Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the worl... more Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the world population (WHO reports), leading to pain and disability. There are as yet no clinically proven therapies to halt OA onset or progression; the development of such therapies is, therefore, a national as well as international research priority. Obesity-related metabolic syndrome has been identified as the most significant, but also an entirely preventable risk factor for OA; however, the mechanisms underlying this link remain unclear. We have examined the available literature linking OA and metabolic syndrome. The two conditions have a shared pathogenesis in which chronic low-grade inflammation of affected tissues is recognized as a major factor that is associated with systemic inflammation. In addition, the occurrence of metabolic syndrome appears to alter systemic and local pro-inflammatory cytokines that are also related to the development of OA-like pathologies. Recent findings highl...
Although articular cartilage is the primary tissues affected by osteoarthritis (OA), the underlyi... more Although articular cartilage is the primary tissues affected by osteoarthritis (OA), the underlying subchondral bone also undergoes noticeable changes. Despite the growing body of research into the biophysical and mechanical properties of OA bone there are few studies that have analysed the structure of the subchondral sclerosis at the nanoscale. In this study, the composition and nano-structural changes of human osteoarthritis (OA) subchondral bone were investigated to better understand the site-specific changes. OA bone samples were collected from patients undergoing total knee replacement surgery and graded according to disease severity (grade I: mild OA; grade IV: severe OA). Transmission electron microscopy (TEM), Electron Diffraction, and Elemental Analysis techniques were used to explore the cross-banding pattern, nature of mineral phase and orientation of the crystal lattice. Subchondral bone nano-hydroxyapatite powders were prepared and characterised using high resolution t...
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation School of Engineering Systems, Jan 12, 2009
Amphiphilic triblock copolymers of methoxy-poly(ethylene glycol)-poly(L-lactide)-poly(L-lysine) (... more Amphiphilic triblock copolymers of methoxy-poly(ethylene glycol)-poly(L-lactide)-poly(L-lysine) (MPEG-b-PLLA-b-PLL) (Mn=8540-22 240) were synthesized through the ring-opening polymerization of Nepsilon-(Z)-lysine-N-carboxyanhydrides (N(epsilon)-(Z)-Lys-NCA) using MPEG-b-PLLA-NH2 as a macroinitiator. The triblock copolymers and diblock precursors were characterized by 1H NMR, ATR-FTIR, and GPC. The chain lengths of each block could be controlled by varying the feed ratios of the monomers. The surface properties of films of PLLA modified by blending with the triblock copolymers were investigated by XPS and AFM and demonstrated an enrichment of PLL blocks on the surface of the PLLA film. No cytotoxicity was detected on a range of modified PLLA films arising from the incorporation of the triblock copolymers. The triblock copolymers MPEG-b-PLLA-b-PLL showed better surface properties in promoting osteoblast adhesion and proliferation compared with pure PLLA and PLLA modified with MPEG-b-PLLA diblock copolymers. This study demonstrated that the triblock copolymers containing free amino groups, which self-segregate on the surface of biodegradable polyesters, have potential for applications in cell delivery and tissue engineering.
Journal of Bone Joint Surgery British Volume, Jul 1, 2011
Purpose: The appropriate means of fixation for hemiarthroplasty of the hip is a matter of ongoing... more Purpose: The appropriate means of fixation for hemiarthroplasty of the hip is a matter of ongoing debate. Proponents of uncemented components cite the risk of perioperative mortality with cement implantation as justification for avoiding cement in certain patients. ...
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation School of Engineering Systems, 2009
ABSTRACT Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic ac... more ABSTRACT Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic activities occurring on endosteal surfaces, whereas the periosteal aspect is somewhat neglected. In terms of bone physiology, periosteum plays a determining role in de novo cortical bone formation and cortical bone expansion through periosteum is the most efficient way of increasing bone strength against fractures. Despite the important role of periosteum in the pathogenesis and treatment of osteoporosis, little is known about the structural and cellular features of periosteum in osteoporosis. This chapter will focus on the major changes occurring in the periosteum of osteoporosis and possible implications of these changes in the pathogenesis of osteoporosis. The changes identified in the periosteum of osteoporosis are mainly located in the metaphyseal compartment, which include: (a) much thicker and more cellular cambial layer; (b) increased number of TRAP (tartrate resistant acid phosphatase), VEGF (vascular endothelial growth factor) cells and the degree of vascularization; and (c) enhanced expression of sympathetic nerve fibers. The structural and cellular changes of osteoporotic periosteum indicate that periosteum plays an important role in the cortical bone resorption in metaphyseal areas and this pathological process may be regulated by the sympathetic nervous system.
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation, Jul 1, 2007
In view of the controversy of the clinical use of hyperbaric oxygen (HBO) treatment to stimulate ... more In view of the controversy of the clinical use of hyperbaric oxygen (HBO) treatment to stimulate fracture healing and bone regeneration, we have analyzed the effects of daily exposure to HBO on the proliferation and differentiation of human osteoblasts in vitro. HBO stimulated proliferation when osteoblasts were cultured in 10% fetal calf serum (FCS), whereas an inhibitory effect of HBO was observed when cultures were supplemented with 2% FCS. On the other hand, HBO enhanced biomineralization with an increase in bone nodule formation, calcium deposition, and alkaline phosphatase activity, whereas no cytotoxic effect was detected using a lactate dehydrogenase activity assay. The data suggest that the exposure of osteoblasts to HBO enhances differentiation toward the osteogenic phenotype, providing cellular evidence of the potential application of HBO in fracture healing and bone regeneration.
Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine, 2007
Clinical experience shows that removal of the Exeter long-stem femoral component (220 mm, 240 mm,... more Clinical experience shows that removal of the Exeter long-stem femoral component (220 mm, 240 mm, 260 mm) of total hip arthroplasty is extremely difficult, often requiring splitting of the femur. To identify the reason for this, measurements of stem geometry and force required to pull the stems out of the cement mantle were conducted on three original Exeter long-stem and one standard femoral components. All implants required an initial force of approximately 4 kN for release from the cement. The long-stem components then required much larger forces and hence much higher expenditure of energy to pull them clear of the cement. This was attributed to the reverse taper seen on the nominally cylindrical distal section of the long-stem components. Following re-design of the manufacturing process to ensure the taper continued to the implant's distal tip, four further implants were tested. These demonstrated the requirement for initial cement release but then required no further energy expenditure similar to the standard stem. This study clearly demonstrated that the original difficulty in removing these long stems was owing to the manufacturing process resulting in a reverse taper on the distal stem. The adoption of recommended manufacturing changes to ensure the taper continues to the distal tip removed this difficulty.
Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the worl... more Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the world population (WHO reports), leading to pain and disability. There are as yet no clinically proven therapies to halt OA onset or progression; the development of such therapies is, therefore, a national as well as international research priority. Obesity-related metabolic syndrome has been identified as the most significant, but also an entirely preventable risk factor for OA; however, the mechanisms underlying this link remain unclear. We have examined the available literature linking OA and metabolic syndrome. The two conditions have a shared pathogenesis in which chronic low-grade inflammation of affected tissues is recognized as a major factor that is associated with systemic inflammation. In addition, the occurrence of metabolic syndrome appears to alter systemic and local pro-inflammatory cytokines that are also related to the development of OA-like pathologies. Recent findings highl...
Although articular cartilage is the primary tissues affected by osteoarthritis (OA), the underlyi... more Although articular cartilage is the primary tissues affected by osteoarthritis (OA), the underlying subchondral bone also undergoes noticeable changes. Despite the growing body of research into the biophysical and mechanical properties of OA bone there are few studies that have analysed the structure of the subchondral sclerosis at the nanoscale. In this study, the composition and nano-structural changes of human osteoarthritis (OA) subchondral bone were investigated to better understand the site-specific changes. OA bone samples were collected from patients undergoing total knee replacement surgery and graded according to disease severity (grade I: mild OA; grade IV: severe OA). Transmission electron microscopy (TEM), Electron Diffraction, and Elemental Analysis techniques were used to explore the cross-banding pattern, nature of mineral phase and orientation of the crystal lattice. Subchondral bone nano-hydroxyapatite powders were prepared and characterised using high resolution t...
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation School of Engineering Systems, Jan 12, 2009
Amphiphilic triblock copolymers of methoxy-poly(ethylene glycol)-poly(L-lactide)-poly(L-lysine) (... more Amphiphilic triblock copolymers of methoxy-poly(ethylene glycol)-poly(L-lactide)-poly(L-lysine) (MPEG-b-PLLA-b-PLL) (Mn=8540-22 240) were synthesized through the ring-opening polymerization of Nepsilon-(Z)-lysine-N-carboxyanhydrides (N(epsilon)-(Z)-Lys-NCA) using MPEG-b-PLLA-NH2 as a macroinitiator. The triblock copolymers and diblock precursors were characterized by 1H NMR, ATR-FTIR, and GPC. The chain lengths of each block could be controlled by varying the feed ratios of the monomers. The surface properties of films of PLLA modified by blending with the triblock copolymers were investigated by XPS and AFM and demonstrated an enrichment of PLL blocks on the surface of the PLLA film. No cytotoxicity was detected on a range of modified PLLA films arising from the incorporation of the triblock copolymers. The triblock copolymers MPEG-b-PLLA-b-PLL showed better surface properties in promoting osteoblast adhesion and proliferation compared with pure PLLA and PLLA modified with MPEG-b-PLLA diblock copolymers. This study demonstrated that the triblock copolymers containing free amino groups, which self-segregate on the surface of biodegradable polyesters, have potential for applications in cell delivery and tissue engineering.
Journal of Bone Joint Surgery British Volume, Jul 1, 2011
Purpose: The appropriate means of fixation for hemiarthroplasty of the hip is a matter of ongoing... more Purpose: The appropriate means of fixation for hemiarthroplasty of the hip is a matter of ongoing debate. Proponents of uncemented components cite the risk of perioperative mortality with cement implantation as justification for avoiding cement in certain patients. ...
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation School of Engineering Systems, 2009
ABSTRACT Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic ac... more ABSTRACT Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic activities occurring on endosteal surfaces, whereas the periosteal aspect is somewhat neglected. In terms of bone physiology, periosteum plays a determining role in de novo cortical bone formation and cortical bone expansion through periosteum is the most efficient way of increasing bone strength against fractures. Despite the important role of periosteum in the pathogenesis and treatment of osteoporosis, little is known about the structural and cellular features of periosteum in osteoporosis. This chapter will focus on the major changes occurring in the periosteum of osteoporosis and possible implications of these changes in the pathogenesis of osteoporosis. The changes identified in the periosteum of osteoporosis are mainly located in the metaphyseal compartment, which include: (a) much thicker and more cellular cambial layer; (b) increased number of TRAP (tartrate resistant acid phosphatase), VEGF (vascular endothelial growth factor) cells and the degree of vascularization; and (c) enhanced expression of sympathetic nerve fibers. The structural and cellular changes of osteoporotic periosteum indicate that periosteum plays an important role in the cortical bone resorption in metaphyseal areas and this pathological process may be regulated by the sympathetic nervous system.
Faculty of Built Environment and Engineering Institute of Health and Biomedical Innovation, Jul 1, 2007
In view of the controversy of the clinical use of hyperbaric oxygen (HBO) treatment to stimulate ... more In view of the controversy of the clinical use of hyperbaric oxygen (HBO) treatment to stimulate fracture healing and bone regeneration, we have analyzed the effects of daily exposure to HBO on the proliferation and differentiation of human osteoblasts in vitro. HBO stimulated proliferation when osteoblasts were cultured in 10% fetal calf serum (FCS), whereas an inhibitory effect of HBO was observed when cultures were supplemented with 2% FCS. On the other hand, HBO enhanced biomineralization with an increase in bone nodule formation, calcium deposition, and alkaline phosphatase activity, whereas no cytotoxic effect was detected using a lactate dehydrogenase activity assay. The data suggest that the exposure of osteoblasts to HBO enhances differentiation toward the osteogenic phenotype, providing cellular evidence of the potential application of HBO in fracture healing and bone regeneration.
Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine, 2007
Clinical experience shows that removal of the Exeter long-stem femoral component (220 mm, 240 mm,... more Clinical experience shows that removal of the Exeter long-stem femoral component (220 mm, 240 mm, 260 mm) of total hip arthroplasty is extremely difficult, often requiring splitting of the femur. To identify the reason for this, measurements of stem geometry and force required to pull the stems out of the cement mantle were conducted on three original Exeter long-stem and one standard femoral components. All implants required an initial force of approximately 4 kN for release from the cement. The long-stem components then required much larger forces and hence much higher expenditure of energy to pull them clear of the cement. This was attributed to the reverse taper seen on the nominally cylindrical distal section of the long-stem components. Following re-design of the manufacturing process to ensure the taper continued to the implant's distal tip, four further implants were tested. These demonstrated the requirement for initial cement release but then required no further energy expenditure similar to the standard stem. This study clearly demonstrated that the original difficulty in removing these long stems was owing to the manufacturing process resulting in a reverse taper on the distal stem. The adoption of recommended manufacturing changes to ensure the taper continues to the distal tip removed this difficulty.
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