Biomedical subjects

S L Whitehouse

Publications and source records attributed to S L Whitehouse.

5 recordsLinked to original sources

PubMed2003

Development and testing of a reduced WOMAC function scale.

We used prospective data from 862 total knee and 716 total hip replacements three years after surgery in order to derive and validate a reduced Western Ontario and McMasters University Osteoarthritis Index (WOMAC) function scale. The reduced scale was derived using the advice of clinical experts as well as analysis of data. The scale was tested for validity, reliability and responsiveness. Items which were retained included: ascending stairs, rising from sitting, walking on the flat, getting in or out of a car, putting on socks, rising from bed, and sitting. The reduced and full scales had comparable, moderate correlations with other measures of function, confirming convergent validity. Cronbach's alpha was high (alpha > 0.85) with the reduced scale confirming reliability. Responsiveness was greater for the reduced scale (full = 1.4, reduced = 1.6). This reduced version of the WOMAC function scale provides a practical, valid, reliable and responsive alternative to the full function scale for use after total joint replacement. Further work is needed to demonstrate its wider applicability.

Activities of Daily Living↗

PubMed2002

A comparative study of the medial St Georg sled and kinematic total knee arthroplasties. Ten-year survivorship.

We have studied the long-term outcome of 408 primary medial St Georg Sled unicompartmental arthroplasties of the knee and 531 primary Kinematic total knee arthroplasties using survivorship analysis. The operations were performed by a number of surgeons under the supervision of two consultants at one orthopaedic centre. Prospective clinical assessment was carried out before and at 2, 5, 8, 10, 12 and 15 years after operation. Failure was defined as follows: revision or removal of the implant; the presence of moderate or severe pain; or 'worst-case' with all patients lost to follow-up. Cumulative survival rates at ten years were calculated using life tables. The follow-up rate was 97%. At ten years, 25 medial sled arthroplasties and 20 Kinematic knee arthroplasties had been revised. With revision or removal as the survivorship endpoint at ten years there was a success rate of 87.5% for the medial sled and 89.6% for the Kinematic knee arthroplasty. When moderate or severe pain was included these rates became 79.4% for both arthroplasties. There was no statistically significant (p > 0.05) difference between the rates of survival for the two arthroplasties using either of the endpoint criteria. Good or excellent results were recorded for 77.9% of the medial sled knees and 75.1% for the Kinematic knees. The former had 93.8% of cases with a final range of movement in excess of 90 degrees compared with 83.7% for the Kinematic knees (p < 0.01). We conclude that at a single orthopaedic centre in the UK, the St Georg Sled medial compartment arthroplasty for appropriate specific indications offers predictable survivorship at ten years which is comparable with that of the Kinematic total knee arthroplasty.

Adult↗

PubMed2001

Harris Galante cementless acetabular replacement in avascular necrosis.

We describe the results of 76 total arthroplasties of the hip for stage-III or stage-IV avascular necrosis of the femoral head. Harris Galante Porous cups were used in 63 patients between 1986 and 1994 and followed prospectively. We reviewed 70 hips with a follow-up of more than five years (mean 7.6). At the latest review the mean Harris Hip Score had improved from a preoperative value of 29 +/- 14.7 to 94 +/- 6.8. Radiologically, there was no evidence of acetabular migration. The rate of revision for the femoral component was 8.6%, three being undertaken for loosening and three to allow downsizing of the femoral head. The rate of revision for the acetabular component was 7.1% (five cups). At the time of revision none of the cups was clinically loose, and only required the liner to be changed. The rate of complications was low with no case of deep infection or dislocation, but nine of the 76 hips (11.8%) showed grade-III heterotopic ossification. Previous studies of patients undergoing cemented total hip arthroplasty for the treatment of advanced avascular necrosis have indicated a high incidence of loosening of the acetabular component. Our findings show good medium-term results using the Harris Galante Porous cup for acetabular reconstruction, together with a variety of cemented femoral components, for the treatment of this difficult problem.

Acetabulum↗

PubMed1997

Massive early subsidence following femoral impaction grafting.

The incidence of massive early subsidence (subsidence greater than 10 mm) following impaction grafting of the femur in revision surgery is reported. The first 79 consecutive revision total hip arthroplasties using morselized allograft, polymethyl methacrylate cement, and a double-tapered, polished, collarless stem were reviewed. Nine (11%) of the 79 revision femoral prostheses showed massive subsidence, with another nine hips subsiding to a lesser degree. Further elucidation of the critical factors contributing to the initial stability of the biologic composite is required.

Adult↗

PubMed1980

Blood pressure studies in rural and urban Western Samoa.

Blood pressure was measured in the rural and urban male and female Polynesian populations of Western Samoa to determine if differences existed in mean blood pressures or in the prevalence of hypertension between these groups. It was found that, in the urban population, both males and females had higher mean blood pressures and approximately double the prevalence of hypertension found in their rural counterparts. There was an age-related rise in mean blood pressure and in the prevalence of hypertension in all groups. Approximately half of the difference in mean blood pressure and hypertension prevalence between rural and urban groups appeared to be due to difference in adiposity. Age and body mass index were significantly and independently correlated with systolic and diastolic blood pressure in each group. The prevalence of hypertension was greater in obese subjects.

Adult↗