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Biomedical subjects

R A Elson

Publications and source records attributed to R A Elson.

30 records · Page 2Linked to original sources
PubMed1981

Management of deep infection of total hip replacement.

Exchange operation is recommended as the treatment of choice for most deep infections involving a total hip replacement. This revision arthroplasty comprises, in one stage, excision of soft tissue, removal of implant and cement, replacement with an appropriate implant using Palacos R acrylic cement loaded with an appropriate antibiotic and, more recently, systemic antibiotics. During our first 10 years without systemic antibiotics we have achieved an overall 77 per cent success rate from a first attempt in 583 patients and a 90 per cent success rate after subsequent exchange procedures. Morbidity is significant but acceptable. Success is defined as control of infection, no loosening, and useful function. The factors associated with failures include, in particular, specific infections (Pseudomonas group, Streptococcus group D, Proteus group, and Escherichia coli), delay in operation and inadequate antibiotic dosage in the cement.

Anti-Bacterial Agents↗
PubMed1977

Antibiotic-loaded acrylic cement.

Laboratory experiments and clinical investigations have confirmed the various claims made originally by Buchholz and Engelbrecht (1970) that antibiotic-loaded acrylic cement releases the antibiotic into the surroundings in useful concentrations. Palacos R cement released higher concentrations than CMW, Simplex and Sulfix brands of cement and over longer periods. Concentrations of gentamycin and fucidin were sufficient to penetrate dead cortical bone. These conclusions need to be assessed with animal studies, mechanical testing and clinical results before the ideal place of antibiotic-loaded acrylic cement is established.

Acrylic Resins↗
PubMed1977

Bacterial infection and acrylic cement in the rat.

In thirty-one rat tibiae, plugs of plain acrylic cement were inoculated with Staphylococcus aureus; these all remained contaminated at the end of two weeks when the animals were killed. Inoculation with known strains of Pseudomonas, Proteus and Gp. G Streptococcus resulted in 70 to 93 per cent persisting contamination. Gentamicin, to which the organisms were fully sensitive, was efficacious in controlling the infection (90 per cent plugs proving sterile after two weeks). Fucidin was less successful against Staphylococcus aureus although effective in vitro. Intravenous inoculation with a suspension of Staphylococcus aureus succeeded in contaminanting 70 per cent of sixty plain cement plugs when injected into the tail vein half an hour after closure of the leg wounds. Only 11 per cent of sixty-four plugs were so contaminanted when the injection was delayed for two weeks. This animal model is submitted as a possible future means of testing different antibiotic-cement combinations against infection.

Animals↗
PubMedDate not supplied

A new method of comparative bone strength measurement.

Most investigations of the material properties of bone have been concerned with the measurement of absolute values for various mechanical parameters. It can be necessary, however, to produce test samples with similar mechanical properties in order to assess the effect on these properties of particular treatments. Absolute values for these properties may not be as important as any changes observed. We describe here a new method whereby many bone test samples with very similar mechanical properties can be produced. If the femoral shaft at the diaphysis is cut in transverse section, it is possible to produce many similar shaped rings of bone. We compared the material properties of 48 ring samples with 65 beam specimens. Both were tested in three-point bending. Global estimates of coefficient of variation (CV) for each parameter were used to assess similarity within each group. All the rings had very similar ash weights (1.98%), thicknesses (1.97%), and diameters (< 0.01%). Values of load/deflection of the rings were more similar than the values of Young's modulus (E) for the beams (7.06 versus 9.9%), and the maximum loads sustainable by the rings were more similar than the bending strengths of the beams (5.7 versus 13.6%). The energy absorbed by the ring samples were more consistent than the beams (14.31 versus 34.41%). We suggest that there is improved similarity in mechanical characteristics within groups of samples produced in this manner than with more conventional sample configurations.

Absorption↗