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Biomedical subjects

G Bentley

Publications and source records attributed to G Bentley.

At least 127 records · Page 7Linked to original sources
PubMed1977

Preliminary experience with the geomedic total knee replacement.

This paper reports preliminary experience with the Geomedic total knee replacement prosthesis. Forty-five prostheses were inserted into the severely damaged knees of 38 patients. Forty-one knees (35 rheumatoid, 6 osteoarthrotic) in 34 patients were available for review by an independent observer, a mean of 18 months (range 4--38 months) post-operatively. The assessment concentrated upon changes in function, pain relief and patient satisfaction, but objective parameters of range of movement and stability were also recorded. There were 23 excellent results, 15 good, 1 fair, and 2 poor. Thus, 93% of operations resulted in definite improvement. Complications occurred following 16 operations, but were mostly minor. One prosthesis dislocated, and there was one case of late infection which was treated successfully.

Aged↗
PubMed1977

Effect of age on thickness of adult patellar articular cartilage.

The thickness of left patellar articular cartilages after formalin fixation was studied in a series of autopsies on 82 subjects aged 25-96 years. For each specimen the minimal uncalcified cartilage thickness in a transverse patellar slab was determined separately for a 'lateral' segment and a 'central and medial' segment. In the women the cartilage from subjects more than 50 years old showed progressive thinning with increasing age. This was due to lesions causing disintegration of the tissue and not to matrix shrinkage. It had a strong potential to progress to full-thickness cartilage loss in the older women, and to give an appearance indistinguishable from osteoarthrosis as seen in surgical excision specimens. This progression towards patellofemoral osteoarthrosis in the elderly affects the female population generally, and not just a special subgroup; however, the incidence of clinical symptoms from this cause is not known. In men progressive thinning with age of patellar cartilage in subjects more than 50 years old was less severe, especially so in the case of the 'lateral' segment; a site of full-thickness uncalcified cartilage loss on the left patella at autopsy was seen only occasionally in the older men.

Adult↗
PubMed1977

A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement.

In a randomized, controlled clinical study, dextran-70, warfarin, or low-dose heparin were administered to patients undergoing total hip replacement on one surgical unit in an attempt to prevent deep venous thrombosis and pulmonary embolism. Calf vein thrombosis was detected by the 125I-fibrinogen uptake test. None of the methods prevented calf vein thrombosis (dextran-70, 51%; warfarin, 58-6%; heparin, 52-6%). Pulmonary embolism was completely prevented in patients treated with warfarin but occurred in 4% of patients treated with dextran-70 and 15-5% of those treated with low-dose heparin. The incidence of complications of therapy was small and comparable in each group. It is suggested that calf vein thrombosis is a frequent and in itself a non-serious complication of total hip replacement surgery and that emphasis might be placed more usefully on prevention of pulmonary embolism.

Aged↗
PubMed1977

Osteochondritis dissecans patellae.

Six cases of osteochondritis dissecans patellae have been studied in five patients in an attempt to clarify the aetiology and prognosis. Assessment of the results of treatment was performed using a standard protocol. The thirty-four previous case reports in the literature are reviewed. In four of the five patients symptoms began after flexing the knee under load and three showed patellar subluxation on tangential radiographs. Thus, repetitive shearing stress on the patellar surface is thought to be an important aetiological factor. The indication for operation is a loose osteochondral fragment either wholly or partly detached from the articular surface of the patella. Vertical excision of the affected area of articular cartilage with drilling of the underlying bone gave two "good" and two "excellent" results. Healing of the drilled area and maintenance of the cartilage space was seen in radiographs of all four cases so treated. This simple method of treatment, which probably causes filling of the defect in the surface by fibrocartilage, is recommended.

Adolescent↗
PubMed1976

Assessment of wound contamination during surgery: a preliminary report comparing vertical laminar flow and conventional theatre systems.

As part of an on-going trial comparing wound infection in "ultra-clean" air and conventional theatres, wound contamination is assessed by a simple wash-out technique. The importance of wound contamination in relation to subsequent wound infection is emphasized. The wash-out technique used is simple to perform and minimizes the risk of contamination. The preliminary results confirm that cleaner air does result in less contaminated wounds.

Air Conditioning↗
PubMed1976

Excision arthroplasty of the elbow in rheumatoid disease.

The results of ten excision arthroplasties of the elbow for rheumatoid disease are described. The operation may afford good relief of pain and a useful increase both of hinge motion and of forearm rotation. Instability is not a serious problem unless the patient has to bear weight on crutches. To increase stability after arthroplasty it appears that Kirschner wire fixation is advisable as well as a plaster cast. For advanced rheumatoid disease unilateral excision arthroplasty has a definite value, especially for patients confined to a wheelchair.

Adult↗
PubMed1975

Chlormethiazole in status epilepticus--three cases.

Despite the use of barbiturates, phenytoin sodium and diazepam given intravenously, status epilepticus continued in the three cases described until chlormethizaole (Heminevrin) was administered, when rapid resolution of the status occurred.

Adult↗
PubMed1975

Prophylaxis with dextran 70 against thrombosis in patients with fractures of the upper end of the femur.

A trial was undertaken to assess the effect of dextran 70 (Macrodex) in prophylaxis against thrombosis in womem over 65 years with fractures of the upper end of the femur. The dosage used was 500 ml at operation and 500 ml on the first postoperative day. At this dosage given at this time there was no difference in the overall incidence of clinically diagnosed deep venous thrombosis in the group of patients given dextran 70 compared with the control group. There was a tendency for thrombosis to occur earlier in the control group. The mortality rates at 3 weeks and even at 6 months were less in the treated group than in the control series.

Clinical Trials as Topic↗
PubMed1975

Rheumatoid arthritis of the elbow. Pattern of joint involvement, and results of synovectomy with excision of the radial head.

Thirty-two rheumatoid elbow joints in 25 patients which had undergone synovectomy and excision of the radial head have been studied from the point of view of pattern of joint involvement and the efficacy of surgery. In this group of patients there was a significant trend towards affection of proximal joints occurring earlier in the course of the disease than distal joints. There was a high incidence of involvement of wrist and knee. There was a positive relationship between dominance and the elbow affected. Pain diminished in all cases after surgery, and there was a significant improvement in hinge movement but no significant improvement in range of forearm rotation though it was less painful. Single lateral approach gave satisfactory exposure and is favoured. Complciations of the procedure were few.

Adult↗
PubMed1975

Articular cartilage studies and osteoarthrosis.

Osteoarthrosis is characterized in the early stages by degradation of articular cartilage matrix. Clinical, radiological, and pathological studies have failed to reveal the factors which initiate the breakdown of cartilage and are not applicable to detailed sequential studies of the affected tissues at all stages in the disease. Therefore animal experiments have been employed to provide more information on degradation and repair process in cartilage. These studies have demonstrated: 1) Matrix protection and induced repair of mature articular cartilage by the use of oral aspirin after lacerative injury. 2) Establishment by the intra-articular injection of the plant enzyme papain of a model of osteoarthrosis in the rabbit hip which mimics human osteoarthrosis and is suitable for further experimental studies. 3) A proliferation of mature articular cartilage chondrocytes in response to loss of matrix, which indicates a latent repair capacity. 4) Repair of extensively damaged hip joints after femoral osteotomy by increased formation of subchondral new bone and formation of fibrocartilage on the articulating surfaces. These tissue repair processes are associated with an increase in vascularity of the femoral head and acetabulum produced by the osteotomy. 5) Succesful transplantation as allografts in both normal and arthrotic rabbit knees of aggregates of epiphysial chondrocytes isolated from their matrix. This method of joint surface replacement may have clinical applications.

Animals↗
PubMed1975

Synovial regeneration and articular cartilage changes after synovectomy in normal and steroid-treated rabbits.

Ltttle is known of the effects of synovectomy on articular cartilage. In order to investigate this matter, anterior synovectomy of the knee was performed in thirty-five normal adult rabbits and in thirty-five which were given 25 milligrams of hydrocortisone intramuscularly each week afterwards. The animals were killed at intervals from four to 110 days after synovectomy. Histological examination of the regenerating synovium in both groups showed complete structural and functional regeneration by eighty days in the first group and a delay in regeneration in the steroid group. Sulphur autoradiographs of the articular cartilage of femoral and tibial condyles revealed surface fibrillation and chondrocyte death in 23 per cent of normal knees after eighty days but only 1.8 per cent of knees of animals receiving hydrocortisone. Thus synovectomy in a healthy joint may have an unfavourable effect on the physiology of cartilage by alteration of synovial composition and hyaluronate content in normal joints. Systemically-administered hydrocortisone may reduce this harmful effect in normal cartilage.

Animals↗