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Biomedical subjects

Andrew W McCaskie

Publications and source records attributed to Andrew W McCaskie.

4 recordsLinked to original sources

Late Streptococcus bovis infection of knee arthroplasty and its association with carcinoma of the colon: a case report.

Streptococcus bovis is a very rare cause of infection of joint arthroplasty. Infections with S. bovis have been reported to be associated with various gastrointestinal conditions. We present a case of total knee arthroplasty infected with S. bovis 40 months after a successful knee replacement. The diagnosis was established on joint fluid as well as blood cultures. Early diagnosis, arthroscopic wash out and appropriate antibiotics helped salvage the prosthesis. Early colonoscopy revealed carcinoma of the sigmoid colon that was surgically resected.

Adenocarcinoma, Mucinous↗

Dynamic void behavior in polymerizing polymethyl methacrylate cement.

Cement mantle voids remain controversial with respect to survival of total hip arthroplasty. Void evolution is poorly understood, and attempts at void manipulation can only be empirical. We induced voids in a cement model simulating the constraints of the proximal femur. Intravoid pressure and temperature were recorded throughout polymerization, and the initial and final void volumes were measured. Temperature-dependent peak intravoid pressures and void volume increases were observed. After solidification, subatmospheric intravoid pressures were observed. The magnitude of these observations could not be explained by the ideal gas law. Partial pressures of the void gas at peak pressures demonstrated a dominant effect of gaseous monomer, thereby suggesting that void growth is a pressure-driven phenomenon resulting from temperature-dependent evaporation of monomer into existing trapped air voids.

Air↗

A reliable DEXA measurement technique for metal-on-metal hip resurfacing.

INTRODUCTION: Dual energy X-ray absorptiometry (DEXA) has been used to measure bone mineral density (BMD) around total hip prostheses. With the recent increase in the use of metal-on-metal hip resurfacing, such as the Birmingham hip resurfacing (BHR), we aimed to produce a reliable method of measuring bone density around a metal-on-metal hip resurfacing. METHODS: We performed DEXA scans on 5 patients (7 BHRs), who had undergone resurfacing with the BHR within the past 2 years. A zonal reporting technique was devised and evaluated. RESULTS: The intraclass correlation (i.e. the correlation between any two assessments of one region of interest) was 0.997, with an overall coefficient of variation of 5%. INTERPRETATION: We have designed and demonstrated a safe, noninvasive and highly reproducible method for interpreting and reporting the results of DEXA scanning of BHR implants in vivo. We will now use this method to prospectively study our BHR population to assess the changes in bone density following BHR within the femoral neck. This method may add to the current techniques available for detection of impending failure.

Absorptiometry, Photon↗

The dynamic volume changes of polymerising polymethyl methacrylate bone cement.

The Swedish hip register found an increased risk of early revision of vacuum-mixed cemented total hip replacements. The influence of cement mixing technique on the dynamic volume change in polymerising PMMA is not well understood and may be relevant to this observation. Applying Archimedes' principle, we have investigated the dynamic volume changes in polymerising cement and determined the influence of mixing technique. All specimens showed an overall volume reduction: hand-mixed 3.4% and vacuum-mixed 6.0%. Regression analysis of sectional porosity and volume reduction showed a highly significant relationship. Hand-mixed porous cement showed a transient volume increase before solidification. However, vacuum-mixed cement showed a progressive volume reduction throughout polymerisation. Transient expansion of porous cement occurs at the critical time of micro-interlock formation, possibly improving fixation. Conversely, progressive volume reduction of vacuum-mixed cement throughout the formation of interlock may damage fixation. Stable fixation of vacuum-mixed cement may depend on additional techniques to offset the altered volumetric behaviour of vacuum-mixed cement.

Bone Cements↗