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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_16 | Pages 38 - 38
17 Nov 2023
Al-Namnam NM Luczak AT Collishaw S Li X Lucas M Simpson AHRW
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Abstract

Introduction

Ultrasonic cutting in surgery has great potential. However, a key limitation is heat created by friction between the bone and the blade. Bone has poor thermal conductivity which hinders the dissipation of heat, causing cell death near the cut site In addition, ultrasonic vibration may create microcracks. It was hypothesised that these effects on bone would vary with the frequency and displacement of the ultrasonically powered blade. Therefore varying frequencies and displacements of the tip of the blade were studied to find the combination with fewest microcracks and lowest temperature rise at the bone-tool interface.

Aim

To explore the effect of different frequencies and tip displacements of ultrasonic cutting devices on the amount of thermal and mechanical damage.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_16 | Pages 62 - 62
1 Nov 2018
Tsang STJ Gwynne PJ Gallagher MP Simpson AHRW
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Staphylococcus aureus is responsible for 60–70% infections of surgical implants and prostheses in Orthopaedic surgery, costing the NHS £120–200 million per annum. Its ability to develop resistance or tolerance to a diverse range of antimicrobial compounds, threatens to halt routine elective implant surgery. One strategy to overcome this problem is to look beyond traditional antimicrobial drug therapies and investigate other treatment modalities. Biophysical modalities, such as ultrasound, are poorly explored, but preliminary work has shown potential benefit, especially when combined with existing antibiotics. Using a methicillin-sensitive S. aureus reference strain and the dissolvable bead assay, biofilms were challenged by a low-intensity ultrasound (1.5MHz, 30mW/cm2, pulse duration 200µs/1KHz) for 20 minutes and gentamicin. The outcome measures were colony-forming units/mL (CFU/mL) and the minimum biofilm eradication concentration (MBEC) of gentamicin. The mean number of S. aureus within control biofilms was 1.04 × 109 CFU/mL. There was no clinically or statistically significant (p=0.531) reduction in viable S. aureus following ultrasound therapy alone. The MBEC of gentamicin for this S. aureus strain was 256 mg/L. The MBEC of gentamicin with the addition of ultrasound was 64mg/L. Low intensity pulsed ultrasound was associated with a 4-fold reduction in the effective biofilm eradication concentration of gentamicin; bringing the MBEC of gentamicin to within clinically achievable concentrations.


Bone & Joint Research
Vol. 5, Issue 4 | Pages 137 - 144
1 Apr 2016
Paterson SI Eltawil NM Simpson AHRW Amin AK Hall AC

Objectives

During open orthopaedic surgery, joints may be exposed to air, potentially leading to cartilage drying and chondrocyte death, however, the long-term effects of joint drying in vivo are poorly understood. We used an animal model to investigate the subsequent effects of joint drying on cartilage and chondrocytes.

Methods

The patellar groove of anaesthetised rats was exposed (sham-operated), or exposed and then subjected to laminar airflow (0.25m/s; 60 minutes) before wounds were sutured and animals recovered. Animals were monitored for up to eight weeks and then sacrificed. Cartilage and chondrocyte properties were studied by histology and confocal microscopy, respectively.


Bone & Joint Research
Vol. 5, Issue 2 | Pages 61 - 65
1 Feb 2016
Scott EEF Hamilton DF Wallace RJ Muir AY Simpson AHRW

Objectives

Temperature is known to influence muscle physiology, with the velocity of shortening, relaxation and propagation all increasing with temperature. Scant data are available, however, regarding thermal influences on energy required to induce muscle damage.

Methods

Gastrocnemius and soleus muscles were harvested from 36 male rat limbs and exposed to increasing impact energy in a mechanical test rig. Muscle temperature was varied in 5°C increments, from 17°C to 42°C (to encompass the in vivo range). The energy causing non-recoverable deformation was recorded for each temperature. A measure of tissue elasticity was determined via accelerometer data, smoothed by low-pass fifth order Butterworth filter (10 kHz). Data were analysed using one-way analysis of variance (ANOVA) and significance was accepted at p = 0.05.