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Journal articleMullington CJ, Kua J, Malhotra S, 2020, , ANESTHESIA AND ANALGESIA, Vol: 131, Pages: E131-E132, ISSN: 0003-2999
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- Citations: 5
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Journal articleDeane JA, Pavlova A, Lim A, et al., 2020, , BMC Musculoskeletal Disorders, Vol: 21, Pages: 1-10, ISSN: 1471-2474
Background: Lumbar disc degeneration (LDD) is a condition associated with recurrentlow back pain (LBP). Knowledge regarding effective management is limited. As a steptowards the identification of risk, prognostic or potentially modifiable factors in LDDpatients, the aim of this study was to explore the hypothesis that intrinsic lumbar spineshape is associated with LDD and clinical outcomes in symptomatic adults. Methods: 3T MRI was used to acquire T2-weighted sagittal images (L1-S1) from 70healthy controls and LDD patients (mean age 49 years, SD 11, range 31-71years). Statistical Shape Modelling (SSM) was used to describe lumbar spine shape.SSM identified variations in lumbar shape as ‘modes’ of variation and quantifieddeviation from the mean. Intrinsic shape differences were determined between LDDgroups using analysis of variance with post-hoc comparisons. The relationshipbetween intrinsic shape and self-reported function, mental health and quality of lifewere also examined.Results: The first 7 modes of variation explained 91% of variance in lumbarshape. Higher LDD sum scores correlated with a larger lumbar lordosis (Mode 1 (55%variance), P=0.02), even lumbar curve distribution (Mode 2 (12% variance), P=0.05),larger anterior-posterior (A-P) vertebral diameter (Mode 3 (10% variance), P=0.007)and smaller L4-S1 disc spaces (Mode 7 (2% variance), P≤0.001). In the presence ofrecurrent LBP, LDD was associated with a larger A-P vertebral diameter (Mode 3) anda more even lumbar curvature with smaller L5/S1 disc spaces (Mode 4), which wassignificantly associated with patient quality of life (P=0.002-0.04, r p =0.43-0.61)).Conclusions: This exploratory study provides new evidence that intrinsic shapephenotypes are associated with LDD and quality of life in patients. Longitudinalstudies are required to establish the potential role of these risk or prognostic shapephenotypes.
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Journal articleSaracco A, Grassi A, Romagnoli M, et al., 2020, , EUROPEAN JOURNAL OF RADIOLOGY, Vol: 128, ISSN: 0720-048X
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- Citations: 1
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Journal articleCarlos Rodriguez-Merchan E, Liddle AD, 2020, , ARCHIVES OF BONE AND JOINT SURGERY-ABJS, Vol: 8, Pages: 465-469, ISSN: 2345-4644
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- Citations: 3
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Conference paperClunie G, Belsi A, Roe J, et al., 2020,
Not Just Dyspnoea – Swallowing as a Concern for Adults with Laryngotracheal Stenosis Who Undergo Reconstructive Surgery?
, UK Swallowing Research Group 2020 Conference -
Journal articleAjdari N, Tempelaere C, Masouleh MI, et al., 2020, , Journal of Shoulder and Elbow Surgery, Vol: 29, Pages: 1019-1029, ISSN: 1058-2746
Background Hemiarthroplasty has clear advantages over alternative procedures and is used in 20% of all shoulder joint replacements. Because of cartilage wear, the clinical outcome of hemiarthroplasty is unreliable and controversial. This paper suggests that the optimal choice of prosthetic material may reduce cartilage degeneration and improve the reliability of the procedure. The specific objectives were to assess 3 materials and assess how the severity of arthritis might affect the choice of prosthetic material. Methods A CoCr alloy, an AL2O3 ceramic, and a polycarbonate urethane polymer (PCU) were mechanically tested against 5 levels of human osteoarthritic cartilage (from intact to severely arthritic, n = 45). A high friction coefficient, a decrease in Young's modulus, an increase in permeability, a decrease in relaxation time, an increase in surface roughness, and a disrupted appearance of the cartilage after testing were used as measures of cartilage damage. The biomaterial that caused minimal cartilage damage was defined as superior. Results The CoCr caused the most damage. This was followed by the AL2O3 ceramic, whereas the PCU caused the least amount of damage. Although the degree of arthritis had an effect on the results, it did not change the trend that CoCr performed worst and PCU the best. Discussion and Conclusion This study indicates that ceramic implants may be a better choice than metals, and the articulating surface should be as smooth as possible. Although our results indicate that the degree of arthritis should not affect the choice of prosthetic material, this suggestion needs to be further investigated.
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Journal articleMaillot C, Auvinet E, Harman C, et al., 2020, , ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, Vol: 106, Pages: 527-534, ISSN: 1877-0568
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- Citations: 13
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Journal articleLogishetty K, Gofton WT, Rudran B, et al., 2020, , JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, Vol: 102, ISSN: 0021-9355
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- Citations: 26
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Journal articleHopkins M, Vaidyanathan R, McGregor AH, 2020, , IEEE Sensors Journal, Vol: 20, Pages: 6992-7000, ISSN: 1530-437X
Velostat is a low-cost, low-profile electrical bagging material with piezoresistive properties, making it an attractive option for in-socket pressure sensing. The focus of this research was to explore the suitability of a Velostat-based system for providing real-time socket pressure profiles. The prototype system performance was explored through a series of bench tests to determine properties including accuracy, repeatability and hysteresis responses, and through participant testing with a single subject. The fabricated sensors demonstrated mean accuracy errors of 110 kPa and significant cyclical and thermal drift effects of up to 0.00715 V/cycle and leading to up to a 67% difference in voltage range respectively. Despite these errors the system was able to capture data within a prosthetic socket, aligning to expected contact and loading patterns for the socket and amputation type. Distinct pressure maps were obtained for standing and walking tasks displaying loading patterns indicative of posture and gait phase. The system demonstrated utility for assessing contact and movement patterns within a prosthetic socket, potentially useful for improvement of socket fit, in a low cost, low profile and adaptable format. However, Velostat requires significant improvement in its electrical properties before proving suitable for accurate pressure measurement tools in lower limb prosthetics.
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Journal articleTukanova K, Papi E, Jamel S, et al., 2020, , JOURNAL OF THORACIC DISEASE, Vol: 12, Pages: 1031-+, ISSN: 2072-1439
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- Citations: 10
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Journal articleAkhbari P, Karamchandani U, Jaggard MKJ, et al., 2020, , BONE & JOINT RESEARCH, Vol: 9, Pages: 108-119, ISSN: 2046-3758
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- Citations: 24
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Book chapterNg KCG, Bankes MJK, Cobb J, et al., 2020, , Hip Dysplasia Understanding and Treating Instability of the Native Hip, Editors: Beaulé, Publisher: Springer, Pages: 55-70, ISBN: 9783030333577
This book represents the most advanced understanding of diagnosis and management of hip dysplasia in the young adult, written by the world’s leading experts and covering advanced imaging and biomechanical studies as well as latest ...
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Journal articlePapi E, Bull AMJ, McGregor AH, 2020, , Journal of Biomechanics, Vol: 100, Pages: 109597-109597, ISSN: 0021-9290
Changes in movement pattern in low back pain (LBP) groups have been analysed by reporting predefined discrete variables. However, this approach does not consider the full kinematic data waveform and its dynamic information, potentially exposing the analysis to bias. Statistical Parametric Mapping (SPM) has been introduced and applied to 1 dimensional (D) kinematic variables allowing the assessment of data over time. The aims of this study were to assess differences in 3D kinematics patterns in people with and without LBP during functional tasks by using SPM and to investigate if SPM analysis was consistent with standard 3D range of motion (RoM) assessments. 3D joints kinematics of the spine and lower limbs were compared between 20 healthy controls and 20 participants with non-specific LBP during walking, sit-to-stand and lifting. SPM analysis showed significant differences in the 3Dkinematics of the lower thoracic segment, upper and lower lumbar segment and knee joint during walking and lifting mostly observed at the beginning and/or towards the end of the tasks. ROMs differed between groups in the lower thoracic segment (walking/sit-to-stand), upper and lower lumbar segments (walking/sit-to-stand/lifting), hip and knee (sit-to-stand/lifting). Based on these results, the two approaches can yield different data interpretations. SPM analysis allows the identification of differences in movement that occur over time. This adds value to LBP movement analysis as it allows an understanding of the LBP strategies adopted during motion that may not be conveyed by simple discrete parameters such as ROMs.
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Journal articleRowland S, Fitzgerald JE, Holme T, et al., 2020, , npj Digital Medicine, Vol: 3, Pages: 1-6, ISSN: 2398-6352
Despite growing interest from both patients and healthcare providers there is little clinical guidance on how mobile apps should be utilised to add value to patient care. We categorize apps according to their functionality (e.g. preventative behavior change, digital self-management of a specific condition, diagnostic) and discuss evidence for effectiveness from published systematic reviews and meta-analyses and the relevance to patient care. We discuss the limitations of the current literature describing clinical outcomes from mHealth apps, what FDA clearance means now (510(k) / de novo FDA clearance) and in the future. We discuss data security and privacy as a major concern for patients when using mHealth apps. Patients are often not involved in the development of mobile health guidelines, and professionals’ views regarding high quality health apps may not reflect patients’ views. We discuss efforts to develop guidelines for the development of safe and effective mHealth apps in the US and elsewhere and the role of independent app reviews sites in identifying mHealth apps for patient care. There are only a small number of clinical scenarios where published evidence suggests that mHealth apps may improve patient outcomes.
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Book chapterRivière C, Harman C, Logishetty K, et al., 2020, , Personalized Hip and Knee Joint Replacement, Pages: 23-32
There have been significant developments since the first attempts to treat degenerated hips with tissue interpositional arthroplasty (with materials such as fascia lata and pig’s bladder) or hemi-resurfacing using glass molds by Smith-Peterson in 1937 [1]. While the first total hip replacement has been attributed to Wiles in 1938, it was considered a failure-its success and widespread adoption only occurred in the 1960s when Sir John Charnley introduced “low-friction arthroplasty” using acrylic cement for fixation. This early age of hip arthroplasty has been followed by decades of incremental development directed at reducing failure (including that related to loosening, instability, implant wear, and osteolysis) while accommodating the high-activity profile and increased longevity of the modern patient [1].
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Book chapterAframian A, Iranpour F, Cobb J, 2020, , Artificial Intelligence in Healthcare, Pages: 163-177
There is near infinite potential for artificial intelligence (AI) in medical devices, with almost all current technologies having the potential for improvement using AI. We discuss here some examples of how it is already being used and we have divided these into physical hardware devices and software or virtual devices, in part because they are different and also because the regulatory requirements vary for different medical devices. These devices have in turn been divided into community and specialist center (such as hospital) uses to provide context. The increasing use of medical devices has led to the need for new regulations in both Europe and worldwide and these too are discussed.
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Book chapterRivière C, Harman C, Logishetty K, 2020, , Personalized Hip and Knee Joint Replacement, Pages: 343-350
Hip and knee arthroplasties are life-changing procedures, reducing pain and restoring function after end-stage arthrosis. Almost 90% of patients who have undergone hip arthroplasty, and 82% after knee arthroplasty, report improvement in quality of life after surgery [1]; this leaves a significant number of dissatisfied patients. The modern surgeon can make decisions regarding surgical approach, implant design and component orientation. However, it is challenging to gain proficiency in a wide variety of surgical configurations. A smaller repertoire is technically and economically more feasible, and thus a one-size-fits-all approach is commonplace. Hip and knee arthroplasties are forgiving procedures, most frequently performed in older patients without high functional demands. The future arthroplasty surgeon is faced with new challenges-patients with higher demand, expectations and longer life expectancy, in addition to an increasing burden of revision surgery. Here, we discuss ‘a la carte’ joint replacement, which is both patient specific and bone/soft tissue conservative. It may improve overall satisfaction while conserving bone stock in the event of future revision surgery.
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Journal articleLogishetty K, Rudran B, Cobb JP, 2019, , BONE & JOINT JOURNAL, Vol: 101B, Pages: 1585-1592, ISSN: 2049-4394
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- Citations: 54
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Journal articleJones G, Clarke S, Harris S, et al., 2019, , The Knee, Vol: 26, Pages: 1421-1428, ISSN: 0968-0160
BackgroundA previous randomised controlled trial (RCT) by our group found that robotic assisted unicompartmental knee arthroplasty (UKA) surgery was significantly more accurate than conventional instrumentation. The aim of this study was to determine whether a low-cost novel PSI design could deliver the same level of accuracy as the robot in the same time efficient manner as conventional instruments.MethodsThirty patients undergoing medial UKA took part. Tibial component position was planned using a low dose CT-scan, and compared to a day 1 postoperative CT-scan to determine the difference between the planned and achieved positions. Operations were performed by one expert surgeon using PSI (Embody, London, UK).ResultsThe mean absolute difference between planned and achieved tibial implant positions using PSI was 2.0° (SD 1.0°) in the coronal plane, 1.8° (SD 1.5) in the sagittal plane, and 4.5° (SD 3.3) in the axial plane. These results were not significantly different to the 13 historical robotic cases (mean difference 0.5°, 0.5°, and 1.7°, p = 0.1907, 0.2867 and 0.1049 respectively). PSI mean operating time was on average 62 min shorter than the robotic group (p < 0.0001) and 40 min shorter than the conventional instrument group (p < 0.0001). No complications were reported.ConclusionsIn conclusion, this clinical trial demonstrates that for tibial component positioning in UKA, a novel design PSI guide in the hands of an expert surgeon, can safely deliver comparable accuracy to a robotic system, whilst being significantly faster than conventional instruments.NIHR Clinical Research Network Reference: 16100.
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Journal articleAkhbari P, Jaggard MK, Boulange CL, et al., 2019, , OSTEOARTHRITIS AND CARTILAGE, Vol: 27, Pages: 1768-1777, ISSN: 1063-4584
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- Citations: 10
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