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Biomedical subjects

D S Muckle

Publications and source records attributed to D S Muckle.

At least 19 recordsLinked to original sources
PubMed1998

A portable monitoring system for measuring weight-bearing during tibial fracture healing.

An ambulatory monitoring system has been developed to measure the weight-bearing achieved by a patient on their fractured leg. The system is lightweight, portable, and can monitor weight-bearing continuously over an extended period of time. In addition to mean weight-bearing, the system can also determine temporal parameters associated with the patients' gait. This system was used to measure the weight-bearing achieved during the course of fracture healing in a small number of patients being treated by a variety of fixation methods for a tibial fracture. In general, weight-bearing was observed to increase with time post fracture, and the fixation method employed appeared to influence the rate of increase of loading of the fractured limb, more rigid methods of fixation enabling full-weight-bearing to be achieved sooner.

Adolescent↗
PubMed1997

Bone mineral changes during tibial fracture healing.

The traditional assessment of fracture healing by manipulation and viewing of radiographs is subjective and qualitative. Dual energy x-ray absorptiometry by contrast provides an accurate, precise, and minimally invasive quantitative measure of bone mineral density, a property that shows strong correlations with various mechanical properties of bone. Fourteen patients with unilateral tibial shaft fractures stabilized by external fixation were monitored with dual energy x-ray absorptiometry at monthly intervals after fracture. Fractured and contralateral unfractured bones (controls) were scanned on each occasion. Changes in mineralization with time over the whole length of the fractured bone could be seen. The most pronounced effects were visible in the area of the fracture, with a minimum recorded fracture site bone mineral density of 38 +/- 13% of contralateral values, but often more long term alterations in bone mineral density affected regions at some distance from this zone. Significantly, in four patients who had scans 5 or more months after fracture, the mineralization at the fracture site had returned to control levels, whereas bone mineral density in a region proximal to the fracture showed evidence of persisting posttraumatic osteoporosis.

Absorptiometry, Photon↗
PubMed1996

Dual-energy X-ray absorptiometry as a measure of healing in fractures treated by intramedullary nailing.

The conventional qualitative techniques of manual manipulation and plain radiography do not give a quantifiable measurement of healing. With internal fixation, manual manipulation is not usually possible, and conventional radiographs may not give much useful information, particularly if only a small amount of callus is formed. Dual-energy x-ray absorptiometry (DXA) provides an accurate method of quantifying the changes in bone mineral density (BMD) which occur during fracture healing. Preliminary work showed that the presence of a highly attenuating metal implant in the scan area did not affect the reliability of BMD data obtained from scans. On this basis, we have assessed the use of DXA in the clinical situation to monitor fractures treated by intramedullary nailing. Five fractures of the mid-shaft of the tibia stabilized by interlocked intramedullary nails have been monitored by DXA at monthly intervals through healing. DXA improves on radiography in giving a quantitative measure of fracture site mineralization. However, it is concluded that, because of the relatively small changes in callus BMD encountered with the rigid fixation provided by interlocked intramedullary nailing, DXA offers no significant diagnostic advantages over plain radiography.

Absorptiometry, Photon↗
PubMed1992

Woven carbon surface replacement in the knee: independent clinical review.

An independent assessment was performed of the results of woven carbon implants of mesh or rods into articular cartilage defects performed by two surgeons in the knees of 96 patients. Eight had symptomatic osteochondritis, 31 had chondromalacia patellae and 57 had early osteoarthritis. They were reviewed up to 5 yr after operation. Seventy-six patients (79%) experienced an improvement in analogue pain score and similar improvements occurred in a range of functional activities (P = 0.002). No evidence of inflammatory change or deterioration in joint damage was found. It is concluded that this relatively minor procedure is valuable in younger patients with troublesome symptoms due to early articular cartilage damage and does not prejudice further operative treatment.

Adolescent↗
PubMed1990

Biological response to woven carbon fibre pads in the knee. A clinical and experimental study.

We assessed the use of woven carbon fibre pads to resurface osteochondral defects in animals and in patients. The pads became filled with structurally strong and compliant fibrous tissue and did not provoke a synovial reaction, though pigmentation was induced in some animals. Of the patients, 77% had a satisfactory response to resurfacing, with no synovitis. Our initial experiments indicate that carbon pads may provide a satisfactory treatment for localised articular defects.

Adolescent↗
PubMed1989

Mechanical and histological response of carbon fibre pads implanted in the rabbit patella.

Small carbon fibre pads (3 mm in diameter) were implanted into rabbit patellae to ascertain the relationship between their mechanical and histological responses. After 3 months a highly vascularized collagenous matrix is formed within and around the implant securely anchored to the bone and providing a continuous layer to the articular surface. Mechanically, the resulting repair is much more compliant than the original articular cartilage/bone structure since the subchondral bone plate is not present within the implant; it also provides a functioning congruent surface with no evidence of fragmentation. This may be attractive in the long term by decreasing friction and the subsequent degeneration and wear commonly seen in fibrillated, disrupted articular cartilage.

Animals↗
PubMed1986

Flurbiprofen for the treatment of soft tissue trauma.

The use of flurbiprofen as an analgesic and anti-inflammatory agent in patients with soft tissue trauma induced by sports injuries, lumbar disk syndrome, or surgery was considered in three clinical trials. In the first study, soft tissue injuries to the lower limb in 51 professional soccer players were treated for six days with 150 mg of flurbiprofen per day or 3.6 g of aspirin per day. The second study compared three weeks of treatment with daily doses of 200 mg of flurbiprofen and 4 g of acetaminophen in 50 patients with acute low back pain. In the third study, 100 postoperative patients were given 400 mg of flurbiprofen per day or 4 g of acetaminophen per day for seven days following total or partial meniscectomy. In all of these trials, flurbiprofen showed excellent analgesic efficacy in reducing pain and swelling, and enhanced the recovery of patients with soft tissue trauma.

Acetaminophen↗
PubMed1984

Open meniscectomy: enhanced recovery after synovial prostaglandin inhibition.

The suppression of the immediate postmeniscectomy synovial reaction by a potent prostaglandin inhibitor (flurbiprofen 400 mg daily) resulted in significantly less knee pain and swelling in 50 patients compared to 50 age-matched controls taking a simple analgesic (paracetamol 4 g daily) (P less than 0.001), thus enhancing recovery by three to four weeks. In the patients undergoing partial meniscectomy knee function was restored by 27 days, a figure comparable with endoscopic methods.

Acetaminophen↗
PubMed1983

Factors affecting the prognosis of meniscectomy in soccer players.

Meniscectomy is a frequent surgical procedure in young soccer players but the results are unpredictable. A long-term survey was carried out to assess certain fundamental features and to establish the predictive factors which affect the prognosis after meniscectomy.

Adult↗
PubMed1982

Ender's nails in femoral shaft fractures.

Thirty-five patients with uncomplicated fractures of the femoral shaft were treated by closed reduction and internal fixation with Ender's nails. Twenty-eight similar patients were treated by Küntscher's nailing. The average blood loss after Ender's fixation was 110 ml compared with 450 ml after Küntscher's nailing and the ranges of operative time were 9-30 minutes and 24-50 minutes respectively. Patients were mobilized on average 9 days after Ender's nailing and 75 per cent had a hospital stay of less than 3 weeks. The comparable figures after Küntscher's nailing were 13 days and 4 weeks. All patients regained 80-90 per cent of knee flexion by 4 months. Thus Ender's nails proved to be a reliable method of medullary fixation in young adults with femoral shaft fractures and caused less morbidity than Küntscher's nailing.

Adolescent↗
PubMed1982

Mechanical properties of traumatized rat tendo-achilles and the effect of an anti-inflammatory drug on the repair properties.

This paper reports on the effect of orally administered flurbiprofen, a potent inhibitor of prostaglandin synthesis (cyclo oxygenase inhibitor), on the mechanical properties of traumatized rat tendo-achilles to see if the F2 alpha prostaglandin was affected and hence the repair process. The drug (1 mg) was administered daily for 7 days to 18 rats whose tendo-achilles were traumatized by crimping using a predetermined force (50 N) applied for 10s. Eighteen sham control rats were identically traumatized and given daily the same volume of liquid (water) not containing the drug. Forty non-traumatized, untreated rats were examined as controls. In vitro studies showed that there was no significant difference in the stress--strain and relaxation characteristics between the three groups and no histological differences were observed.

Achilles Tendon↗
PubMed1982

The repair of osteochondral defects in osteoarthritic rabbit knees by the use of carbon fibre.

Implants of carbon fibres and carbon fibre patches were tested for their biocompatibility in osteochondral defects in rabbits with instability induced knee osteoarthrosis. The resulting repairs were compared to control holes in which no implant was inserted. There was no apparent biodegradation when fibre bundles were implanted for periods from 2 to 18 weeks, and the carbon fibre patches appeared to induce the gross appearance of a restored joint surface, mechanically strong to loading for periods from 2 to 26 weeks. Also carbon fibre in the form of a patch promoted the healing of the osteochondral defects in osteoarthritic femora with well organised fibrous tissue over repaired subchondral bone. The use of these carbon-fibre patches is suggested as an implant material for the restoration of articular surfaces in osteoarthritis.

Animals↗
PubMed1982

Injuries in sport.

Explore the source record for details and available documents.

Athletic Injuries↗
PubMed1982

The role of the meniscus in an instability model for osteoarthritis in the rabbit knee.

After division of the cruciate ligaments and one meniscus in the knee joint of the rabbit, degenerative changes were observed in both the articular cartilage and bone. This was more apparent on the tibial plateau in which the meniscus had been removed, progressive changes occurring from 3 to 16 weeks after trauma. A parallel in vitro experiment, involving measuring the lateral displacement of the tibia in the rabbit knee during medial-lateral leading, was performed before and after transverse division of the meniscus alone. The resulting displacements during medial-lateral shear loading approximately doubled after meniscectomy in the mechanical tests, the apparent clinical stability still being provided after meniscus division by the collateral ligaments, joint capsule, cruciates and bone geometry.

Animals↗
PubMed1982

Inflammatory involvement in osteoarthritis and lessons to be learnt from animal models.

In a series of 40 rabbits knees experimentally induced osteoarthritis was produced by removal of the lateral or medial meniscus. Ligamentous injury accentuated changes seen in the hyaline cartilage. Within 8 weeks of meniscectomy increased radioisotope uptake was detected by scintigraphy in osteoarthritic knees. At 26 weeks radiological features of osteoarthritis were seen. Scanning electron microscope studies showed surface change on the femoral condyles and tibial plateaux within 4 weeks of meniscectomy and these became progressively more pronounced over the ensuing 18 weeks.

Animals↗
PubMed1981

Injuries in professional footballers.

The incidence of injuries in footballers is described. Nearly half of footballer's injuries involve the knee, with vertical tearing of the meniscus being common; surgical intervention may be required. Approximately one third of injuries involve the ankle, and will often require immobilisation. Other injuries include muscle damage, spondylosis of L4 or L5, concussion, and dislocations. The importance of prompt and correct treatment of injuries is emphasised.

Ankle Injuries↗