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  • Journal article
    Mordecai SC, Al-Hadithy N, Ware HE, Gupte CMet al., 2014,

    Treatment of meniscal tears: An evidence based approach.

    , World J Orthop, Vol: 5, Pages: 233-241, ISSN: 2218-5836

    Treatment options for meniscal tears fall into three broad categories; non-operative, meniscectomy or meniscal repair. Selecting the most appropriate treatment for a given patient involves both patient factors (e.g., age, co-morbidities and compliance) and tear characteristics (e.g., location of tear/age/reducibility of tear). There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line. Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically. Partial meniscectomy is suitable for symptomatic tears not amenable to repair, and can still preserve meniscal function especially when the peripheral meniscal rim is intact. Meniscal repair shows 80% success at 2 years and is more suitable in younger patients with reducible tears that are peripheral (e.g., nearer the capsular attachment) and horizontal or longitudinal in nature. However, careful patient selection and repair technique is required with good compliance to post-operative rehabilitation, which often consists of bracing and non-weight bearing for 4-6 wk.
  • Journal article
    Buckeridge EM, Bull AMJ, McGregor AH, 2014,

    Biomechanical determinants of elite rowing technique and performance

    , Scandinavian Journal of Medicine & Science in Sports, Vol: 25, Pages: e176-e183, ISSN: 0905-7188
  • Journal article
    Bayona S, Akhtar K, Gupte C, Emery RJH, Dodds AL, Bello Fet al., 2014,

    Assessing performance in shoulder arthroscopy: The Imperial Global Arthroscopy Rating Scale (IGARS)

    , Journal of Bone and Joint Surgery: American Volume, Vol: 96A, ISSN: 0021-9355

    Background: Surgical training is undergoing major changes with reduced resident work hours and an increasing focus on patient safety and surgical aptitude. The aim of this study was to create a valid, reliable method for an assessment of arthroscopic skills that is independent of time and place and is designed for both real and simulated settings. The validity of the scale was tested using a virtual reality shoulder arthroscopy simulator.Methods: The study consisted of two parts. In the first part, an Imperial Global Arthroscopy Rating Scale for assessing technical performance was developed using a Delphi method. Application of this scale required installing a dual-camera system to synchronously record the simulator screen and body movements of trainees to allow an assessment that is independent of time and place. The scale includes aspects such as efficient portal positioning, angles of instrument insertion, proficiency in handling the arthroscope and adequately manipulating the camera, and triangulation skills. In the second part of the study, a validation study was conducted. Two experienced arthroscopic surgeons, blinded to the identities and experience of the participants, each assessed forty-nine subjects performing three different tests using the Imperial Global Arthroscopy Rating Scale. Results were analyzed using two-way analysis of variance with measures of absolute agreement. The intraclass correlation coefficient was calculated for each test to assess inter-rater reliability.Results: The scale demonstrated high internal consistency (Cronbach alpha, 0.918). The intraclass correlation coefficient demonstrated high agreement between the assessors: 0.91 (p < 0.001). Construct validity was evaluated using Kruskal-Wallis one-way analysis of variance (chi-square test, 29.826; p < 0.001), demonstrating that the Imperial Global Arthroscopy Rating Scale distinguishes significantly between subjects with different levels of experience utilizing a virtual reali
  • Journal article
    Chiou SY, Shih YF, Chou LW, McGregor AH, Strutton PHet al., 2014,

    Impaired neural drive in patients with low back pain

    , European Journal of Pain, Vol: 18, Pages: 794-802, ISSN: 1090-3801

    BackgroundControl of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.MethodsSeventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction – MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry.ResultsThe size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer time‐to‐peak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and root‐mean‐square EMG activity of ES muscles during MVCs.ConclusionsA decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
  • Journal article
    McGregor AH, Probyn K, Cro S, Dore CJ, Burton AK, Balague F, Pincus T, Fairbank Jet al., 2014,

    Rehabilitation Following Surgery for Lumbar Spinal Stenosis <i>A Cochrane Review</i>

    , SPINE, Vol: 39, Pages: 1044-1054, ISSN: 0362-2436
  • Journal article
    Akhtar KSN, Chen A, Standfield NJ, Gupte CMet al., 2014,

    The role of simulation in developing surgical skills.

    , Curr Rev Musculoskelet Med, Vol: 7, Pages: 155-160, ISSN: 1935-973X

    Surgical training has followed the master-apprentice model for centuries but is currently undergoing a paradigm shift. The traditional model is inefficient with no guarantee of case mix, quality, or quantity. There is a growing focus on competency-based medical education in response to restrictions on doctors' working hours and the traditional mantra of "see one, do one, teach one" is being increasingly questioned. The medical profession is subject to more scrutiny than ever before and is facing mounting financial, clinical, and political pressures. Simulation may be a means of addressing these challenges. It provides a way for trainees to practice technical tasks in a protected environment without putting patients at risk and helps to shorten the learning curve. The evidence for simulation-based training in orthopedic surgery using synthetic models, cadavers, and virtual reality simulators is constantly developing, though further work is needed to ensure the transfer of skills to the operating theatre.
  • Book chapter
    Fletcher A, Pearson J, Molleson T, Abel R, Ambers J, Wiles CCet al., 2014,

    Beneath the surface: imaging techniques and the Jericho Skull

    , Regarding the Dead Human Remains in the British Museum, Editors: Fletcher, Antoine, Hill, Publisher: British Museum Publications Limited, ISBN: 9780861591978

    A key publication on the British Museum&#39;s approach to the ethical issues surrounding the inclusion of human remains in museum collections and possible solutions to the dilemmas relating to their curation, storage, access management and ...
  • Book chapter
    Fletcher A, Pearson J, Molleson T, Abel R, Ambers J, Wiles CCRet al., 2014,

    Beneath the surface: imaging techniques and the Jericho Skull

    , Regarding the Dead Human Remains in the British Museum, Publisher: British Museum Publications Limited, ISBN: 9780861591978

    A key publication on the British Museum&#39;s approach to the ethical issues surrounding the inclusion of human remains in museum collections and possible solutions to the dilemmas relating to their curation, storage, access management and ...
  • Conference paper
    Langley RE, Trinh D, Jovic G, Cafferty F, Honeyfield L, Abel R, Stone M, Kynaston H, Alhasso AA, Scrase CD, Paez EM, Spittle B, Bara A, Parmar MMK, Abel PDet al., 2014,

    Bone density in men receiving androgen deprivation therapy for prostate cancer: A randomized comparison between transdermal estrogen and luteinising hormone-releasing hormone agonists.

    , 50th Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
  • Journal article
    Atallah L, Wiik A, Lo B, Cobb JP, Amis AA, Yang G-Zet al., 2014,

    Gait asymmetry detection in older adults using a light ear-worn sensor

    , PHYSIOLOGICAL MEASUREMENT, Vol: 35, Pages: N29-N40, ISSN: 0967-3334
    • Cite
    • Citations: 18
  • Conference paper
    Coudrillier B, Abel RL, Albon J, Campbell IC, Ethier CRet al., 2014,

    Micro-computed Tomography (μCT) for the Structural Analysis of the Lamina Cribrosa (LC)

    , Publisher: ASSOC RESEARCH VISION OPHTHALMOLOGY INC, ISSN: 0146-0404
  • Journal article
    Duffell LD, Southgate DFL, Gulati V, McGregor AHet al., 2014,

    Balance and gait adaptations in patients with early knee osteoarthritis

    , GAIT & POSTURE, Vol: 39, Pages: 1057-1061, ISSN: 0966-6362
    • Cite
    • Citations: 74
  • Conference paper
    Ethier CR, Campbell IC, Coudrillier B, Abel RLet al., 2014,

    Automated detection of Lamina Cribrosa (LC) beam microarchitecture from imaging data using a Frangi filter

    , Publisher: ASSOC RESEARCH VISION OPHTHALMOLOGY INC, ISSN: 0146-0404
  • Conference paper
    Campbell IC, Coudrillier B, Abel RL, Ethier CRet al., 2014,

    Effects of Lamina Cribrosa Microarchitecture on Biomechanics in Glaucoma

    , Publisher: ASSOC RESEARCH VISION OPHTHALMOLOGY INC, ISSN: 0146-0404
  • Journal article
    Gupte CM, Schaerf DA, Sandison A, Bull AMJ, Amis AAet al., 2014,

    Neural Structures within Human Meniscofemoral Ligaments: A Cadaveric Study.

    , ISRN Anatomy, Vol: 2014, ISSN: 2314-4726

    Aim. To investigate the existence of neural structures within the meniscofemoral ligaments (MFLs) of the human knee. Methods. The MFLs from 8 human cadaveric knees were harvested. 5 μm sections were H&E-stained and examined under light microscopy. The harvested ligaments were then stained using an S100 monoclonal antibody utilising the ABC technique to detect neural components. Further examination was performed on 60–80 nm sections under electron microscopy. Results. Of the 8 knees, 6 were suitable for examination. From these both MFLs existed in 3, only anterior MFLs were present in 2, and an isolated posterior MFL existed in 1. Out of the 9 MFLs, 4 demonstrated neural structures on light and electron microscopy and this was confirmed with S100 staining. The ultrastructure of these neural components was morphologically similar to mechanoreceptors. Conclusion. Neural structures are present in MFLs near to their meniscal attachments. It is likely that the meniscofemoral ligaments contribute not only as passive secondary restraints to posterior draw but more importantly to proprioception and may therefore play an active role in providing a neurosensory feedback loop. This may be particularly important when the primary restraint has reduced function as in the posterior cruciate ligament—deficient human knee.
  • Journal article
    Newman SD, Lotfibakhshaiesh N, O'Donnell M, Walboomers XF, Horwood N, Jansen JA, Amis AA, Cobb JP, Stevens MMet al., 2014,

    Enhanced Osseous Implant Fixation with Strontium-Substituted Bioactive Glass Coating

    , TISSUE ENGINEERING PART A, Vol: 20, Pages: 1850-1857, ISSN: 1937-3341

    The use of endosseous implants is firmly established in skeletal reconstructive surgery, with rapid and permanent fixation of prostheses being a highly desirable feature. Implant coatings composed of hydroxyapatite (HA) have become the standard and have been used with some success in prolonging the time to revision surgery, but aseptic loosening remains a significant issue. The development of a new generation of more biologically active coatings is a promising approach for tackling this problem. Bioactive glasses are an ideal candidate material due to the osteostimulative properties of their dissolution products. However, to date, they have not been formulated with stability to devitrification or thermal expansion coefficients (TECs) that are suitable for stable coating onto metal implants while still retaining their bioactive properties. Here, we present a strontium-substituted bioactive glass (SrBG) implant coating which has been designed to encourage peri-implant bone formation and with a TEC similar to that of HA. The coating can be successfully applied to roughened Ti6Al4V and after implantation into the distal femur and proximal tibia of twenty-seven New Zealand White rabbits for 6, 12, or 24 weeks, it produced no adverse tissue reaction. The glass dissolved over a 6 week period, stimulating enhanced peri-implant bone formation compared with matched HA coated implants in the contralateral limb. Furthermore, superior mechanical fixation was evident in the SrBG group after 24 weeks of implantation. We propose that this coating has the potential to enhance implant fixation in a variety of orthopedic reconstructive surgery applications.
  • Journal article
    Cobb JP, 2014,

    SELECTING THE RIGHT HIP REPLACEMENT Patient survival matters as much as implant survival when selecting the right hip replacement

    , BMJ-BRITISH MEDICAL JOURNAL, Vol: 348, ISSN: 1756-1833
  • Journal article
    Dodds AL, Halewood C, Gupte CM, Williams A, Amis AAet al., 2014,

    The anterolateral ligament ANATOMY, LENGTH CHANGES AND ASSOCIATION WITH THE SEGOND FRACTURE

    , BONE & JOINT JOURNAL, Vol: 96B, Pages: 325-331, ISSN: 2049-4394
  • Journal article
    Duffell LD, Hope N, McGregor AH, 2014,

    Comparison of kinematic and kinetic parameters calculated using a cluster-based model and Vicon's plug-in gait

    , PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 228, Pages: 206-210, ISSN: 0954-4119
    • Cite
    • Citations: 73
  • Journal article
    McGregor AH, Probyn K, Cro S, Doré CJ, Burton AK, Balagué F, Pincus T, Fairbank Jet al., 2014,

    Rehabilitation following surgery for lumbar spinal stenosis.

    , J Evid Based Med, Vol: 7, Pages: 62-63

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