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Item Metadata only 3D bioprinting of methylcellulose/gelatin-methacryloyl (MC/GelMA) bioink with high shape integrity(American Chemical Society; ACS Publications, 2020) Rastin, H.; Ormsby, R.T.; Atkins, G.J.; Losic, D.The advent of three-dimensional (3D) bioprinting offers a feasible approach to construct complex structures suitable for tissue regeneration, during which cell-laden materials are dispensed on a substrate according to a predesigned structure. However, the lack of ideal printable bioinks with high shape fidelity and improved biological stability remains a major challenge. In this study, methylcellulose/gelatin-methacryloyl (MC/GelMA) bioink with high shape integrity is presented, which takes advantage of the printability of MC and the permanent photo-cross-linking of GelMA under UV irradiation. Although MC demonstrates good printability at room temperature, the lack of cross-linking ability causes distortion and finally dissociation of printed MC in biological media within a few days. However, UV-cross-linked MC/GelMA bioink remains stable in biological media over a period of several months. The shape integrity of MC/GelMA was systematically characterized in terms of yield stress and complex modulus. Unlike pure MC ink, the MC/GelMA ink demonstrated self-supporting behavior once printed due to the higher complex modulus and yield stress induced by GelMA in the system. Shape integrity of MC/GelMA ink resulted in higher resolution and printability which are evaluated by the successful printing of various 1D, 2D, and 3D constructs. Moreover, human primary osteoblasts encapsulated within the MC/GelMA hydrogel show cell viability of >95%. Overall, this work introduces MC/GelMA bioink with high shape integrity and improved biological stability and highlights the importance of rheological properties and post-cross-linking for fabrication of physiologically scaled tissue implants.Item Open Access A bioinformatics resource for TWEAK-Fn14 signaling pathway(Hindawi Publishing Corporation, 2012) Bhattacharjee, M.; Raju, R.; Radhakrishnan, A.; Nanjappa, V.; Muthusamy, B.; Singh, K.; Kuppusamy, D.; Lingala, B.T.; Pan, A.; Mathur, P.P.; Harsha, H.C.; Prasad, T.S.K.; Atkins, G.J.; Pandey, A.; Chatterjee, A.TNF-related weak inducer of apoptosis (TWEAK) is a new member of the TNF superfamily. It signals through TNFRSF12A, commonly known as Fn14. The TWEAK-Fn14 interaction regulates cellular activities including proliferation, migration, differentiation, apoptosis, angiogenesis, tissue remodeling and inflammation. Although TWEAK has been reported to be associated with autoimmune diseases, cancers, stroke, and kidney-related disorders, the downstream molecular events of TWEAK-Fn14 signaling are yet not available in any signaling pathway repository. In this paper, we manually compiled from the literature, in particular those reported in human systems, the downstream reactions stimulated by TWEAK-Fn14 interactions. Our manual amassment of the TWEAK-Fn14 pathway has resulted in cataloging of 46 proteins involved in various biochemical reactions and TWEAK-Fn14 induced expression of 28 genes. We have enabled the availability of data in various standard exchange formats from NetPath, a repository for signaling pathways. We believe that this composite molecular interaction pathway will enable identification of new signaling components in TWEAK signaling pathway. This in turn may lead to the identification of potential therapeutic targets in TWEAK-associated disorders.Item Metadata only A combined randomised and observational study of surgery for fractures in the distal radius in the elderly (CROSSFIRE) - a study protocol(BMJ Group, 2017) Harris, I.; Naylor, J.; Lawson, A.; Buchbinder, R.; Ivers, R.; Balogh, Z.; Smith, P.; Mittal, R.; Xuan, W.; Howard, K.; Vafa, A.; Yates, P.; Rieger, B.; Smith, G.; Elkinson, I.; Kim, W.; Chehade, M.; Sungaran, J.; Latendresse, K.; Wong, J.; et al.Introduction: Fractures of the distal radius are common and occur in all age groups. The incidence is high in older populations due to osteoporosis and increased falls risk. Considerable practice variation exists in the management of distal radius fractures in older patients ranging from closed reduction with cast immobilisation to open reduction with plate fixation. Plating is currently the most common surgical treatment. While there is evidence showing no significant advantage for some forms of surgical fixation over conservative treatment, and no difference between different surgical techniques, there is a lack of evidence comparing two of the most common treatments used: closed reduction and casting versus plating. Surgical management involves significant costs and risks compared with conservative management. High-level evidence is required to address practice variation, justify costs and to provide the best clinical outcomes for patients. Methods and Analysis: This pragmatic, multicentre randomised comparative effectiveness trial aims to determine whether plating leads to better pain and function and is more cost-effective than closed reduction and casting of displaced distal radius fractures in adults aged 60 years and older. The trial will compare the two techniques but will also follow consenting patients who are unwilling to be randomised in a separate, observational cohort. Inclusion of non-randomised patients addresses selection bias, provides practice and outcome insights about standard care, and improves the generalisability of the results from the randomised trial.Item Metadata only A Comparison of Different Surgical Approaches for the Periacetabular Osteotomy(LIPPINCOTT WILLIAMS & WILKINS, 1999) Hussell, G.; Mast, J.; Mayo, K.; Howie, D.; Reinhold, G.The periacetabular osteotomy is a well established surgical procedure for the preventative treatment of degenerative joint disease caused by symptomatic acetabular dysplasia. Surgeons on several continents use varying surgical approaches to achieve the same effective osteotomy. Individual surgical approaches must provide accurate and adequate exposure for the osteotomy and the reorientation of the acetabular fragment. The aim of the surgical approach for such complex and expansive surgery is to minimize morbidity related to the approach. This article compares experiences among three common approaches including the modified Smith-Petersen, ilioinguinal, and direct anterior approaches and describes the double approach.Item Metadata only A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder(Journal Bone Joint Surgery Inc, 2005) Bryant, D.; Litchfield, R.; Sandow, M.; Gartsman, G.; Guyatt, G.; Kirkley, A.Background
A systematic review of the literature was performed to estimate the impact of hemiarthroplasty compared with total shoulder arthroplasty on function and range of motion in patients suffering from osteoarthritis of the shoulder.Methods
We conducted an electronic search for relevant studies published in any language from 1966 to 2004, a manual search of the proceedings from five major orthopaedic meetings from 1995 to 2003, and a review of the reference lists from potentially relevant studies. Four randomized clinical trials, with similar eligibility criteria and surgical techniques, that compared hemiarthroplasty and total shoulder arthroplasty for the treatment of primary osteoarthritis of the shoulder were found to be eligible. Authors from three of the four studies provided original patient data. Analysis of covariance focused on the two-year outcome and included a comparison of the aggregate University of California at Los Angeles shoulder score, four University of California at Los Angeles domain scores, and range of motion.Results
A total of 112 patients (fifty managed with hemiarthroplasty and sixty-two managed with total shoulder arthroplasty), who had a mean age of sixty-eight years, were included in this analysis. A significant moderate effect was detected in the function domain of the University of California at Los Angeles shoulder score (p < 0.001) in favor of total shoulder arthroplasty (mean [and standard deviation], 8.1 +/- 0.3) compared with hemiarthroplasty (mean, 6.6 +/- 0.3). A significant difference in the pain score was found in favor of the total shoulder arthroplasty group (p < 0.0001). However, the large degree of heterogeneity (p = 0.006, I(2) = 80.2%) among the studies decreased our confidence that total shoulder arthroplasty provides a true, consistent benefit with regard to pain. There was a significant difference in the overall change in forward elevation of 13 degrees (95% confidence interval, 0.5 degrees to 26 degrees ) in favor of the total shoulder arthroplasty group (p = 0.008).Conclusions
At a minimum of two years of follow-up, total shoulder arthroplasty provided better functional outcome than hemiarthroplasty for patients with osteoarthritis of the shoulder. Since continuous degeneration of the glenoid after hemiarthroplasty or glenoid loosening after total shoulder arthroplasty may affect the eventual outcome, longer-term (five to ten-year) results are necessary to determine whether these findings remain consistent over time.Item Metadata only A comparison of radiostereometric analysis and computed tomography for the assessment of lumbar spinal fusion in a sheep model(Thieme Medical Publishers, 2013) Humadi, A.; Freeman, B.; Moore, R.; Callary, S.; Halldin, K.; David, V.; Maclaurin, W.; Tauro, P.; Scoenwaelder, M.Objective: The aim of this animal study is to evaluate the accuracy of radiostereometric analysis (RSA) compared with computed tomographic (CT) scan in the assessment of spinal fusion after anterior lumbar interbody fusion (ALIF) using histology as a gold standard. Methods: Three non-adjacent ALIFs (L1–L2, L3–L4, and L5–L6) were performed in nine sheep. The sheep were divided into three groups of three sheep. All the animals were humanely killed immediately after having the last scheduled RSA. The lumbar spine was removed and in vitro fine cut CT and histopathology were performed. Results: Using histological assessment as the gold standard for assessing fusion, RSA demonstrated better results (100% sensitivity and 66.7% specificity; positive predictive value [PPV] = 27.3%, negative predictive value [NPV] =100.0%) compared with CT (66.7% sensitivity and 60.0% specificity [PPV = 16.7%, NPV = 93.8%]). Conclusions: RSA demonstrated higher sensitivity and specificity when compared with CT. Furthermore, RSA has the advantage of much lower radiation exposure compared with fine cut CT. Further studies are required to see if RSA remains superior to CT scan for the assessment spinal fusion in the clinical setting.Item Metadata only A comprehensive classification of proximal humeral fractures: HGLS system(Mosby Inc, 2013) Sukthankar, A.; Leonello, D.; Hertel, R.; Ding, G.; Sandow, M.Background
This study assessed the intraobserver and interobserver reliability of a binary classification system using an easy-to-remember acronym (the HGLS system--based on the reappraisal of Codman's description by Hertel et al) and compared it with the AO and Neer systems.Materials and methods
Forty-seven proximal humeral fractures in 47 patients treated at the Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia, were identified in the period from July 2007 until January 2008. Fractures of the proximal humerus were examined with anteroposterior, lateral, and axillary radiographs. Three independent reviewers classified the fractures using the AO, Neer, and HGLS systems. Reclassification of the same fractures was undertaken after a 6-month interval, and interobserver and intraobserver correlation, by use of the κ statistic, was calculated for all 3 classification systems.Results
The mean age of patients was 64.5 years (range, 16-95 years). The interobserver correlations for the AO system (κ value, 0.47) and Neer system (κ value, 0.44) were graded as poor and were consistent with the values of previously published studies. The HGLS classification showed good interobserver agreement for all 3 examiners at the first interpretation (κ value, 0.73) and second interpretation (κ value, 0.61). Good intraobserver agreement after a 6-month period was also seen for the HGLS classification (κ values, 0.87-0.92) compared with the AO system (κ, 0.61-0.71) and Neer system (κ, 0.42-0.77).Conclusion
The HGLS system provided a more reliable description of fractures of the proximal humerus compared with the Neer and AO systems. Further studies are necessary to assess the validity of the HGLS system.Item Metadata only A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet(Journal Bone Joint Surgery Inc, 2003) Solomon, L.; Ruhli, F.; Taylor, J.; Ferris, L.; Pope, R.; Henneberg, M.Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC. The aims of our study were to establish the incidence of TC; the association between TC and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7+/-10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 31 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.5% of the coalitions. CT did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous TC is higher than previously thought (12.72%). The calcaneonavicular coalitions are the most common single type (9.09%) and they do not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.Item Metadata only A Further Tendon Retrieval Trick(Churchill Livingstone, 1997) Sandow, M.Atraumatic delivery of the retracted flexor tendon ends following laceration is crucial for accurate tenorrhaphy. Sourmelis and McGrouther (1987) developed a useful method of delivering the proximal flexor tendon and a modification is presented here which further aids atraumatic tenorrhaphy.Item Metadata only A long-term review of a modified Evans procedure - A 5- to 15-year follow-up of 111 ankles(British Editorial Soc Bone Joint Surgery, 2001) Nimon, G.; Dobson, P.; Angel, K.; Lewis, P.; Stevenson, T.Of 111 primary ankle ligament arthroplasties (modified Evans procedure) performed between 1983 and 1994, we were able to identify 89 patients (94 ankles) for follow-up. All were under 50 years of age. Two had died and one refused to co-operate; 86 patients (91 ankles) were therefore reviewed, 25 by telephone and the remainder by clinical examination with all but three also undergoing radiological review. Of the 91 ankles, 70 had no or very mild pain and 72 had no or rare episodes of instability and when considered together only 59 (65%) had no or mild pain and minimal instability. The results were supported by the Karlsson grading system. Clinical examination showed that 17 of the 66 ankles examined had increased inversion, while 21 had some limitation of inversion. Early degenerative changes were seen in 11 ankles, although only four had subtalar changes. These results show that this procedure does not give universally good clinical results. Patient satisfaction, however, was high with 97.7% being willing to undergo the same procedure if their other ankle became similarly affected.Item Metadata only A novel sideways fall simulator to study hip fractures ex vivo(Public Library of Science, 2018) Fleps, I.; Vuille, M.; Melnyk, A.; Ferguson, S.J.; Guy, P.; Helgason, B.; Cripton, P.A.; Pérez, M.A.Falls to the side are the leading cause of hip fractures in the elderly. The load that a person experiences during a fall cannot be measured with volunteers for ethical reasons. To evaluate injurious loads, while considering relevant energy input and body posture for a sideways fall, a subject-specific cadaveric impact experiment was developed. Full cadaveric femur-pelvis constructs (N = 2) were embedded in surrogate soft tissue material and attached to metallic surrogate lower limbs. The specimens were then subjected to an inverted pendulum motion, simulating a fall to the side with an impact to the greater trochanter. The load at the ground and the deformation of the pelvis were evaluated using a 6-axis force transducer and two high-speed cameras. Post-test, a trauma surgeon (PG) evaluated specimen injuries. Peak ground contact forces were 7132 N and 5641 N for the fractured and non-fractured specimen, respectively. We observed a cervical fracture of the femur in one specimen and no injuries in a second specimen, showing that the developed protocol can be used to differentiate between specimens at high and low fracture risk.Item Metadata only A novel way to reconstruct the neglected achilles tendon rupture(Sage Publications, 2014) Asopa, V.; Douglas, R.J.; Clayton, J.J.Neglected (chronic) rupture of the Achilles tendon is an uncommon injury, for which the optimal treatment is operative repair.9 Despite many repair techniques for the condition having been described, the current literature does not allow clinicians to definitively determine the optimal operative technique for successful tendon repair.5 The various turndown flaps that may be utilized in the repair of a chronically ruptured Achilles tendon have been summarized in the literature,7,11 and modified techniques continue to evolve.2 In 1959, Lindholm 10 described a technique to augment Achilles tendon repair by turndown of the gastrocnemius fascia. This repair is bulky and can cause discomfort for the patient. In this article, we describe a novel technique that eliminates the bulk by incorporating a free flap interpositional graft to the Achilles tendon defect. Early data suggest that our technique provides an excellent clinical result.Item Metadata only A preamble to Charles Robert Darwin: his connection with South Australia(Royal Soc South Australia Inc, 2013) Wiebkin, O.Item Metadata only A preclinical study of stem subsidence and graft incorporation after femoral impaction grafting using porous hydroxyapatite as a bone graft extender(Churchill Livingstone Inc Medical Publishers, 2011) Howie, D.; Mc Gee, M.; Callary, S.; Carbone, A.; Stamenkov, R.; Bruce, W.; Findlay, D.This preclinical in vivo screening study compared bone graft incorporation and stem subsidence in cemented hemiarthroplasty after femoral impaction bone grafting with either morselized allograft bone (n = 5, control group) or a 1:1 mix of allograft and porous hydroxyapatite ceramics (HA) granules (n = 5, HA group). At 14 weeks, there was excellent bone graft incorporation by bone, and the stems were well fixed in both groups. The median subsidence at the cement-bone interface, measured using radiostereometric analysis, was 0.14 and 0.93 mm in the control and HA groups, respectively. The comparable histologic results between groups and good stem fixation in this study support the conduct of a larger scale investigation of the use of porous HA in femoral impaction bone grafting at revision hip arthroplasty.Item Metadata only A prospective randomised controlled trial of femoral ring allograft versus a titanium cage in circumferential lumbar spinal fusion with minimum 2-year clinical results(Springer, 2005) McKenna, P.; Freeman, B.; Mulholland, R.; Grevitt, M.; Webb, J.; Mehdian, H.The literature reports on the safety and efficacy of titanium cages (TCs) with additional posterior fixation for anterior lumbar interbody fusion. However, these papers are limited to prospective cohort studies. The introduction of TCs for spinal fusion has resulted in increased costs, without evidence of superiority over the established practice. There are currently no prospective controlled trials comparing TCs to femoral ring allografts (FRAs) for circumferential fusion in the literature. In this prospective, randomised controlled trial, our objective was to compare the clinical outcome following the use of FRA (current practice) to the use of TC in circumferential lumbar spinal fusion. Full ethical committee approval and institutional research and development departmental approval were obtained. Power calculations estimated a total of 80 patients (40 in each arm) would be required to detect clinically relevant differences in functional outcome. Eighty-three patients were recruited for the study fulfilling strict entry requirements (>6 months chronic discogenic low back pain, failure of conservative treatment, one- or two-level discographically proven discogenic low back pain). The patients completed the Oswestry Disability Index (ODI), Visual Analogue Score (VAS) for back and leg pain and the Short-Form 36 (SF-36) preoperatively and also postoperatively at 6, 12 and 24 months, respectively. The results were available for all the 83 patients with a mean follow-up of 28 months (range 24–75 months). Five patients were excluded on the basis of technical infringements (unable to insert TC in four patients and FRA in one patient due to the narrowing of the disc space). From the remaining 78 patients randomised, 37 received the FRA and 41 received the TC. Posterior stabilisation was achieved with translaminar or pedicle screws. Baseline demographic data (age, sex, smoking history, number of operated levels and preoperative outcome measures) showed no statistical difference between groups (p<0.05) other than for the vitality domain of the SF-36. For patients who received the FRA, mean VAS (back pain) improved by 2.0 points (p<0.01), mean ODI improved by 15 points (p=<0.01) and mean SF-36 scores improved by >11 points in all domains (p<0.03) except that of general health and emotional role. For patients who received the TC, mean VAS improved by 1.1 points (p=0.004), mean ODI improved by 6 points (p=0.01) and SF-36 improved significantly in only two of the eight domains (bodily pain and physical function). Revision procedures and complications were similar in both groups. In conclusion, this prospective, randomised controlled clinical trial shows the use of FRA in circumferential lumbar fusion to be associated with superior clinical outcomes when compared to those observed following the use of TCs. The use of TCs for circumferential lumbar spinal fusion is not justified on the basis of inferior clinical outcome and the tenfold increase in cost.Item Metadata only A prospective randomized comparison of coralline hydroxyapatite with autograft in cervical interbody fusion(Lippincott Williams & Wilkins, 2003) McConnell, J.; Freeman, B.; Debnath, U.; Grevitt, M.; Prince, H.; Webb, J.Study Design. A prospective randomized trial with independent clinical and radiographic outcome review of patients receiving either hydroxyapatite or tricortical iliac crest graft for cervical interbody fusion was conducted. Objective. To determine whether coralline-derived hydroxyapatite is a suitable bone graft substitute in cervical interbody fusion. of Background Data. Tricortical iliac crest bone is the gold standard graft material for cervical interbody fusion. Various bone substitutes have been used for this procedure to avoid potential donor site morbidity. ProOsteon 200 is a coralline-derived hydroxyapatite product, the use of which remains unclear for cervical interbody fusion. Methods. In this study, 29 patients undergoing anterior cervical fusion and plating were randomized to receive either ProOsteon 200 or iliac crest grafts. The SF-36 and Oswestry Disability index were used to measure clinical outcome. Postoperative radiographs were analyzed for graft fragmentation, loss of height, angular alignment, and hardware failure to assess structural integrity of the graft material. Plain radiographs and computed tomography scans were used to evaluate fusion. Results. Both the ProOsteon 200 and iliac crest groups demonstrated significant improvement in clinical outcome scores. There was no significant difference in clinical outcome or fusion rates between the two groups. Graft fragmentation occurred in 89% of the hydroxyapatite grafts and 11% of the autografts (P = 0.001). Significant graft settling occurred in 50% of the hydroxyapatite grafts, as compared with 11% of the autografts (P = 0. 009). One patient in the ProOsteon 200 group required revision surgery for graft failure. Conclusions. ProOsteon 200 does not possess adequate structural integrity to resist axial loading and maintain disc height or segmental lordosis during cervical interbody fusion.Item Metadata only A randomized, double-blind, controlled trial - Intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain(Lippincott Williams & Wilkins, 2005) Freeman, B.; Fraser, R.; Cain, C.; Hall, D.; Chapple, D.Study design
A prospective, randomized, double-blind, placebo-controlled trial of intradiscal electrothermal therapy (IDET) for the treatment of chronic discogenic low back pain (CDLBP).Objectives
To test the safety and efficacy of IDET compared with a sham treatment (placebo).Summary of background data
In North America alone, more than 40,000 intradiscal catheters have been used to treat CDLBP. The evidence for efficacy of IDET is weak coming from retrospective and prospective cohort studies providing only Class II and Class III evidence. There is one study published with Class I evidence. This demonstrates statistically significant improvements following IDET; however, the clinical significance of these improvements is questionable.Methods
Patients with CDLBP who failed to improve following conservative therapy were considered for this study. Inclusion criteria included the presence of one- or two-level symptomatic disc degeneration with posterior or posterolateral anular tears as determined by provocative computed tomography (CT) discography. Patients were excluded if there was greater than 50% loss of disc height or previous spinal surgery. Fifty-seven patients were randomized with a 2:1 ratio: 38 to IDET and 19 to sham procedure (placebo). In all cases, the IDET catheter was positioned to cover at least 75% of the annular tear as defined by the CT discography. An independent technician connected the catheter to the generator and then either delivered electrothermal energy (active group) or did not (sham group). Surgeon, patient, and independent outcome assessor were all blinded to the treatment. All patients followed a standard postprocedural rehabilitation program. Independent statistical analysis was performed.Outcome measures
Low Back Outcome Score (LBOS), Oswestry Disability Index (ODI), Short Form 36 questionnaire (SF-36), Zung Depression Index (ZDI), and Modified Somatic Perceptions Questionnaire (MSPQ) were measured at baseline and 6 months. Successful outcome was defined as: no neurologic deficit, improvement in LBOS of greater then 7 points, and improvement in SF-36 subsets (physical function and bodily pain) of greater than 1 standard deviation.Results
Baseline demographic data, initial LBOS, ODI, SF-36, ZDI, and MSPQ were similar for both groups. No neurologic deficits occurred. No subject in either arm showed improvement of greater than 7 points in LBOS or greater than 1 standard deviation in the specified domains of the SF-36. Mean ODI was 41.42 at baseline and 39.77 at 6 months for the IDET group, compared with 40.74 at baseline and 41.58 at 6 months for the placebo group. There was no significant change in ZDI or MSPQ scores for either group.Conclusions
The IDET procedure appeared safe with no permanent complications. No subject in either arm met criteria for successful outcome. Further detailed analyses showed no significant change in outcome measures in either group at 6 months. This study demonstrates no significant benefit from IDET over placebo.Item Metadata only A Review of Complex Trauma to the Elbow(BLACKWELL SCIENCE ASIA, 1999) Bain, G.This paper presents a review of common complex elbow traumatic disorders. It presents an algorithm to aid in the management of these cases and discusses indications for radial head replacement and dynamic external fixateurs.Item Metadata only A stitch in time: stitching errors in digital radiology(Australasian Medical Publishing Company, 2017) Faurie, C.; Williams, N.; Cundy, P.J.Item Metadata only A survival model of thoracic contusion spinal cord injury in the domestic pig(Mary Ann Liebert, 2023) Gayen, C.; Bessen, M.; Dorrian, R.; Quarrington, R.; Mulaibrahimovic, A.; O'Hare Doig, R.; Freeman, B.; Leonard, A.; Jones, C.Spinal cord injury (SCI) frequently results in motor, sensory and autonomic dysfunction for which there is currently no cure. Recent preclinical and clinical research has led to promising advances in treatment; however, therapeutics indicating promise in rodents have not translated successfully in human trials, likely due, in part, to gross anatomical and physiological differences between the species. Therefore, large animal models of SCI may facilitate the study of secondary injury processes that are influenced by scale, and assist the translation of potential therapeutic interventions. The aim of this study was to characterize two severities of thoracic contusion SCI in female domestic pigs, measuring motor function and spinal cord lesion characteristics, over two weeks post-SCI. A custom instrumented weight drop injury device was used to release a 50 g impactor from 10 cm (n=3) or 20 cm (n=7) onto the exposed dura, to induce a contusion at the T10 thoracic spinal level. Hind limb motor function was assessed at 8 and 13 days post-SCI using a 10-point scale. Volume and extent of lesion-associated signal hyperintensity in T2-weighted magnetic resonance (MR) images was assessed at 3, 7 and 14 days post-injury. Animals were transcardially perfused at 14 days post-SCI and spinal cord tissue was harvested for histological analysis. Bowel function was retained in all animals and transient urinary retention occurred in one animal after catheter removal. All animals displayed hind limb motor deficits. Animals in the 10 cm group demonstrated some stepping and weight bearing and scored a median 2- 3 points higher on the 10-point motor function scale at 8 and 13 days post-SCI, than the 20 cm group. Histological lesion volume was 20 % greater, and 30 % less white matter was spared, in the 20 cm group than in the 10 cm group. The MR signal hyperintensity in the 20 cm injury group had a median cranial-caudal extent approximately 1.5 times greater than the 10 cm injury group at all three time points, and median volumes 1.8, 2.5 and 4.5 times greater at day 3, 7 and 14 post-injury, respectively. Regional differences in axonal injury were observed between groups, with amyloid precursor protein immunoreactivity greatest in the 20 cm group in spinal cord sections adjacent the injury epicenter. This study demonstrated graded injuries in a domestic pig strain, with outcome measures comparable to miniature pig models of contusion SCI. The model provides a vehicle for the study of SCI and potential treatments, particularly where miniature pig strains are not available and/or where small animal models are not appropriate for the research question.