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Biomedical subjects

Paul Stanton

Publications and source records attributed to Paul Stanton.

9 recordsLinked to original sources
PubMed2006

Correlation between radiographic findings of osteoarthritis and arthroscopic findings of articular cartilage degeneration within the patellofemoral joint.

OBJECTIVES: To correlate radiographic findings of osteoarthritis on axial knee radiographs with arthroscopic findings of articular cartilage degeneration within the patellofemoral joint in patients with chronic knee pain. SUBJECTS AND METHODS: The study group consisted of 104 patients with osteoarthritis of the patellofemoral joint and 30 patients of similar age with no osteoarthritis of the patellofemoral joint. All patients in the study group had an axial radiograph of the knee performed prior to arthroscopic knee surgery. At the time of arthroscopy, each articular surface of the patellofemoral joint was graded using the Noyes classification system. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the various radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the patellofemoral joint were determined. RESULTS: The sensitivity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 73%, 37%, 4%, and 0% respectively. The specificity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 67%, 90%, 100%, and 100% respectively. CONCLUSION: Marginal osteophytes were the most sensitive radiographic feature for the detection of articular cartilage degeneration within the patellofemoral joint. Joint-space narrowing, subchondral sclerosis, and subchondral cysts were insensitive radiographic features of osteoarthritis, and rarely occurred in the absence of associated osteophyte formation.

Adult↗
PubMed2006

Subchondral bone marrow edema in patients with degeneration of the articular cartilage of the knee joint.

PURPOSE: To retrospectively determine at magnetic resonance (MR) imaging the prevalence of subchondral bone marrow edema beneath arthroscopically proved articular cartilage defects. MATERIALS AND METHODS: The study was performed in compliance with HIPAA regulations, and a waiver of informed consent was obtained from the institutional review board before the study was performed. The study consisted of 132 patients (70 men, 62 women; average age, 53 years) with articular cartilage defects of the knee joint who underwent MR imaging of the knee and subsequent arthroscopic knee surgery. At the time of arthroscopy, each articular cartilage lesion was graded by using the Noyes classification system. MR examinations were retrospectively reviewed to determine the size, depth, and location of subchondral bone marrow edema without knowledge of the arthroscopic findings. Pairwise Fisher exact tests and two-sample t tests were used to correlate MR imaging findings of subchondral bone marrow edema with the arthroscopic grade of articular cartilage degeneration. RESULTS: Subchondral bone marrow edema was seen beneath 105 (19%) of 554 articular cartilage defects identified at arthroscopy. It was not observed beneath any of the six grade 1 cartilage defects but was observed beneath eight (4.9%) of 163 grade 2A defects, 40 (14.4%) of 278 grade 2B defects, 54 (55.1%) of 98 grade 3A defects, and three (33.3%) of nine grade 3B defects. Subchondral bone marrow edema was also seen beneath four (1.4%) of 238 articular surfaces that appeared normal at arthroscopy. The mean depth and cross-sectional area of subchondral bone marrow edema increased with increasing grade of the articular cartilage lesion. CONCLUSION: Higher grades of articular cartilage defects are associated with higher prevalence and greater depth and cross-sectional area of subchondral bone marrow edema.

Adult↗
PubMed2006

Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint.

OBJECTIVE: The purpose of this study was to use the Kellgren-Lawrence, Ahlback, and Brandt grading scales to correlate radiographic grade of osteoarthritis with the actual degree of articular cartilage degeneration within the tibiofemoral joint in patients with chronic knee pain. SUBJECTS AND METHODS: The study group consisted of 125 patients with symptomatic osteoarthritis of the tibiofemoral joint. For all patients, standing anteroposterior radiographs of the knee were obtained before arthroscopic knee surgery. Each articular surface of the tibiofemoral joint was graded at arthroscopy. Two radiologists retrospectively reviewed the knee radiographs without knowledge of the arthroscopic findings to determine the presence and severity of osteoarthritis of the tibiofemoral joint using the Kellgren-Lawrence, Ahlback, and Brandt grading scales. Correlation coefficients describing the relation between grade of osteoarthritis and severity of articular cartilage degeneration were calculated for each grading scale. RESULTS: The correlation coefficients for the Kellgren-Lawrence, Ahlback, and Brandt grading scales were 0.49, 0.41, and 0.56, respectively. The differences between the correlation coefficients for the Kellgren-Lawrence and Ahlback grading scales and the correlation coefficients for the Brandt and Ahlback grading scales were statistically significant (p < 0.05). Many patients with no radiographic findings of osteoarthritis had significant articular cartilage degeneration within the tibiofemoral joint. CONCLUSION: The Kellgren-Lawrence and Brandt grading scales were equally effective in defining the presence of and estimating the severity of osteoarthritis of the tibiofemoral joint but had only a moderately strong correlation with the actual degree of articular cartilage degeneration.

Adult↗
PubMed2005

Good management. Make boards work better.

Performance reviews for trust boards are rare, despite their strategic importance. Cohesion between executives and non-executives, and willingness for board members to challenge one another, are critical. Too much challenge and too little trust can suppress innovation.

Community-Institutional Relations↗
PubMed2004

Management. Gently does it.

Soft intelligence is information gathered from conversations, observations and experiences that allow judgements to be made. Research by York University shows that less than one in four of those interviewed used hard data to inform their judgements of NHS trusts. Sources of soft information can be direct: based on first-hand experiences; and indirect: the accounts and views of colleagues, patients, public, friends, journalists.

Administrative Personnel↗
PubMed2004

Effective boards. Born & bred.

If a board is to be effective its members must understand their roles and share trust with their colleagues. Members must be prepared to challenge colleagues, conventions and their own assumptions. Individual responsibility dissolves in large groups. Successful boards avoid this phenomenon.

Decision Making, Organizational↗