onset of sarcopenia, frailty, osteoporosis, fractures, and mortality. Nutrition may affect the progression and trajectory of these changes in skeletal muscle but the role of the micronutrient-rich Mediterranean diet (MD) has hardly been investigated in relation to these muscle outcomes. METHODS We examined associations between the MD score (MDS) and FFM% (fat-free mass / weight × 100), FFMI (fat-free mass/height2), hand grip strength, and leg explosive power (LEP, watts/kg) in a cross-sectional study in 2570 women aged 18-79 years from the TwinsUK study. Measurements of body composition were made using dual-energy X-ray absorptiometry and dietary intake assessed by a food frequency questionnaire. FFM%, FFMI, grip strength, and LEP were compared across quartiles of the MDS after adjustment for covariates, with CRP measured in a subgroup (n = 1658). RESULTS Higher adherence to the MDS was positively associated with measurements of muscle outcomes, with significant differences of 1.7 % for FFM% and 9.6 % for LEP (P trend <0.001), comparing extreme quartiles of intake, but not with grip strength or CRP concentrations. CONCLUSIONS For the first time in a northern European population, we have observed significant positive associations between the MDS and FFM% and LEP in healthy women that are potentially clinically relevant, independent of the factors known to influence muscle outcomes. Our findings emphasize the potential role for overall diet quality based on the MD in the prevention of age-related loss of skeletal muscle outcomes.
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Affiliation(s)
- E Kelaiditi
- Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - A Jennings
- Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - C J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, SE1 7EH, UK
| | - J Skinner
- Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - A Cassidy
- Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - A J MacGregor
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - A A Welch
- Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
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36
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Agnew J, Nicholson R, Wilson N, Skinner J. Advanced AV Conduction Abnormality in Acute Rheumatic Fever. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Baker A, Morse J, Skinner J, O'Neill A, Ker J. Creating excellence in clinical skills practice for remote and rural communities using on line learning as part of a Managed Educational Network. Rural Remote Health 2016. [DOI: 10.22605/rrh4114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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38
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Ker J, Hardie L, Somerville S, Morse J, Skinner J, O'Neill A. Educating health care practitioners: an in depth evaluation of the Mobile Skills Unit (MSU) training programme in three exemplar venues. Rural Remote Health 2016. [DOI: 10.22605/rrh4077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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39
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Berber R, Skinner J, Board T, Kendoff D, Eskelinen A, Kwon YM, Padgett DE, Hart A. International metal-on-metal multidisciplinary teams: do we manage patients with metal-on-metal hip arthroplasty in the same way? An analysis from the International Specialist Centre Collaboration on MOM Hips (ISCCoMH). Bone Joint J 2016; 98-B:179-86. [PMID: 26850422 DOI: 10.1302/0301-620x.98b2.36201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS There are many guidelines that help direct the management of patients with metal-on-metal (MOM) hip arthroplasties. We have undertaken a study to compare the management of patients with MOM hip arthroplasties in different countries. METHODS Six international tertiary referral orthopaedic centres were invited to participate by organising a multi-disciplinary team (MDT) meeting, consisting of two or more revision hip arthroplasty surgeons and a musculoskeletal radiologist. A full clinical dataset including history, blood tests and imaging for ten patients was sent to each unit, for discussion and treatment planning. Differences in the interpretation of findings, management decisions and rationale for decisions were compared using quantitative and qualitative methods. RESULTS Overall agreement between the orthopaedic centres and the recommended treatment plans for the ten patients with MOM hip implants was moderate (kappa = 0.6). Full agreement was seen in a third of cases, however split decisions were also seen in a third of cases. Units differed in their interpretation of the significance of the investigation findings and put varying emphasis on serial changes, in the presence of symptoms. DISCUSSION In conclusion, the management of raised or rising blood metal ions, cystic pseudotumours and peri-acetabular osteolysis led to inconsistency in the agreement between centres. Coordinated international guidance and MDT panel discussions are recommended to improve consensus in decision making. TAKE HOME MESSAGE A lack of evidence and the subsequent variation in regulator guidance leads to differences in opinions, the clinical impact of which can be reduced through a multi-disciplinary team approach to managing patients with MOM hip implants. Cite this article: Bone Joint J 2016;98-B:179-86.
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Affiliation(s)
- R Berber
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore Middlesex, HA7 4LP, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore Middlesex, HA7 4LP, UK
| | - T Board
- Wrightington Hospital, Hall Lane, Appley Bridge, Wrightington, Lancashire, WN6 9EP, UK
| | - D Kendoff
- ENDOKLINIK, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin
| | - A Eskelinen
- COXA Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland
| | - Y-M Kwon
- Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02114, USA
| | - D E Padgett
- Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - A Hart
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore Middlesex, HA7 4LP, UK
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Ternouth I, Skinner J. PM192 Short QT Syndrome, Aborted Sudden Death - Case Report and Possible New Genotype. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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41
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Sabah SA, Henckel J, Koutsouris S, Rajani R, Hothi H, Skinner JA, Hart AJ. 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. Bone Joint J 2016; 98-B:33-9. [PMID: 26733513 PMCID: PMC4714035 DOI: 10.1302/0301-620x.98b1.36431] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
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. A total of 69 929 revision procedures from the NJR and 929 revised pairs of components from the LIRC were included. RESULTS We were able to link 716 (77.1%) revision procedures on the NJR to the LIRC. This meant that 213 (22.9%) revision procedures at the LIRC could not be identified on the NJR. We found that 349 (37.6%) explants at the LIRC completed the full linkage process to both NJR primary and revision databases. Data completion was excellent (> 99.9%) for revision procedures reported to the NJR. DISCUSSION This study has shown that only approximately one third of retrieved components at the LIRC, contributed to survival curves on the NJR. We recommend prospective registry-retrieval linkage as a tool to feedback missing and erroneous data to the NJR and improve data quality. TAKE HOME MESSAGE Prospective Registry - retrieval linkage is a simple tool to evaluate and improve data quality on the NJR.
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Affiliation(s)
- S A Sabah
- Great Ormond Street Hospital for Children, London, UK
| | - J Henckel
- Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - S Koutsouris
- University College London, Gower St, London WC1E 6BT, UK
| | - R Rajani
- University College London, Gower St, London WC1E 6BT, UK
| | - H Hothi
- University College London, Stanmore, HA7 4LP, UK
| | - J A Skinner
- Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - A J Hart
- University College London, Stanmore, HA7 4LP, UK
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Scott G, Imam MA, Eifert A, Freeman MAR, Pinskerova V, Field RE, Skinner J, Banks SA. Can a total knee arthroplasty be both rotationally unconstrained and anteroposteriorly stabilised? A pulsed fluoroscopic investigation. Bone Joint Res 2016; 5:80-6. [PMID: 26965166 PMCID: PMC4852793 DOI: 10.1302/2046-3758.53.2000621] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/18/2016] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Throughout the 20th Century, it has been postulated that the knee moves on the basis of a four-bar link mechanism composed of the cruciate ligaments, the femur and the tibia. As a consequence, the femur has been thought to roll back with flexion, and total knee arthroplasty (TKA) prostheses have been designed on this basis. Recent work, however, has proposed that at a position of between 0° and 120° the medial femoral condyle does not move anteroposteriorly whereas the lateral femoral condyle tends, but is not obliged, to roll back - a combination of movements which equates to tibial internal/ femoral external rotation with flexion. The aim of this paper was to assess if the articular geometry of the GMK Sphere TKA could recreate the natural knee movements in situ/in vivo. METHODS The pattern of knee movement was studied in 15 patients (six male: nine female; one male with bilateral TKAs) with 16 GMK Sphere implants, at a mean age of 66 years (53 to 76) with a mean BMI of 30 kg/m(2) (20 to 35). The motions of all 16 knees were observed using pulsed fluoroscopy during a number of weight-bearing and non-weight-bearing static and dynamic activities. RESULTS During maximally flexed kneeling and lunging activities, the mean tibial internal rotation was 8° (standard deviation (sd) 6). At a mean 112° flexion (sd 16) during lunging, the medial and lateral condyles were a mean of 2 mm (sd 3) and 8 mm (sd 4) posterior to a transverse line passing through the centre of the medial tibial concavity. With a mean flexion of 117° (sd 14) during kneeling, the medial and lateral condyles were a mean of 1 mm (sd 4) anterior and 6 mm (sd 4) posterior to the same line. During dynamic stair and pivoting activities, there was a mean anteroposterior translation of 0 mm to 2 mm of the medial femoral condyle. Backward lateral condylar translation occurred and was linearly related to tibial rotation. CONCLUSION The GMK Sphere TKA in our study group shows movements similar in pattern, although reduced in magnitude, to those in recent reports relating to normal knees during several activities. Specifically, little or no translation of the medial femoral condyle was observed during flexion, but there was posterior roll-back of the lateral femoral condyle, equating to tibiofemoral rotation. We conclude that the GMK Sphere is anteroposteriorly stable medially and permits rotation about the medial compartment.Cite this article: Professor G. Scott. Can a total knee arthroplasty be both rotationally unconstrained and anteroposteriorly stabilised?: A pulsed fluoroscopic investigation. Bone Joint Res 2016;5:80-86. DOI: 10.1302/2046-3758.53.2000621.
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Affiliation(s)
- G Scott
- Trauma and Orthopaedic Department, Royal London Hospital, Whitechapel, London, E1 1BB, UK
| | - M A Imam
- South West London Elective Orthopaedic Centre, Epsom, UK
| | - A Eifert
- Department of Biomedical Engineering, University of Florida, Florida, USA
| | | | | | - R E Field
- St Georges University of London, Director of Research, South West London Elective Orthopaedic Centre, Epsom, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Stanmore, UK
| | - S A Banks
- Department of Mechanical and Aerospace Engineering, University of Florida, Florida, USA
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Arasaradnam RP, McFarlane M, Ling K, Wurie S, O'Connell N, Nwokolo CU, Bardhan KD, Skinner J, Savage RS, Covington JA. Breathomics--exhaled volatile organic compound analysis to detect hepatic encephalopathy: a pilot study. J Breath Res 2016; 10:016012. [PMID: 26866470 DOI: 10.1088/1752-7155/10/1/016012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The current diagnostic challenge with diagnosing hepatic encephalopathy (HE) is identifying those with minimal HE as opposed to the more clinically apparent covert/overt HE. Rifaximin, is an effective therapy but earlier identification and treatment of HE could prevent liver disease progression and hospitalization. Our pilot study aimed to analyse breath samples of patients with different HE grades, and controls, using a portable electronic (e) nose. 42 patients were enrolled; 22 with HE and 20 controls. Bedside breath samples were captured and analysed using an uvFAIMS machine (portable e-nose). West Haven criteria applied and MELD scores calculated. We classify HE patients from controls with a sensitivity and specificity of 0.88 (0.73-0.95) and 0.68 (0.51-0.81) respectively, AUROC 0.84 (0.75-0.93). Minimal HE was distinguishable from covert/overt HE with sensitivity of 0.79 and specificity of 0.5, AUROC 0.71 (0.57-0.84). This pilot study has highlighted the potential of breathomics to identify VOCs signatures in HE patients for diagnostic purposes. Importantly this was performed utilizing a non-invasive, portable bedside device and holds potential for future early HE diagnosis.
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Affiliation(s)
- R P Arasaradnam
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK. Clinical Sciences Research Institute, University of Warwick, UK
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Anderson K, Coats T, Monks P, White I, Pandya H, Beardsmore C, Skinner J. A COMPARISON OF TIDAL AND INCENTIVE BREATH COLLECTION METHODS FOR THE DETERMINATION OF BREATH VOLATILES CONCENTRATION. Arch Emerg Med 2015. [DOI: 10.1136/emermed-2015-205372.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Panagiotidou A, Meswania J, Osman K, Bolland B, Latham J, Skinner J, Haddad FS, Hart A, Blunn G. The effect of frictional torque and bending moment on corrosion at the taper interface : an in vitro study. Bone Joint J 2015; 97-B:463-72. [PMID: 25820883 DOI: 10.1302/0301-620x.97b4.34800] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this study was to assess the effect of frictional torque and bending moment on fretting corrosion at the taper interface of a modular femoral component and to investigate whether different combinations of material also had an effect. The combinations we examined were 1) cobalt-chromium (CoCr) heads on CoCr stems 2) CoCr heads on titanium alloy (Ti) stems and 3) ceramic heads on CoCr stems. In test 1 increasing torque was imposed by offsetting the stem in the anteroposterior plane in increments of 0 mm, 4 mm, 6 mm and 8 mm when the torque generated was equivalent to 0 Nm, 9 Nm, 14 Nm and 18 Nm. In test 2 we investigated the effect of increasing the bending moment by offsetting the application of axial load from the midline in the mediolateral plane. Increments of offset equivalent to head + 0 mm, head + 7 mm and head + 14 mm were used. Significantly higher currents and amplitudes were seen with increasing torque for all combinations of material. However, Ti stems showed the highest corrosion currents. Increased bending moments associated with using larger offset heads produced more corrosion: Ti stems generally performed worse than CoCr stems. Using ceramic heads did not prevent corrosion, but reduced it significantly in all loading configurations.
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Affiliation(s)
- A Panagiotidou
- University College London, Gower Street, London WC1E 6BT, UK
| | - J Meswania
- University College London, Gower Street, London WC1E 6BT, UK
| | - K Osman
- University College London Hospitals NHS Foundation Trust, 170 Tottenham Court Road, London W1T 7HA, UK
| | - B Bolland
- Musgrove Park Hospital, Taunton, Somerset, TA1 5DA, UK
| | - J Latham
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - J Skinner
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - F S Haddad
- University College London Hospitals, 235 Euston Road, London NW1 2BU, UK
| | - A Hart
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - G Blunn
- University College London, Gower Street, London WC1E 6BT, UK
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Skinner J, Byun R, Blinkhorn A, Johnson G. Sugary drink consumption and dental caries in New South Wales teenagers. Aust Dent J 2015; 60:169-75. [DOI: 10.1111/adj.12310] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J Skinner
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
| | - R Byun
- Centre for Research; Evidence Management and Surveillance; Sydney and South Western Sydney Local Health Districts; New South Wales
| | - A Blinkhorn
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
| | - G Johnson
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
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Berber R, Pappas Y, Khoo M, Miles J, Carrington R, Skinner J, Hart A. A New Approach to Managing Patients with Problematic Metal Hip Implants: The Use of an Internet-Enhanced Multidisciplinary Team Meeting. AAOS Exhibit Selection. J Bone Joint Surg Am 2015; 97:e42. [PMID: 25948527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Sabah SA, Henckel J, Cook E, Whittaker R, Hothi H, Pappas Y, Blunn G, Skinner JA, Hart AJ. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre: a study using the NJR dataset. Bone Joint J 2015; 97-B:10-8. [PMID: 25568407 PMCID: PMC4548488 DOI: 10.1302/0301-620x.97b1.35279] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Arthroplasty registries are important for the
surveillance of joint replacements and the evaluation of outcome. Independent
validation of registry data ensures high quality. The ability for
orthopaedic implant retrieval centres to validate registry data
is not known. We analysed data from the National Joint Registry
for England, Wales and Northern Ireland (NJR) for primary metal-on-metal
hip arthroplasties performed between 2003 and 2013. Records were
linked to the London Implant Retrieval Centre (RC) for validation.
A total of 67 045 procedures on the NJR and 782 revised pairs of
components from the RC were included. We were able to link 476 procedures
(60.9%) recorded with the RC to the NJR successfully. However, 306
procedures (39.1%) could not be linked. The outcome recorded by the
NJR (as either revised, unrevised or death) for a primary procedure
was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval
linkage and correct assignment of outcome code improved over time.
The rates of error for component reference numbers on the NJR were
as follows: femoral head category number 14/229 (5.0%); femoral head
batch number 13/232 (5.3%); acetabular component category number
2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation
of data, particularly for component fields. This study suggests
that NJR reports may underestimate rates of revision for many types
of metal-on-metal hip replacement. This is topical given the increasing
scope for NJR data. We recommend a system for continuous independent
evaluation of the quality and validity of NJR data. Cite this article: Bone Joint J 2015;97-B:10–18.
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Affiliation(s)
- S A Sabah
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - J Henckel
- Hillingdon Hospital, Uxbridge, London, UK
| | - E Cook
- University of Bedfordshire, Luton, Bedfordshire, UK
| | - R Whittaker
- University College London Hospitals, Institute of Orthopaedics and Musculoskeletal Science, Brockley Hill, Stanmore, HA7 4LP, UK
| | - H Hothi
- University College London Hospitals, Institute of Orthopaedics and Musculoskeletal Science, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Y Pappas
- University of Bedfordshire, Luton, Bedfordshire, UK
| | - G Blunn
- University College London Hospitals, Institute of Orthopaedics and Musculoskeletal Science, Brockley Hill, Stanmore, HA7 4LP, UK
| | - J A Skinner
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - A J Hart
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
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Abstract
BACKGROUND Hip resurfacing arthroplasty (HRA) is primarily indicated for young, active patients with disabling coxarthrosis who wish to remain active and return to sports after surgery. Relatively few prospective studies have assessed return to sporting activity and impact of gender and age on this. MATERIALS AND METHODS Seventy-nine consecutive patients treated with HRA were included. Patients were reviewed clinically and radiologically. Function was assessed using the modified University of California Los Angeles (UCLA) activity score. The Oxford, Harris and WOMAC hip scores were calculated. RESULTS Average age at the time of surgery was 54.9 years (range 34.5-73.6 years). Average preoperative and postoperative UCLA scores were 4 and 7.6 respectively. Patients were involved in 2 (0-4) sporting activities preoperatively and 2 (0-5) postoperatively. Preoperative and postoperative Oxford Hip Scores, Harris Hip Score and WOMAC scores were 40, 46 and 51 and 16, 94 and 3 respectively (P < 0.0001). Patients returned to sports at an average of 3 months postoperatively. CONCLUSION Patients were able to return to sports by 3 months and perform the same number of activities at preoperative intensity. Activity levels are maintained up to the medium term with few complications.
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Affiliation(s)
- Nemandra Sandiford
- Limb Reconstruction Unit, The London Hip Unit, London W1G 6PU, London, UK,Address for correspondence: Dr. Nemandra Sandiford, The London Hip Unit, 3 Eynswood Drive, Sidcup, Kent DA14 6JQ, London, UK. E-mail:
| | - SK Muirhead-Allwood
- Limb Reconstruction Unit, The London Hip Unit, London W1G 6PU, London, UK,Limb Reconstruction and Tumor Unit, The Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, London, UK
| | - JA Skinner
- Limb Reconstruction and Tumor Unit, The Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, London, UK
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Sandiford NA, Alao U, Salamut W, Weitzel S, Skinner JA. Patella resurfacing during total knee arthroplasty: have we got the issue covered? Clin Orthop Surg 2014; 6:373-8. [PMID: 25436059 PMCID: PMC4233214 DOI: 10.4055/cios.2014.6.4.373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 03/18/2014] [Indexed: 11/08/2022] Open
Abstract
Background Management of the patella during total knee arthroplasty (TKA) is controversial. Multiple studies have examined mechanical and clinical results of TKA with native and resurfaced patellae with no clear consensus. Methods We surveyed a large cohort of consultant surgeons in a questionnaire based study in order to assess the indications for patella resurfacing and to correlate practice with degree of specialization, experience and volume of procedures performed. Results Six hundred and nineteen surgeons were included. The main indication for patella resurfacing was patellofemoral arthritis. The ratio of those who always:sometimes:never resurfaced was 1:2:1 irrespective of experience or volume performed. There was no difference between knee specialists and non-specialists (p = 0.977) or between high and lower volume surgeons (p = 0.826). Senior and high volume surgeons tended to always resurface. Conclusions The majority of surgeons only sometimes resurfaced the patella. The number who always and never resurfaced were similar. There was a tendency for more experienced and high volume surgeons to always resurface.
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Affiliation(s)
| | - Uthman Alao
- Kent and Sussex Hospital, Tunbridge Wells, UK
| | | | | | - J A Skinner
- The Royal National Orthopaedic Hospital, Stanmore, UK
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