bluuebunny/crossref_metadata_2025_split huggingface dataset:
Achilles tendon stiffness is unchanged one hour after a marathon
Authors: Peltonen Jussi , Cronin Neil J. , Stenroth Lauri , Finni Taija , Avela Janne 
Published: September 2012

SUMMARY
Overuse-induced injuries have been proposed as a predisposing factor for Achilles tendon (AT) ruptures. If tendons can be overloaded, their mechanical properties should change during exercise. Because there data are lacking on the effects of a single bout of long-lasting exercise on AT mechanical properties, the present study measured AT stiffness before and after a marathon. AT stiffness was determined as the slope of the force–elongation curve between 10 and 80% of maximum voluntary force. AT force–elongation characteristics were measured in an ankle dynamometer using simultaneous motion-capture-assisted ultrasonography. Oxygen consumption and ankle kinematics were also measured on a treadmill at the marathon pace. All measurements were performed before and after the marathon. AT stiffness did not change significantly from the pre-race value of 197±62 N mm−1 (mean ± s.d.) to the post-race value of 206±59 N mm−1 (N=12, P=0.312). Oxygen consumption increased after the race by 7±10% (P&lt;0.05) and ankle kinematic data revealed that in nine out of 12 subjects, the marathon induced a change in their foot strike technique. The AT of the physically active individuals seems to be able to resist mechanical changes under physiological stress. We therefore suggest that natural loading, like in running, may not overstress the AT or predispose it to injury. In addition, decreased running economy, as well as altered foot strike technique, was probably attributable to muscle fatigue.
Perception of dimethyl sulfide (DMS) by loggerhead sea turtles: a possible mechanism for locating high-productivity oceanic regions for foraging
Authors: Endres Courtney S. , Lohmann Kenneth J. 
Published: September 2012

SUMMARY
During their long-distance migrations, sea turtles of several species feed on jellyfish and other invertebrates that are particularly abundant in ocean regions characterized by high productivity. An ability to distinguish productive oceanic regions from other areas, and to concentrate foraging activities in locations where prey density is highest, might therefore be adaptive. The volatile compound dimethyl sulfide (DMS) accumulates in the air above productive ocean areas such as upwelling and frontal zones. In principle, DMS might therefore serve as an indicator of high prey density for turtles. To determine whether turtles perceive DMS, juvenile loggerhead sea turtles (Caretta caretta) were placed into a water-filled arena in which DMS and other odorants could be introduced to the air above the water surface. Turtles exposed to air that had passed over a cup containing 10 nmol l−1 DMS spent more time at the surface with their noses out of the water than control turtles, which were exposed to air that had passed over a cup containing distilled water. Odors that do not occur in the sea (cinnamon, jasmine and lemon) did not elicit increased surface time, implying that the response to DMS is unlikely to reflect a generalized response to any novel odor. The results demonstrate for the first time that sea turtles can detect DMS, an ability that might enable the identification of favorable foraging areas.
Does the posterolateral bundle influence rotational movement more than the anteromedial bundle in anterior cruciate ligament reconstruction?
Authors: Komzák M. , Hart R. , Okál F. , Safi A. 
Published: September 2012

The biomechanical function of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) remains controversial. Some studies report that the AM bundle stabilises the knee joint in anteroposterior (AP) translation and rotational movement (both internal and external) to the same extent as the PL bundle. Others conclude that the PL bundle is more important than the AM in controlling rotational movement.The objective of this randomised cohort study involving 60 patients (39 men and 21 women) with a mean age of 32.9 years (18 to 53) was to evaluate the function of the AM and the PL bundles of the ACL in both AP and rotational movements of the knee joint after single-bundle and double-bundle ACL reconstruction using a computer navigation system. In the double-bundle group the patients were also randomised to have the AM or the PL bundle tensioned first, with knee laxity measured after each stage of reconstruction. All patients had isolated complete ACL tears, and the presence of a meniscal injury was the only supplementary pathology permitted for inclusion in the trial. The KT-1000 arthrometer was used to apply a constant load to evaluate the AP translation and the rolimeter was used to apply a constant rotational force. For the single-bundle group deviation was measured before and after ACL reconstruction. In the double-bundle group deviation was measured for the ACL-deficient, AM- or PL-reconstructed first conditions and for the total reconstruction.We found that the AM bundle in the double-bundle group controlled rotation as much as the single-bundle technique, and to a greater extent than the PL bundle in the double-bundle technique. The double-bundle technique increases AP translation and rotational stability in internal rotation more than the single-bundle technique.
Evaluation of the relationship between anteroposterior translation of a posterior cruciate ligament-retaining total knee replacement and functional outcome
Authors: Seah R. B. , Pang H. N. , Lo N. N. , Chong H. C. , Chin P. L. , Chia S. L. , Yeo S. J. 
Published: September 2012

The success of total knee replacement (TKR) depends on optimal soft-tissue balancing, among many other factors. The objective of this study is to correlate post-operative anteroposterior (AP) translation of a posterior cruciate ligament-retaining TKR with clinical outcome at two years. In total 100 patients were divided into three groups based on their AP translation as measured by the KT-1000 arthrometer. Group 1 patients had AP translation < 5 mm, Group 2 had AP translation from 5 mm to 10 mm, and Group 3 had AP translation > 10 mm. Outcome assessment included range of movement of the knee, the presence of flexion contractures, hyperextension, knee mechanical axes and functional outcome using the Knee Society score, Oxford knee score and the Short-Form 36 questionnaire.At two years, patients in Group 2 reported significantly better Oxford knee scores than the other groups (p = 0.045). A positive correlation between range of movement and AP translation was noted, with patients in group 3 having the greatest range of movement (mean flexion: 117.9° (106° to 130°)) (p < 0.001). However, significantly more patients in Group 3 developed hyperextension > 10° (p = 0.01).In this study, the best outcome for cruciate-ligament retaining TKR was achieved in patients with an AP translation of 5 mm to 10 mm.
Mobile-bearing lateral unicompartmental knee replacement with the Oxford domed tibial component
Authors: Streit M. R. , Walker T. , Bruckner T. , Merle C. , Kretzer J. P. , Clarius M. , Aldinger P. R. , Gotterbarm T. 
Published: September 2012

The Oxford mobile-bearing unicompartmental knee replacement (UKR) is an effective and safe treatment for osteoarthritis of the medial compartment. The results in the lateral compartment have been disappointing due to a high early rate of dislocation of the bearing. A series using a newly designed domed tibial component is reported.The first 50 consecutive domed lateral Oxford UKRs in 50 patients with a mean follow-up of three years (2.0 to 4.3) were included. Clinical scores were obtained prospectively and Kaplan-Meier survival analysis was performed for different endpoints. Radiological variables related to the position and alignment of the components were measured.One patient died and none was lost to follow-up. The cumulative incidence of dislocation was 6.2% (95% confidence interval (CI) 2.0 to 17.9) at three years. Survival using revision for any reason and aseptic revision was 94% (95% CI 82 to 98) and 96% (95% CI 85 to 99) at three years, respectively. Outcome scores, visual analogue scale for pain and maximum knee flexion showed a significant improvement (p < 0.001). The mean Oxford knee score was 43 (sd 5.3), the mean Objective American Knee Society score was 91 (sd 13.9) and the mean Functional American Knee Society score was 90 (sd 17.5). The mean maximum flexion was 127° (90° to 145°). Significant elevation of the lateral joint line as measured by the proximal tibial varus angle (p = 0.04) was evident in the dislocation group when compared with the non-dislocation group.Clinical results are excellent and short-term survival has improved when compared with earlier series. The risk of dislocation remains higher using a mobile-bearing UKR in the lateral compartment when compared with the medial compartment. Patients should be informed about this complication. To avoid dislocations, care must be taken not to elevate the lateral joint line.
The role of the sensory nerve response in ultrasound accelerated fracture repair
Authors: Lam W-L. , Guo X. , Leung K-S. , Kwong K. S. C. 
Published: September 2012

This study was designed to test the hypothesis that the sensory innervation of bone might play an important role in sensing and responding to low-intensity pulsed ultrasound and explain its effect in promoting fracture healing. In 112 rats a standardised mid-shaft tibial fracture was created, supported with an intramedullary needle and divided into four groups of 28. These either had a sciatic neurectomy or a patellar tendon resection as control, and received the ultrasound or not as a sham treatment. Fracture union, callus mineralisation and remodelling were assessed using plain radiography, peripheral quantitative computed tomography and histomorphology. Daily ultrasound treatment significantly increased the rate of union and the volumetric bone mineral density in the fracture callus in the neurally intact rats (p = 0.025), but this stimulating effect was absent in the rats with sciatic neurectomy. Histomorphology demonstrated faster maturation of the callus in the group treated with ultrasound when compared with the control group. The results supported the hypothesis that intact innervation plays an important role in allowing low-intensity pulsed ultrasound to promote fracture healing.
The adverse effect of elevated body mass index on outcome after autologous chondrocyte implantation
Authors: Jaiswal P. K. , Bentley G. , Carrington R. W. J. , Skinner J. A. , Briggs T. W. R. 
Published: September 2012

We analysed whether a high body mass index (BMI) had a deleterious effect on outcome following autologous chondrocyte implantation (ACI) or matrix-carried autologous chondrocyte implantation (MACI) for the treatment of full-thickness chondral defects of the knee from a subset of patients enrolled in the ACI vs MACI trial at The Royal National Orthopaedic Hospital.The mean Modified Cincinnati scores (MCS) were significantly higher (p < 0.001) post-operatively in patients who had an ideal body weight (n = 53; 20 to 24.9 kg/m2) than in overweight (n = 63; 25 to 30 kg/m2) and obese patients (n = 22; > 30 kg/m2). At a follow-up of two years, obese patients demonstrated no sustained improvement in the MCS. Patients with an ideal weight experienced significant improvements as early as six months after surgery (p = 0.007). In total, 82% of patients (31 of 38) in the ideal group had a good or excellent result, compared with 49% (22 of 45) of the overweight and 5.5% (one of 18) in the obese group (p < 0.001). There was a significant negative relationship between BMI and the MCS 24 months after surgery (r = -0.4, p = 0.001).This study demonstrates that obese patients have worse knee function before surgery and experience no sustained benefit from ACI or MACI at two years after surgery. There was a correlation between increasing BMI and a lower MCS according to a linear regression analysis. On the basis of our findings patient selection can be more appropriately targeted.
The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics
Authors: Sutton PA , El-Duhwaib Y , Dyer J , Guy AJ 
Published: September 2012

INTRODUCTION The aim of this study was to establish the incidence of post-operative venous thromboembolism (VTE) following varicose vein treatment. METHODS Hospital Episode Statistics (HES) data were obtained for all patients undergoing varicose vein treatment between April 2006 and April 2007 to identify those reattending with either deep vein thrombosis or pulmonary embolism within 12 months. RESULTS The incidence of VTE was 0.51%, which was comparable with the incidence for those undergoing open surgery (0.54%), sclerotherapy (0.19%) and endovenous laser therapy (EVLT) (0.47%). The incidence of VTE in those undergoing combined EVLT and phlebectomy was 1.26% (p=0.01). In contrast to unilateral treatment (all modalities), where bilateral treatment was performed an increase in the incidence of VTE was seen in those undergoing redo (1.62%) and short saphenous system (1.16%) treatments.Overall, 1.02% of cases were performed under local anaesthesia with zero incidence of VTE in this cohort. CONCLUSIONS The overall incidence of VTE recorded in HES was 0.51% and appears to be highest in those undergoing bilateral redo or short saphenous system surgery as well as those undergoing a combination of EVLT and phlebectomy. The use of VTE prophylaxis, particularly in these groups, is recommended.
Buried or unburied K-wires for lateral condyle elbow fractures
Authors: McGonagle L , Elamin S , Wright DM 
Published: September 2012

INTRODUCTION Lateral humeral condyle fractures typically require a longer period of internal fixation than other distal humeral fractures due to the increased risk of non-union. K-wires can be buried and left in situ until union or they can be left unburied and require removal after four weeks, with plaster immobilisation until union. There is no consensus as to whether wire burial is preferable or not. The aim of this study was to determine whether K-wire burial is associated with more complications than non-buried wires in treating lateral condyle fractures of the elbow. METHODS All patients with lateral humeral condyle fractures treated with K-wire fixation at our institution from May 2008 to August 2011 were included in the study. Fracture configuration, mode of reduction, wire burial and complications were assessed. RESULTS Sixty-seven patients (19 girls and 48 boys, mean age: 6.5 years, range: 1–17 years) were included in the study. All had closed injuries and were treated with open reduction and K-wire fixation. K-wires were buried in 55 patients. Thirteen cases of buried wires eroded through skin and were removed on average 45 days (range: 30–58 days) post-operatively. Of the wire erosion cases, three developed microbiologically proven infections, one of which was a deep infection. There were a further three superficial wound infections in the absence of wire erosion through the skin. There were complications in 2 of the 12 cases in the unburied wires group: 1 microbiologically proven superficial wire site infection and 1 wire backed out after 11 days, requiring refixation. CONCLUSIONS Wire erosion through the skin is the most common complication of K-wire burial. This may be due to the decrease in swelling after fracture fixation, making the wires more prominent under the skin. Skin integrity should be monitored closely if wires are buried.
Graduated compression stockings in hip fractures
Authors: Alsawadi A , Loeffler M 
Published: September 2012

INTRODUCTION Hip fractures are the most common cause of acute admissions to orthopaedics and in the UK approximately 70,000–75,000 hip fractures occur annually. Hip fractures carry a significant risk of developing a venous thromboembolism. The National Institute for Health and Clinical Excellence (NICE) estimated that the risk of developing a venous thromboembolism in patients with hip fractures who do not receive thromboprophylaxis is 43%. In their recent guidelines, NICE recommended that combined mechanical and pharmacological thromboprophylaxis should be offered to patients undergoing hip fracture surgery and mechanical prophylaxis should be commenced at admission. The aim of this review was to search for available evidence that could support using graduated compression stockings combined with low molecular weight heparin (LMWH) in hip fracture patients. METHODS NICE guidelines and the reference list of the guidance were reviewed and a thorough literature search was performed on main electronic databases (MEDLINE®, Embase™ and the Cochrane Library). RESULTS A literature search was unable to find sufficient evidence to support the use of graduated compression stockings combined with LMWH in hip fracture settings. The guidelines are critically reviewed and the available evidence discussed. CONCLUSIONS The evidence supporting these recommendations is very limited and there is considerable concern regarding the safety and efficacy of the mechanical devices used in thromboprophylaxis. Further studies are needed urgently before specific guidelines can be agreed confidently for patients with hip fractures.
The clinical relevance of microbiology specimens in orofacial abscesses of dental origin
Authors: Fowell C , Igbokwe B , MacBean A 
Published: September 2012

INTRODUCTION It is common surgical practice to take a specimen for microbial culture and susceptibility (MC&S) when draining an orofacial abscess. The aim of this study was to determine if routine MC&S has any therapeutic value in the care of these patients. METHODS A retrospective study was undertaken of records of patients admitted for surgical management of orofacial abscesses between January 2010 and December 2011. Records were reviewed for bacteriology specimen and result, admission details, antimicrobial treatment and outcome. RESULTS A total of 79 patients were included in the study and specimens sent from 62 patients (78.4%). Samples were positive in 86.2% of cases, of which Streptococcus viridans was the most commonly isolated organism (54.7%). Interim reports were published on average after 3.25 days, with 89.9% of patients having been discharged within 2 post-operative days. According to clinical records, no patients in the cohort required further intervention or alteration of prescribed antimicrobial treatments following discharge. CONCLUSIONS Almost 90% of patients were discharged before bacteriology results were available, without complication. This study suggests bacteriology culture has no therapeutic value in these patients. Omission of this practice in the case of uncomplicated orofacial abscesses could improve efficiency in the National Health Service without affecting patient care.
Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women
Authors: Hashim H , Terry TR 
Published: September 2012

INTRODUCTIONSynthetic midurethral slings are the most common operations performed for women with stress urinary incontinence (SUI). However, there is only very scarce evidence regarding the management of complications from these operations. The aim of this survey was to canvass expert opinion regarding the management of recurrent SUI and urinary retention following insertion of these slings.METHODSExpert urologists and urogynaecologists in the UK with an interest in SUI were identified. Three clinical scenarios on recurrent SUI and one on urinary retention following midurethral sling placements were emailed twice to the experts.RESULTSThe majority of the experts chose a repeat synthetic midurethral retropubic transvaginal tape (TVT) as the procedure of choice for recurrent SUI in patients who had had a previous TVT or midurethral transobturator tape inserted. In patients who continued to suffer SUI after a failed second TVT, there were mixed results with experts choosing fascial slings, colposuspension and bulking agents as their preferred method of treatment. In women who develop urinary retention following a TVT, tape pull-down within two weeks was the preferred method among the experts. However, division of the tape within two to six weeks following the procedure was also popular.CONCLUSIONSBased on expert opinion, it is difficult to make a recommendation as to the best method of treating recurrent SUI or urinary retention following tape insertion. There is an urgent requirement for well conducted, multicentre, randomised clinical trials to look at the management of these complications and also the tools used to assess the patient before salvage surgical management.
Early results of a prospective study on the pyrolytic carbon (pyrocarbon) Amandys® for osteoarthritis of the wrist
Authors: Daruwalla ZJ , Davies KL , Shafighian A , Gillham NR 
Published: September 2012

INTRODUCTION The preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients were reviewed. As it is currently only a limited release product, we describe to potential users early complications and negative outcomes. METHODS Patients were assessed using pain levels, ranges of motion, grip strength, type of and time to return to work as well as pre-operative and post-operative DASH (Disabilities of the Arm, Shoulder and Hand) scores. Radiographs were taken and patient satisfaction was recorded. RESULTS All six patients were contacted. One was not satisfied. Three had reduced motion. None experienced squeaking. There were no immediate or late post-operative complications. There was one early volar displacement of an implant. CONCLUSIONS Although our early results are somewhat encouraging, further and longer studies are warranted before supporting the use of this particular pyrocarbon implant as a primary procedure.
An Initial Investigation into the Anti-inflammatory Activity and Antioxidant Capacity of alpha-Cyclodextrin-Complexed Manuka Honey
Authors: Chepulis Lynne M. , Francis Evelyn 
Published: September 2012

Abstract
The bioactive properties of Manuka honey are now well recognised, but the nature of honey (a sticky, viscous fluid) can make it hard to use as a health remedy. A new technology using encapsulation of Manuka honey with alpha-cyclodextrin molecules has been developed, creating a free-flowing powder that can easily be added to foods and beverages, or tableted / made into capsules for use in health. In this study, we investigated for antioxidant and anti-inflammatory activity. Antioxidant capacity of raw Manuka honeys and matched complexes was measured using the CUPRAC method. Results showed that the antioxidant activity of honey decreased when complexed, this being directly related to dilution of the final product with alpha-cyclodextrin. Anti-inflammatory activity was assessed by measuring inhibition of neutrophil TNF-alpha secretion. Contradictory results were produced, with both stimulation and inhibition of TNF-alpha being observed. Data from this study indicate that the formation of cyclodextrin-based complexes of Manuka honey may potentiate the anti-inflammatory activity of honey, but this may differ depending on methylglyoxal content and the presence of other factors.