Imperial College London

ProfessorRogerEmery

Faculty of MedicineDepartment of Surgery & Cancer

Professor of Orthopaedic Surgery
 
 
 
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Contact

 

r.emery

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

44 results found

Alidousti H, Giles JW, Emery RJH, Jeffers Jet al., 2017, Spatial mapping of humeral head bone density, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 26, Pages: 1653-1661, ISSN: 1058-2746

JOURNAL ARTICLE

Amirthanayagam TD, Amis AA, Reilly P, Emery RJHet al., 2017, Rotator cuff-sparing approaches for glenohumeral joint access: an anatomic feasibility study, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 26, Pages: 512-520, ISSN: 1058-2746

JOURNAL ARTICLE

Blackwood C, Dixon J, Reilly P, Emery RJet al., 2017, Legal and psychological considerations for obtaining informed consent for reverse total shoulder arthroplasty., Shoulder Elbow, Vol: 9, Pages: 15-22, ISSN: 1758-5732

This paper seeks to outline recent legal developments and requirements pertinent to obtaining informed consent. We argue that this is of particular relevance to patients considering a reverse total shoulder arthroplasty, due to the high complication rate associated with this procedure. By examining the cognitive processes involved in decision-making, and other clinician-related factors such as delivery of information, gender bias and conflict of interest, we explore some of the barriers that can undermine the processes of shared decision-making and obtaining genuine informed consent. We argue that these issues highlight the importance for surgeons in understanding the cognitive processes and other influential factors involved in patients' comprehension and decision-making. We recommend, based on strong evidence, that decision aids could prove useful in overcoming such challenges and could provide one way of mitigating the ethical, professional and legal consequences of failing to obtain proper informed consent. They are not widely used in orthopaedics at present, although it would be in the interests of both the surgeon and patient for such measures to be explored.

JOURNAL ARTICLE

Sukjamsri C, Geraldes DM, Gregory T, Ahmed F, Hollis D, Schenk S, Amis A, Emery R, Hansen Uet al., 2015, Digital volume correlation and micro-CT: An in-vitro technique for measuring full-field interface micromotion around polyethylene implants, JOURNAL OF BIOMECHANICS, Vol: 48, Pages: 3447-3454, ISSN: 0021-9290

JOURNAL ARTICLE

Shah M, Gburcik V, Reilly P, Sankey RA, Emery RJ, Clarkin CE, Pitsillides AAet al., 2015, LOCAL ORIGINS IMPART CONSERVED BONE TYPE-RELATED DIFFERENCES IN HUMAN OSTEOBLAST BEHAVIOUR, EUROPEAN CELLS & MATERIALS, Vol: 29, Pages: 155-176, ISSN: 1473-2262

JOURNAL ARTICLE

Amirthanayagam TD, Emery RJH, 2014, Primum non nocere: risk assessment for new surgical procedures, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 23, Pages: 1417-1418, ISSN: 1058-2746

JOURNAL ARTICLE

Amadi HO, Emery RJ, Wallace A, Bull Aet al., 2014, Specificity of clinical examinations for testing glenohumeral ligament integrity: a computational study, COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING, Vol: 17, Pages: 933-943, ISSN: 1025-5842

JOURNAL ARTICLE

Bayona S, Akhtar K, Gupte C, Emery RJH, Dodds AL, Bello Fet al., 2014, Assessing Performance in Shoulder Arthroscopy: The Imperial Global Arthroscopy Rating Scale (IGARS), JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, Vol: 96A, ISSN: 0021-9355

JOURNAL ARTICLE

Thompson SM, Reilly P, Emery RJH, Bull AMJet al., 2012, A comparison of the degree of retraction of full-thickness supraspinatus tears with the Goutallier grading system, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 21, Pages: 749-753, ISSN: 1058-2746

JOURNAL ARTICLE

Amadi HO, Fogg QA, Ugbolue UC, Emery RJH, Bull AMJet al., 2012, Reliability of a set of protractors for direct anatomical measurements around the glenoid and humeral head rims, JOURNAL OF ANATOMY, Vol: 220, Pages: 525-528, ISSN: 0021-8782

JOURNAL ARTICLE

Amadi HO, Bull AMJ, Emery RJH, 2012, Development and validation of a model for quantifying glenohumeral ligament strains during function, PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 226, Pages: 461-468, ISSN: 0954-4119

JOURNAL ARTICLE

Baring TKA, Cashman PPM, Reilly P, Emery RJH, Amis AAet al., 2011, Rotator cuff repair failure in vivo: a radiostereometric measurement study, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 20, Pages: 1194-1199, ISSN: 1058-2746

JOURNAL ARTICLE

Majed A, Macleod I, Bull AMJ, Zyto K, Resch H, Hertel R, Reilly P, Emery RJHet al., 2011, Proximal humeral fracture classification systems revisited, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 20, Pages: 1125-1132, ISSN: 1058-2746

JOURNAL ARTICLE

Thompson SM, Reilly P, Emery RJ, Bull AMJet al., 2011, An anatomical description of the pennation angles and central tendon angle of the supraspinatus both in its normal configuration and with full thickness tears, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 20, Pages: 899-903, ISSN: 1058-2746

JOURNAL ARTICLE

Cashman PMM, Baring T, Reilly P, Emery RJH, Amis AAet al., 2010, Measurement of migration of soft tissue by modified Roentgen stereophotogrammetric analysis (RSA): validation of a new technique to monitor rotator cuff tears., J Med Eng Technol, Vol: 34, Pages: 159-165

The purpose of this study was to develop a technique to use Roentgen stereophotogrammetric analysis (RSA) to measure migration of soft-tissue structures after rotator cuff repair. RSA stereo films were obtained; images were analysed using a semi-automatic software program allowing 3D viewing of results. RSA imaging experiments were performed to validate the technique, using a glass phantom with implanted RSA beads and an animal model with steel sutures as RSA markers which were moved known distances. Repeated measurements allowed assessment of inter- and intra-observer variability at a maximum of 1.06 mm. RSA analysis of the phantom showed a variation up to 0.22 mm for static and 0.28 mm for dynamic studies. The ovine tissue specimen demonstrated that using steel sutures as RSA markers in soft tissue is feasible, although less accurate than when measuring bone motion. This novel application of RSA to measure soft tissue migration is practicable and can be extended to in vivo studies.

JOURNAL ARTICLE

Amadi HO, Majed A, Emery RJH, Bull AMJet al., 2009, A humeral coordinate system for in vivo 3-d kinematics of the glenohumeral joint, Journal of Musculoskeletal Research, Vol: 12, Pages: 169-174, ISSN: 0218-9577

The aim of this study was to define axes from clearly identifiable landmarks on the proximal aspect of the humerus and to compare these for reasonable best alternatives to the use of the humeral canal and elbow epicondylar axes to define a humeral coordinate frame (HCF). The elbow epicondylar axis (EC) and six different humeral canal axes (HC) based on varying lengths of humerus were quantified from 21 computed tomography (CT) scans of humeri. Six additional axes were defined using the proximal humerus only. These included a line from the center of a sphere fit on the humeral head to the 3D surface area centroid of the greater tubercle region, (GT). The inclinations of these axes relative to EC were calculated. GT was found to be the most closely aligned to EC (13.4° ± 6.8°). The inclinations of the other axes ranged from 36.3° to 86.8°. The HC axis orientation was found to be insensitive to humeral shaft lengths (variability, within average: 0.6°). This was chosen as one of two axes for the HCF. It was also the most inter-subject related axis to EC with inclination standard deviation of ±1.8°. EC was therefore predicted from this such that if the superior axis [1 0 0] of an image scan is maintained and the humerus rotated to make its quantified HC align superiorly in the direction [0.98 0.01 0.01], then its EC axis lies laterally in the direction [0 0 1]. This study demonstrates that it is possible with confidence to apply an orthogonal coordinate frame to the humerus based on proximal imaging data only. © 2009 World Scientific Publishing Company.

JOURNAL ARTICLE

Brassart N, Sanghavi S, Hansen UN, Emery RJ, Amis AAet al., 2008, Loss of rotator cuff tendon-to-bone interface pressure after reattachment using a suture anchor, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 17, Pages: 784-789, ISSN: 1058-2746

JOURNAL ARTICLE

Leong JJH, Leff DR, Das A, Aggarwal R, Reilly P, Atkinson HDE, Emery RJ, Darzi AWet al., 2008, Validation of orthopaedic bench models for trauma surgery., J Bone Joint Surg Br, Vol: 90, Pages: 958-965

The aim of this study was to validate the use of three models of fracture fixation in the assessment of technical skills. We recruited 21 subjects (six experts, seven intermediates, and eight novices) to perform three procedures: application of a dynamic compression plate on a cadaver porcine model, insertion of an unreamed tibial intramedullary nail, and application of a forearm external fixator, both on synthetic bone models. The primary outcome measures were the Objective Structural Assessment of technical skills global rating scale on video recordings of the procedures which were scored by two independent expert observers, and the hand movements of the surgeons which were analysed using the Imperial College Surgical Assessment Device. The video scores were significantly different for the three groups in all three procedures (p < 0.05), with excellent inter-rater reliability (alpha = 0.88). The novice and intermediate groups specifically were significantly different in their performance with dynamic compression plate and intramedullary nails (p < 0.05). Movement analysis distinguished between the three groups in the dynamic compression plate model, but a ceiling effect was demonstrated in the intramedullary nail and external fixator procedures, where intermediates and experts performed to comparable standards (p > 0.6). A total of 85% (18 of 21) of the subjects found the dynamic compression model and 57% (12 of 21) found all the models acceptable tools of assessment. This study has validated a low-cost, high-fidelity porcine dynamic compression plate model using video rating scores for skills assessment and movement analysis. It has also demonstrated that Synbone models for the application of and intramedullary nail and an external fixator are less sensitive and should be improved for further assessment of surgical skills in trauma. The availability of valid objective tools of assessment of surgical skills allows further studies into improving methods of

JOURNAL ARTICLE

Clarkin CE, Emery RJ, Pitsillides AA, Wheeler-Jones CPDet al., 2008, Evaluation of VEGF-Mediated signaling in primary human cells reveals a paracrine action for VEGF in osteoblast-mediated crosstalk to endothelial cells, JOURNAL OF CELLULAR PHYSIOLOGY, Vol: 214, Pages: 537-544, ISSN: 0021-9541

JOURNAL ARTICLE

Leong JJH, Atallah L, Mylonas GP, Leff DR, Emery RJ, Darzi AW, Yang G-Zet al., 2008, Investigation of partial directed coherence for hand-eye coordination in laparoscopic training, 4th International Workshop on Medical Imaging and Augmented Reality, Publisher: SPRINGER-VERLAG BERLIN, Pages: 270-+, ISSN: 0302-9743

CONFERENCE PAPER

Leong JJH, Nicolaou M, Emery RJ, Darzi AW, Yang G-Zet al., 2007, Visual search behaviour in skeletal radiographs: a cross-speciality study, CLINICAL RADIOLOGY, Vol: 62, Pages: 1069-1077, ISSN: 0009-9260

JOURNAL ARTICLE

Bethune R, Bull AMJ, Dickinson RJ, Emery RJHet al., 2007, Removal of calcific deposits of the rotator cuff tendon using an intra-articular ultrasound probe, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 15, Pages: 289-291, ISSN: 0942-2056

JOURNAL ARTICLE

Gregory T, Hansen U, Emery RJ, Augereau B, Amis AAet al., 2007, Developments in shoulder arthroplasty, PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 221, Pages: 87-96, ISSN: 0954-4119

JOURNAL ARTICLE

Hopkins AR, Hansen UN, Amis AA, Taylor M, Emery RJet al., 2007, Glenohumeral kinematics following total shoulder arthroplasty: A finite element investigation, JOURNAL OF ORTHOPAEDIC RESEARCH, Vol: 25, Pages: 108-115, ISSN: 0736-0266

JOURNAL ARTICLE

Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJHet al., 2006, Dead men and radiologists don't lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence., Ann R Coll Surg Engl, Vol: 88, Pages: 116-121

INTRODUCTION: Rotator cuff tears are a common pathology, with a varied prevalence reported. PATIENTS AND METHODS: A literature review was undertaken to determine the cadaveric and radiological (ultrasonography and magnetic resonance imaging [MRI]) prevalence of rotator cuff tear. The radiological studies were subdivided into symptomatic and asymptomatic subjects. RESULTS: Cadaveric rotator cuff tears were found in 4629 shoulders of which only 2553 met the inclusion criteria. The prevalence of full-thickness tears was 11.75% and partial thickness 18.49% (total tears 30.24%). The total tear rate in ultrasound asymptomatic was 38.9% and ultrasound symptomatic 41.4%. The total rate in MRI asymptomatic was 26.2% whilst MRI symptomatic was 49.4%. DISCUSSION: The unselected cadaveric population should contain both symptomatic and asymptomatic subjects. A prevalence of tears between the symptomatic and asymptomatic radiological groups would be expected. However, apart from the MRI asymptomatic group, the radiological prevalence of rotator cuff tears exceeds the cadaveric. CONCLUSIONS: Rotator cuff tears are frequently asymptomatic. Tears demonstrated during radiological investigation of the shoulder may be asymptomatic. It is important to correlate radiological and clinical findings in the shoulder.

JOURNAL ARTICLE

Bull AMJ, Reilly P, Wallace AL, Amis AA, Emery RJHet al., 2005, A novel technique to measure active tendon forces: application to the subscapularis tendon, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 13, Pages: 145-150, ISSN: 0942-2056

JOURNAL ARTICLE

Reilly P, Bull AMJ, Amis AA, Wallace AL, Richards A, Hill AM, Emery RJHet al., 2004, Passive tension and gap formation of rotator cuff repairs, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 13, Pages: 664-667, ISSN: 1058-2746

JOURNAL ARTICLE

Chambler AFW, Bull AMJ, Reilly P, Amis AA, Emery RJHet al., 2003, Coracoacromial ligament tension in vivo, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 12, Pages: 365-367, ISSN: 1058-2746

JOURNAL ARTICLE

Chambler AFW, Pitsillides AA, Emery RJH, 2003, Acromial spur formation in patients with rotator cuff tears., J Shoulder Elbow Surg, Vol: 12, Pages: 314-321, ISSN: 1058-2746

In this study we analyzed the acromial spurs of 15 patients with impingement syndrome undergoing open rotator cuff repair. Mineral apposition analysis and quantitative cytochemical techniques for glucose-6-phosphate dehydrogenase (G6PD) activity (pentose phosphate pathway), alkaline phosphatase (ALP) activity (osteoblast activity), and tartrate-resistant acid phosphatase (TRAP) activity (osteoclast phenotype) were used to examine the distribution and level of activity of selected marker enzymes within the acromial spur insertion into the coracoacromial ligament in order to establish whether local behavior of bone cells is consistent with the proposed secondary development of the acromial spur. Our results indicate that G6PD and ALP activity was higher in osteoblasts on the inferior surface compared with the superior surface of the acromial spur in all patients (P <.001). This area correlated to the most intense area of mineral apposition shown by dual tetracycline labeling. TRAP activity revealed a heterogeneous distribution within the samples. A greater G6PD activity per cell (mean increase of 87%) was seen at the tip compared with that in post- and pre-tip zones within the coronal plane (P <.0002). The qualitative and quantitative enzyme analyses show that the acromial insertion of the coracoacromial ligament is actively involved in bone turnover. The spatial distribution patterns of metabolically active bone-forming osteoblastic cells compared with a heterogeneous distribution of TRAP-positive osteoclasts provide evidence of bone remodeling consistent with the morphologic contours of the acromial enthesis. The sites of oxytetracycline labeling appear to correlate with the sites of high ALP and G6PD activity, which supports the concept of spur formation being a secondary phenomenon in the presence of established rotator cuff tears.

JOURNAL ARTICLE

Reilly P, Amis AA, Wallace AL, Emery RJHet al., 2003, Mechanical factors in the initiation and propagation of tears of the rotator cuff - Quantification of strains of the supraspinatus tendon in vitro, JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, Vol: 85B, Pages: 594-599, ISSN: 0301-620X

JOURNAL ARTICLE

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