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Biomedical subjects

C Darrah

Publications and source records attributed to C Darrah.

8 recordsLinked to original sources
PubMed2006

Evidence-based practice in the utilization of knee radiographs--a survey of all members of the British Orthopaedic Association.

There has been a debate amongst orthopaedic surgeons about which plain radiographs are required in common knee conditions and this is a 5-year review assessing the influence of recent publications on the use of radiographs. A postal survey of all members of the British Orthopaedic Association was performed. The response rate was 60% (990/1,650). There was a broad agreement on the use of anteroposterior and lateral radiographs. The use of the posteroanterior (PA) weight-bearing radiograph has increased from 82 to 86%. The use of skyline view for suspected arthritis and after knee replacement has increased from 23 to 41%. There is still disparity amongst orthopaedic surgeons regarding the knee flexion angle for skyline and weight-bearing views. After review of the literature we recommend that a single skyline view in 30 degrees flexion is adequate and should be a standard investigation in knee disorders. We also stress the importance of weight-bearing PA radiograph in 30 degrees knee flexion for adequate assessment in all patients with suspected arthritis.

Arthrography↗
PubMed2005

The Elite Plus total hip arthroplasty: the need for radiological surveillance.

We prospectively studied 217 patients who underwent 234 Elite Plus total hip arthroplasties. At a mean of 6.4 (SD 0.7) years post-operatively, 39 patients had died and 22 were either lost to follow-up or had no radiographs available. Clinical (Oxford hip score) and radiological assessments were performed on 156 patients (168 hip arthroplasties) who had a mean age of 67.7 (SD 9.7) years at operation. In the assessed group, 26 of 159 (16.4%) of femoral stems which had not already been revised and 19 of 159 (11.9%) of acetabular cups were definitely loose. In total, 52 of 168 (31%) of hips had either been revised or had definite evidence of loosening of a component. We could not establish any relationship between clinical and radiological outcomes. Despite the fact that the clinical outcome and rate of revision for the Elite Plus appeared to meet international standards, our findings give us cause for concern. We believe that joint registries should include radiological surveillance in order to provide reliable information about medium-term outcomes for hip prostheses.

Age Factors↗
PubMed2004

The optimum knee flexion angle for skyline radiography is thirty degrees.

There is wide variation in practice among orthopaedic surgeons regarding the use of skyline tangential patellar radiographs of the patellofemoral joint in patients with anterior knee pain. Various techniques are available for taking such radiographs and numerous radiologic parameters can be measured from them. There is no information as to which knee flexion angle is superior when taking skyline radiographs. The purpose of the current study was to compare the results of skyline radiographs taken at 30 degrees, 50 degrees, and 90 degrees knee flexion. Sixty-seven knees were studied prospectively. All radiographs were made anonymous and then were studied in random order by two observers. Five recognized patellofemoral parameters were recorded. All the parameters studied were measured most reproducibly when measured from the radiograph taken at 30 degrees knee flexion. The parameters were least reproducible when measured from the radiograph taken at 90 degrees knee flexion. In terms of detecting abnormality of the parameters measured, the radiographs taken at 30 degrees and 50 degrees were similar. The radiograph taken at 90 degrees knee flexion detected the fewest abnormalities. Skyline radiographic examination of the patellofemoral joint should be a mandatory part of the investigation of all knee problems. One radiograph, ideally taken at 30 degrees knee flexion, offers the best means of assessing the patellofemoral joint. There is no benefit to requesting multiple images at different angles of knee flexion.

Adolescent↗
PubMed2003

Immediate full-weight-bearing mobilisation for repaired Achilles tendon ruptures: a pilot study.

Recent experimental and clinical evidence suggests that early loading and mobilisation for Achilles tendon ruptures may improve functional outcomes. This paper presents the results of a pilot study designed to assess the safety of immediate weight-bearing mobilisation. Twenty-eight operatively repaired patients were randomised to either immediate loading in an orthosis or traditional serial plaster casting. An independent observer, blinded to treatment, assessed the results. Improved clinical, anthropometric, and functional outcomes were noted in the immediate loading group. Ultrasound assessment confirmed no deleterious effects upon the tenodesis. There was one re-rupture of the tendon at a minimum follow-up of 1 year.

Achilles Tendon↗
PubMed2001

Calcaneal compartment syndrome after tibial fractures.

Compartment syndrome of the newly discovered calcaneal compartment of the foot is a theoretical possibility following tibial fracture due to the communication with the deep posterior compartment of the calf. Forty-nine patients were reviewed at least 18 months after open or closed tibial shaft fractures treated with tibial nailing in order to determine the prevalence of foot deformities secondary to previously undetected calcaneal or leg compartment syndromes. Ankle movements, foot height, length of feet and degree of clawing of the toes were all measured and compared with the unaffected opposite side. None of the patients complained of any symptoms from their feet and none had any significant foot deformities. Calcaneal compartment syndrome is rare after tibial fracture and routine measurement of calcaneal compartment pressures after such injuries is not indicated.

Bone Nails↗
PubMed1998

Ribozyme-mediated trans-splicing of a trinucleotide repeat.

Trinucleotide repeat expansions (TREs) are a recently described class of mutations characterized by a change in the size of the genomic fragment due to amplification of the repeated unit. A number of diseases have been attributed to TRE, including Huntington disease and myotonic dystrophy (DM), but attempts at genetic therapy have yet to prove successful. A potential therapeutic approach would be to repair the expanded repeat using the trans-splicing ability of group I intron ribozymes. We have used DM as a model to test this hypothesis. A group I intron ribozyme (DMPK-RZ1) was designed to modify the TRE at the 3' end of the human myotonic dystrophy protein kinase (DMPK) transcripts. DMPK-RZ1 was shown to ligate a small DMPK mRNA fragment, contained within the ribozyme, to a simple DMPK-target RNA in vitro. It also modified a larger target transcript, leading to replacement of twelve repeats with five repeats, both in vitro and in mammalian cells. Finally, this ribozyme successfully replaced the 3' end of endogenous DMPK mRNA in fibroblasts with a different 3' region. Ribozyme-mediated RNA repair may thus form a novel therapeutic strategy for diseases associated with repeat expansions.

Cell Line↗