Spatial links between subchondral bone architectural features and cartilage degeneration in osteoarthritic joints.

Early diagnosis of osteoarthritis (OA), before the onset of irreversible changes is crucial for understanding the disease process and identifying potential disease-modifying treatments from the earliest stage. OA is a whole joint disease and affects both cartilage and the underlying subchondral bone. However, spatial relationships between cartilage lesion severity (CLS) and microstructural changes in subchondral plate and trabecular bone remain elusive.

The Role of Arthroscopic Simulation in Teaching Surgical Skills: A Systematic Review of the Literature.

Background: Following the introduction of worktime regulations across the world along with existing concerns over the nonuniform nature of the traditional apprenticeship model, an alternative method for teaching surgical skills is being sought. Simulation training offers a safe and standardized environment to develop and improve surgical skills. The purpose of the present study was to review the existing and most recent research into the utility of arthroscopic simulators in training and the teaching of surgical skills.

Gaucher disease: outcome following total hip replacements and effect of enzyme replacement therapy in a cohort of UK patients.

Only a limited number of reports of total hip replacements (THRs) in patients with Gaucher disease (GD) have been published, with the majority showing high rates of early aseptic loosening as well as an increased number of peri-operative complications. We present a series of twelve THRs in nine affected patients, with a mean age of 39 years at the time of surgery (median 37 years; range 27-60 years). We examine the medium- to long-term results and present the outcome scores, survival, and assess the effect of enzyme replacement therapy (ERT).

Advanced trauma life support radiographic trauma series: Part 3--The pelvis radiograph.

Pelvic fractures are often high energy injuries and are associated with a high morbidity and mortality. The plain antero-posterior pelvis radiograph is part of the advanced trauma life support radiographic trauma series and is used as a screening test. The main limitation of plain anteroposterior pelvic radiographs is the difficulty in identification of some fractures, in particular posterior fractures, therefore radiographic findings should be considered in conjunction with clinical assessment.

Advanced trauma life support radiographic trauma series: part 2--the chest radiograph.

The chest radiograph is used as a screening test to exclude significant thoracic injuries in cases of major trauma. A systematic approach to reviewing chest radiographs is necessary for accurate interpretation. Radiographic findings should be considered together with clinical assessment.

Perioperative blood transfusion: the role of allogenous and autologous transfusions, and pharmacological agents.

The decision to transfuse patients perioperatively is made on an individual basis and should consider factors such as duration and severity of anaemia, symptoms, physiological parameters and comorbidities. Autologous blood transfusion has the benefit of avoiding some of the immunological and infective complications associated with allogenic blood transfusion. Pharmacological agents as well as anaesthetic and surgical techniques have a role in avoiding the need for blood transfusion.

The importance of correct patient positioning in theatres and implications of mal-positioning.

Patient positioning in theatre pertains to how a patient is transferred and positioned for a specific procedure. Patient safety is a central focus of care within the NHS and every healthcare practitioner must ensure that patients are protected from harm where possible. Mal-positioning of the patient has important implications in terms of associated problems of pressure sores, nerve compressions, deep vein thrombosis and compartment syndrome, and should be avoided.