A5019872192- Orthopaedic implants and arthroplasty
- Total Knee Arthroplasty Outcomes
- Orthopedic Infections and Treatments
- Hip disorders and treatments
- Knee injuries and reconstruction techniques
- Advanced materials and composites
- Advanced X-ray and CT Imaging
- Musculoskeletal Disorders and Rehabilitation
- Hip and Femur Fractures
- Bone fractures and treatments
- Foot and Ankle Surgery
- Facial Trauma and Fracture Management
- Orthopedic Surgery and Rehabilitation
- Lower Extremity Biomechanics and Pathologies
- Electron and X-Ray Spectroscopy Techniques
- Management of metastatic bone disease
- Bone and Joint Diseases
- Silicon and Solar Cell Technologies
- Tendon Structure and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Psychometric Methodologies and Testing
- Alkaline Phosphatase Research Studies
- Shoulder Injury and Treatment
- Surgical site infection prevention
- Sinusitis and nasal conditions
University College London
2013-2025
Royal National Orthopaedic Hospital
2013-2025
Nuffield Orthopaedic Centre
2020-2025
University of Oxford
2020-2025
Australian National University
2024
Oxford University Hospitals NHS Trust
2024
Creative Commons
2023
Nuffield Health
2023
University of Liverpool
2023
Marymount University
2021
Many papers have been published recently on the subject of pseudotumors surrounding metal-on-metal hip resurfacing and replacement prostheses. These are sterile, inflammatory lesions within periprosthetic tissues variously termed masses, cysts, bursae, collections, or aseptic lymphocyte-dominated vasculitis-associated (ALVAL). The prevalence in patients with a well-functioning prosthesis is not well known. purpose this study was to quantify adjacent painful prostheses, characterize these use...
Blood metal ions have been widely used to investigate metal-on-metal hip replacements, but their ability discriminate between well-functioning and failed hips is not known. The Medicines Healthcare products Regulatory Agency (MHRA) has suggested a cut-off level of 7 parts per billion (ppb). We performed pair-matched, case-control study the sensitivity specificity blood ion levels for diagnosing failure in 176 patients with unilateral replacement. recruited 88 cases pre-revision, unexplained...
Revision knee replacement (RevKR) for infection is rare but increasing. It hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit with outcomes following first, single-stage RevKR infection. This population-based cohort study merged data from United Kingdom National Joint Registry, Hospital Episode Statistics, Patient Reported Outcome Measures and Civil Registrations Death. Patients undergoing procedures between 1 January...
We carried out metal artefact-reduction MRI, three-dimensional CT measurement of the position component and inductively-coupled plasma mass spectrometry analysis cobalt chromium levels in whole blood on 26 patients with unexplained pain following metal-on-metal resurfacing arthroplasty. MRI showed periprosthetic lesions around 16 hips, 14 collections fluid two soft-tissue masses. The were seen both men women symptomatic asymptomatic hips. Using CT, median inclination acetabular was found to...
We designed a prospective, single-center study to assess whether blood metal ion levels could predict implant failure in patients managed with unilateral metal-on-metal hip resurfacing or total arthroplasty.Five hundred and ninety-seven who had received Articular Surface Replacement prostheses at least twelve months earlier were recruited. Blood compared between the group of failed implants non-failed implants. Implant was defined as associated revision, an intention revise, poor...
Background and purpose Operative findings during revision of metal-on-metal hip arthroplasty (MOMHA) vary widely can involve massive soft tissue bone disruption. As a result, planning theater time resources is difficult, surgery challenging, outcomes are often poor. We describe our experience with MOMHA provide recommendations for management.Patients methods present the 39 consecutive MOMHAs (in 35 patients) revised in tertiary unit (median follow-up 30 (12–54) months). The patients...
Arthroplasty registries are important for the surveillance of joint replacements and evaluation outcome. Independent validation registry data ensures high quality. The ability orthopaedic implant retrieval centres to validate is not known. We analysed from National Joint Registry England, Wales Northern Ireland (NJR) primary metal-on-metal hip arthroplasties performed between 2003 2013. Records were linked London Implant Retrieval Centre (RC) validation. A total 67 045 procedures on NJR 782...
ObjectivesTo create estimates for clinically meaningful changes and differences in pain joint function the Oxford Hip Knee Scores (OHS/OKS) primary revision replacement.Study Design Setting694,487 replacement procedures were analyzed from NHS PROMs dataset between 2012-2020. Minimal important (MIC) (MID) calculated using distribution anchor-based methods (including receiver-operating characteristic (ROC) curve predictive-modelling techniques).ResultsFor comparison of two or more groups (such...
Routinely collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip arthroplasty (THA) knee (TKA) in the UK for past decade. This study aimed explore whether following primary THA TKA had improved over seven years.Secondary data analysis 277,430 THAs 308,007 TKAs from NHS PROMs programme was undertaken. Outcome were: postoperative Oxford Hip/Knee Score (OHS/OKS); proportion patients achieving a clinically important improvement...
Metal artifact reduction sequence (MARS) MRI and ultrasound scanning (USS) can both be used to detect pseudotumors, abductor muscle atrophy, tendinous pathology in patients with painful metal-on-metal (MOM) hip arthroplasty. We wanted determine the diagnostic test characteristics of USS using MARS as a reference for detection pseudotumors atrophy. PatienTS AND METHODS: performed prospective cohort study compare findings 19 consecutive unilateral MOM hips. Protocolized was by consultant...
Aims The National Joint Registry for England, Wales and Northern Ireland (NJR) has extended its scope to report on hospital, surgeon implant performance. Data linkage of the NJR London Implant Retrieval Centre (LIRC) previously evaluated data quality hip primary procedures, but did not assess revision records. Methods We analysed metal-on-metal procedures performed between 2003 2013. A total 69 929 from revised pairs components LIRC were included. Results able link 716 (77.1%) LIRC. This...
Metal artifact reduction sequence (MARS) MRI is widely advocated for surveillance of metal-on-metal hip arthroplasties (MOM-HAs). However, its use limited by susceptibility at the prosthesis-bone interface, local availability, patient compliance, and cost (Hayter et al. 2011a). We wanted to determine whether CT a suitable substitute MARS in evaluation painful MOM-HA.50 MOM-HA patients (30 female) with unexplained prostheses underwent imaging. 2 observers who were blind regarding clinical...
Aims The aim of this study was to determine whether patients with metal-on-metal (MoM) arthroplasties the hip have an increased risk cardiac failure compared those alternative types (non-MoM). Patients and Methods A linkage between National Joint Registry, Hospital Episodes Statistics records Office for on deaths undertaken. who underwent elective total arthroplasty January 2003 December 2014 no past history were included stratified as having either a MoM (n = 53 529) or non-MoM 482 247)...
ObjectiveTo investigate trends in the incidence rate and main indication for revision knee replacement (rKR) over past 15 years UK.MethodRepeated national cross-sectional study from 2006 to 2020 using data National Joint Registry (NJR). Crude rates were calculated population statistics Office Statistics.ResultsAnnual total counts of rKR increased 2,743 procedures 6,819 2019 (149% increase). The 6.3 per 100,000 adults (95% CI 6.1 6.5) 14 14) (122% Annual increases became smaller period. There...
Aims To compare rates of serious adverse events in patients undergoing revision knee arthroplasty with consideration the indication for (urgent versus elective indications), and these primary re-revision arthroplasty. Methods Patients were identified national Hospital Episode Statistics (HES) between 1 April 1997 to 31 March 2017. Subsequent procedures same identified. The outcome was 90-day mortality a logistic regression model used investigate factors associated secondary outcomes,...
To develop item response theory (IRT) models for the Oxford hip and knee scores which convert patient responses into continuous with quantifiable precision provide these as web applications efficient score conversion.
Aims To map the Oxford Knee Score (OKS) and High Activity Arthroplasty (HAAS) items to a common scale, investigate psychometric properties of this new scale for measurement knee health. Methods Patient-reported outcome measure (PROM) data measuring health were obtained from NHS PROMs dataset Total or Partial Trial (TOPKAT). Assumptions modelling tested. A graded response model (fitted OKS item responses in dataset) was used as an anchor calibrate paired HAAS TOPKAT dataset. Information...
Periprosthetic joint infection (PJI) following unicompartmental knee replacement (UKR) is an uncommon, yet serious, complication. There a paucity of evidence regarding the effectiveness Debridement-Antibiotics-and-Implant-Retention (DAIR) in this setting. The aim study to investigate DAIR for acute UKR PJI.
Abstract Introduction A spacer is required to maintain limb length and alignment provide a stable for mobilisation in two-stage revision total knee arthroplasty (rTKA) periprosthetic joint infection (PJI). Static spacers are indicated cases of massive bone loss, compromised soft tissues, ligamentous and/or extensor mechanism insufficiency. The aim this study was compare the use Ilizarov rods arthrodesis nails static constructs first-stage rTKA PJI. Methods This retrospective cohort 40...