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The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 2 | Pages 195 - 198
1 Mar 2001
Walker CRC Myles C Nutton R Rowe P

We used electrogoniometers to measure the range of movement (ROM) of the knee during various activities, comparing 50 patients with osteoarthritis of the knee (OA) with 20 healthy age- and sex-matched subjects.

The minimum and maximum joint angles and the ranges of excursion of the patient and control groups were tested for significant differences, using an unrelated Student’s t-test with pooled variance. Knee flexion in patients with OA was significantly reduced during all activities (p < 0.05), but differences in knee extension were not significant except when patients negotiated stairs. We believe that this reduction in ROM is caused by inhibition due to pain when load-bearing. Static non-load-bearing measurements of the ROM poorly reflected the functional ROM, with a coefficient of determination (r2) of 0.59 in the patient group and 0.60 in the control group. Electrogoniometry of the ROM of the knee provides a reliable, accurate and objective measurement of knee function.


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 5 | Pages 886 - 889
1 Sep 1999
Davis N Curry A Gambhir AK Panigrahi H Walker CRC Wilkins EGL Worsley MA Kay PR

All surgical operations have the potential for contamination, and the equipment used can harbour bacteria. We collected samples from 100 elective primary hip and knee arthroplasties. These showed rates of contamination of 11.4% for the sucker tips, 14.5% for light handles, 9.4% for skin blades and 3.2% for the inside blades used during surgery; 28.7% of gloves used for preparation were also contaminated. Of the samples taken from the collection bags used during hip arthroplasty, 20% grew bacteria, which represents a significant microbial reservoir. Also, 17% of theatre gowns were contaminated at the end of the operation. Contamination was found in 10% of the needles used during closure of the fascia. Overall, 76% of the organisms grown were coagulase-negative staphylococcus. A total of 63% of operations showed contamination in the field of operation. Some changes in practice are suggested. Follow-up for a minimum of two years revealed one deep infection but the organism was not identified as a contaminant. These data provide a baseline for studying the bacteriology of the surgery of revision arthroplasty.


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 3 | Pages 402 - 405
1 May 1999
McLauchlan GJ Walker CRC Cowan B Robb JE Prescott RJ

We tested the hypothesis that children who sustain a supracondylar fracture have a greater range of elbow hyperextension than those with a fracture of the distal radius.

Three observers made 358 measurements in 183 children (114 boys and 69 girls). There were 119 fractures of the distal radius and 64 supracondylar fractures.

Initially, the group with a supracondylar fracture appeared to have extension 1.7° greater than that of the group with fracture of the distal radius. On average, there was a maximum variation of 3° between observers. After allowing for age, gender and observer, there was no significant difference between the groups. Our study had greater than 80% power to detect a difference in hyperextension of 2° at the 5% level with the above observer variability.

When age and gender are taken into account, any variation in the amount of hyperextension at the elbow is not sufficient to explain the occurrence of a supracondylar fracture.