Biomedical subjects

D W Murray

Publications and source records attributed to D W Murray.

8 recordsLinked to original sources

PubMed1992

Meniscal suture: a simple method.

A simple technique of meniscal suture is described. It avoids the main problem with most other outside-to-inside suture techniques, which is that knots either have to be left inside the joint or have to be pulled out through the meniscus. These knots often come undone or damage either the joint surface or meniscus. Essentially, a suture is inserted from outside to inside through the meniscus, using a cannulated needle. The end of this suture is then pulled back out through a separate hole in the meniscus, using a suture loop inserted with another cannulated needle. The two ends of the first suture are then tied together.

Humans↗

PubMed1992

Impingement and loosening of the long posterior wall acetabular implant.

Long posterior wall (LPW) Charnley acetabular implants are widely used as it is believed that the LPW helps to prevent dislocation. This has, however, not been proven statistically. In a preliminary study of these implants removed at revision marked erosion of the LPW was frequently seen, indicating that repetitive impingement may occur. The influence of the long posterior wall was therefore investigated mathematically. LPW and standard sockets were found to be equally likely to dislocate provided that the standard socket was anteverted 5 degrees more than the LPW socket. With simulated external rotation, LPW sockets impinge 30% earlier than standard sockets. When impingement occurs a torque is applied to the components, which increases the shear stresses at the cement-bone interface. The torques, although not large enough to dislodge the socket immediately, are repetitive and so may contribute to loosening. The LPW socket can generate twice as much torque as the standard socket and therefore is more likely to loosen.

Acetabulum↗

PubMed1992

Mediators of bone resorption around implants.

An important cause of prosthetic loosening is bone resorption that results from the interaction of macrophages with implant surfaces and particulate debris. The mediators involved in this bone resorption were investigated in vitro. Medium conditioned by macrophages interacting with foreign materials was assayed for bone resorption stimulation and inhibition, and for prostaglandin E2 (PGE2). In some experiments, the medium was dialyzed, and in others indomethacin was added. Macrophages were found to release stimulators and inhibitors of bone resorption. The relative amount of these was variable. When macrophages interacted with foreign surfaces, their stimulatory effect was ten times their inhibitory effect. Further activation by phagocytosis caused a further 15-fold increase in stimulation, with no change in inhibition. It is probable that before macrophages encounter foreign materials their stimulatory and inhibitory effects are the same so that they do not cause net bone resorption. Important stimulatory and inhibitory mediators were not dialyzable and so were probably cytokines or possibly collagenase. Prostaglandins were neither important stimulators nor inhibitors. There was only enough PGE2 released to account for 2% of the bone resorption that was stimulated.

Animals↗

PubMed1992

Drug abuse treatment programs in the Federal Bureau of Prisons: initiatives for the 1990s.

Developing high-quality treatment programs is a foreboding challenge in any setting, particularly within a correctional setting. The groundwork has been established for one of the most comprehensive, longitudinal evaluations ever conducted with correctional populations regarding the effectiveness of professionally managed treatment programs. The long-term outcome evaluations should provide information regarding the effectiveness of a multitiered intervention strategy within the correctional setting. This kind of evaluation is reflected in the proposal for the evaluation of the BOP Drug Abuse Treatment Programs, submitted to NIDA (Federal Bureau of Prisons 1990). In the months and years ahead the study is expected to yield important information that will advance knowledge of substance abuse treatment.

Humans↗

PubMed1990

The effect of strain on bone cell prostaglandin E2 release: a new experimental method.

A new method of investigating the mechanisms of strain-induced bone remodeling has been developed. Bone cells were subjected to cyclical strains in vitro by computer-controlled stretching of the plastic substrate on which they were cultured, enabling both physiological and pathological strains to be investigated. Physiological strains have not previously been investigated in vitro. The prostaglandin E2 (PGE2) released by the cells was found to depend on the strain magnitude. It was independent of cycle time, and 5 hours after straining had ceased, it had returned to control levels. These results are similar to the in vivo findings that bone remodeling is dependent on strain magnitude and not strain frequency, indicating that PGE2 may play an important role in strain-induced bone remodeling. The relationship between PGE2 release and strain magnitude was biphasic, with particularly high levels being released at strains that would be associated with either abnormally strenuous activity or microstructural bone damage. It is therefore possible that PGE2 stimulates the osteogenesis caused by increased functional demands, and initiates the remodeling caused by bone damage. This new method of investigating strain-induced remodeling is useful, as any cell type, any mediator, and any strain pattern or parameter can be individually studied.

Alkaline Phosphatase↗

PubMed1990

Macrophages stimulate bone resorption when they phagocytose particles.

We investigated in vitro a mechanism by which particulate debris may induce bone resorption and cause implant loosening. We first studied two standard particles: latex, which is considered to be inert, and zymosan, which is inflammatory. Macrophages that phagocytosed either particle became activated, and stimulated 15 times as much bone resorption as did control macrophages. For activation to occur, 100 times more latex than zymosan had to be phagocytosed. We also found that bone cement and polyethylene particles activated macrophages in a similar manner, and that the necessary amounts of these were intermediate between those of latex and zymosan. None of the particles were toxic. It was concluded that implant loosening may result from bone resorption stimulated by mediators released by macrophages that have phagocytosed particles of bone cement or polyethylene.

Animals↗

PubMed1989

The influence of the surface energy and roughness of implants on bone resorption.

We investigated the possibility that the macrophages which are seen around implants may stimulate bone resorption and cause loosening. We found that macrophages release mediators that stimulate bone resorption, and that the amount of resorption increased by between 2.5 and 10 times when the macrophages adhered to a foreign surface. This bone resorption depended on the surface energy and roughness of the foreign surface, varying with these physical properties rather than with the chemical nature of the material. It is concluded that loosening of orthopaedic implants is likely to be influenced by the surface energy and roughness of the implant.

Animals↗

PubMed1989

The effect of starch glove powder on joint and other tissues.

The purpose of this research was to establish the possible role of starch glove powder in complications following orthopaedic surgery using in vivo and in vitro techniques. Exposure of primary mouse peritoneal macrophages to starch glove powder caused 10% release of prostaglandin E2 (0.1 mg/ml, 16 h) but no increased release of lactate dehydrogenase, demonstrating that cell integrity had not been compromised. Long-term tissue reaction to starch glove powder was investigated in vivo by injection into mouse knee joints. Over a period of 52 weeks no inflammatory response was elicited, no starch was observed in the regional lymph nodes and none was found in joints after the 8th week. Starch glove powder appeared to be innocuous in the joint and although prostaglandin E2 release was stimulated in vitro, this had no apparent effect on joints in vivo.

Animals↗