Staphylococcus aureus is one
of the leading causes of surgical site infection (SSI). Over the
past decade there has been an increase in methicillin-resistant S.
aureus (MRSA). This is a subpopulation of the bacterium
with unique resistance and virulence characteristics. Nasal colonisation
with either S. aureus or MRSA has been demonstrated to
be an important independent risk factor associated with the increasing
incidence and severity of SSI after
Objectives. Prosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty. Non-contact induction heating of metal implants is a new and emerging treatment for PJI. However, there may be concerns for potential tissue necrosis. It is thought that segmental induction heating can be used to control the thermal dose and to limit collateral thermal injury to the bone and surrounding tissues. The purpose of this study was to determine the thermal dose, for commonly used metal implants in
The ability of mesenchymal stem cells (MSCs)
to differentiate in vitro into chondrocytes, osteocytes
and myocytes holds great promise for tissue engineering. Skeletal
defects are emerging as key targets for treatment using MSCs due
to the high responsiveness of bone to interventions in animal models.
Interest in MSCs has further expanded in recognition of their ability
to release growth factors and to adjust immune responses. Despite their increasing application in clinical trials, the
origin and role of MSCs in the development, repair and regeneration
of organs have remained unclear. Until recently, MSCs could only
be isolated in a process that requires culture in a laboratory;
these cells were being used for tissue engineering without understanding
their native location and function. MSCs isolated in this indirect
way have been used in clinical trials and remain the reference standard
cellular substrate for musculoskeletal engineering. The therapeutic
use of autologous MSCs is currently limited by the need for ex
vivo expansion and by heterogeneity within MSC preparations.
The recent discovery that the walls of blood vessels harbour native
precursors of MSCs has led to their prospective identification and isolation.
MSCs may therefore now be purified from dispensable tissues such
as lipo-aspirate and returned for clinical use in sufficient quantity,
negating the requirement for ex vivo expansion
and a second surgical procedure. In this annotation we provide an update on the recent developments
in the understanding of the identity of MSCs within tissues and
outline how this may affect their use in
We examined the outcomes and levels of patient
satisfaction in 202 consecutive cases of ultrasound-guided supraclavicular
brachial plexus block (SBPB) in upper limb surgery performed between
September 2007 and March 2010. All blocks were performed by orthopaedic surgeons using ultrasound
visualisation with a high-frequency linear probe. The probe was
placed in the coronal–oblique plane in the supraclavicular fossa,
and the puncture was ‘in-plane’ from lateral to medial. Most of
the blocks were performed with 0.75% ropivacaine/1% lidocaine (1:1),
with or without adrenaline in 1:200 000 dilution. In 201 patients
(99.5%) the brachial plexus block permitted surgery without conversion
to general anaesthesia. The mean procedure time for block was 3.9
min (2 to 12), the mean waiting time for surgery was 34.1 min (10
to 64), the mean surgical time was 75.2 min (6 to 232), and the
mean duration of post-anaesthetic analgesia was 437 min (171 to
992). A total of 20 patients (10%) developed a transient Horner’s syndrome.
No nerve injury, pneumothorax, arterial puncture or systemic anaesthetic
toxicity were recorded. Most patients (96.7%) were satisfied with
ultrasound-guided SBPB. This study demonstrates the efficacy and
safety of ultrasound-guided SBPB for
Bacterial infection in
Aims. Lifestyle risk factors are thought to increase the risk of infection
after acute
There is a high risk of venous thromboembolism when patients are immobilised following trauma. The combination of low-molecular-weight heparin (LMWH) with graduated compression stockings is frequently used in
Implant-associated infection is a major source
of morbidity in
Objectives. Implant-related infection is one of the most devastating complications in
In order to assess the efficacy of inspection and accreditation by the Specialist Advisory Committee for higher surgical training in
J. E. Lang, S. Mannava, A. J. Floyd, M. S. Goddard, B. P. Smith, A. Mofidi , T. M. Seyler, R. H. Jinnah. Robotic systems in
J. E. Lang, S. Mannava, A. J. Floyd, M. S. Goddard, B. P. Smith, A. Mofidi , T. M. Seyler, R. H. Jinnah. Robotic systems in
Over recent years hip arthroscopic surgery has
evolved into one of the most rapidly expanding fields in
Conventional non-steroidal anti-inflammatory drugs (NSAIDs) and newer specific cyclo-oxygenase-2 (cox-2) inhibitors are commonly used in musculoskeletal trauma and
Despite worldwide clinical use of bio-absorbable devices for internal fixation in
Fresh-frozen allograft bone is frequently used
in
1. The usefulness of the halo method of traction in
In cerebral palsy, the site and severity of the brain lesion are directly linked to gross motor function and the development of musculoskeletal deformities. The relationship between walking ability and
1. The history of microvascular surgery is reviewed; the necessary instruments and the technique of suture are described. 2. Modern trends in the experimental and clinical applications in
We evaluated the top 13 journals in trauma and
orthopaedics by impact factor and looked at the longer-term effect regarding
citations of their papers. All 4951 papers published in these journals during 2007 and 2008
were reviewed and categorised by their type, subspecialty and super-specialty.
All citations indexed through Google Scholar were reviewed to establish
the rate of citation per paper at two, four and five years post-publication.
The top five journals published a total of 1986 papers. Only three
(0.15%) were on operative