Imperial College London

Dr Warren Macdonald

Faculty of EngineeringDepartment of Bioengineering

Senior Teaching Fellow
 
 
 
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Contact

 

+44 (0)20 7594 6372w.macdonald

 
 
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Location

 

RSM 4.35Royal School of MinesSouth Kensington Campus

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Summary

 

Publications

Publication Type
Year
to

28 results found

Campos Pires R, Koziakova M, Yonis A, Pau A, Macdonald W, Harris K, Edge C, Franks N, Mahoney P, Dickinson Ret al., 2018, Xenon protects against blast-induced traumatic brain injury in an in vitro model, Journal of Neurotrauma, Vol: 35, Pages: 1037-1044, ISSN: 0897-7151

The aim of this study was to evaluate the neuroprotective efficacy of the inert gas xenon as a treatment for patients with blast-induced traumatic brain injury in an in vitro laboratory model. We developed a novel blast traumatic brain injury model using C57BL/6N mouse organotypic hippocampal brain-slice cultures exposed to a single shockwave, with the resulting injury quantified using propidium iodide fluorescence. A shock tube blast generator was used to simulate open field explosive blast shockwaves, modeled by the Friedlander waveform. Exposure to blast shockwave resulted in significant (p < 0.01) injury that increased with peak-overpressure and impulse of the shockwave, and which exhibited a secondary injury development up to 72 h after trauma. Blast-induced propidium iodide fluorescence overlapped with cleaved caspase-3 immunofluorescence, indicating that shock-wave–induced cell death involves apoptosis. Xenon (50% atm) applied 1 h after blast exposure reduced injury 24 h (p < 0.01), 48 h (p < 0.05), and 72 h (p < 0.001) later, compared with untreated control injury. Xenon-treated injured slices were not significantly different from uninjured sham slices at 24 h and 72 h. We demonstrate for the first time that xenon treatment after blast traumatic brain injury reduces initial injury and prevents subsequent injury development in vitro. Our findings support the idea that xenon may be a potential first-line treatment for those with blast-induced traumatic brain injury.

Journal article

Eftaxiopoulou T, Barnett-Vanes A, Arora H, Macdonald W, Nguyen TTN, Itadani M, Sharrock AE, Britzman D, Proud WG, Bull AMJ, Rankin SMet al., 2016, Prolonged but not short duration blast waves elicit acute inflammation in a rodent model of primary blast limb trauma, Injury, Vol: 47, Pages: 625-632, ISSN: 0020-1383

BackgroundBlast injuries from conventional and improvised explosive devices account for 75% of injuries from current conflicts; of these over 70% involve the limbs. Variable duration and magnitude of blast wave loading occurs in real-life explosions and is hypothesised to cause different injuries. While a number of in-vivo models report the inflammatory response to blast injuries, the extent of this response has not been investigated with respect to the duration of the primary blast wave. The relevance is that explosions in open air are of short duration compared to those in confined spaces. MethodsHind limbs of adult Sprauge-Dawley rats were subjected to focal isolated primary blast waves of varying overpressure (1.8-3.65kPa) and duration (3.0-11.5ms), utilising a shock tube and purpose built experimental rig. Rats were monitored during and after blast. At 6 and 24hrs after exposure blood, lungs, liver and muscle tissue were collected and prepared for histology and flow cytometry.ResultsAt 6hrs increases in circulating neutrophils and CD43Lo/His48Hi monocytes were observed in rats subjected to longer duration blast waves. This was accompanied by increases in circulating pro-inflammatory chemo/cytokines KC and IL-6. No changes were observed with shorter duration blast waves irrespective of overpressure. In all cases, no histological damage was observed in muscle, lung or liver. By 24hrs post-blast all inflammatory parameters had normalised. ConclusionsWe report the development of a rodent model of primary blast limb trauma that is the first to highlight an important role played by blast wave duration and magnitude in initiating acute inflammatory response following limb injury in the absence of limb fracture or penetrating trauma. The combined biological and mechanical method developed can be used to further understand the complex effects of blast waves in a range of different tissues and organs in-vivo.

Journal article

Macdonald W, Shefelbine SR, 2013, Characterising neovascularisation in fracture healing with laser Doppler and micro-CT scanning., Medical & Biological Engineering & Computing., Vol: 51, Pages: 1157-1165

Journal article

Nguyen TT, Wilgeroth J, Macdonald W, Proud Wet al., 2013, Methods of Controlled Shock Wave Generation in A Shock Tube for Biological Applications, Bulletin of the American Physical Society, Vol: 58

The shock tube is a versatile yet simple equipment used in a wide range of scientific research. The diaphragm breakage process, manipulated by different operation methods, is closely linked to the shock wave generated. Experiments were performed on a compressed air-driven shock tube with mylar and aluminium diaphragms of various thicknesses to characterise the output. The evolution of the pressure generated was measured and the diaphragm rupture investigated. Single-diaphragm and double-diaphragm configurations were employed, as were open or closed tube configurations. The arrangement was designed to enable high-speed photography and pressure measurements. Overall, results are highly reproducible, and show that the double-diaphragm system enables a more controllable diaphragm burst pressure. The diaphragm burst pressure was linearly related to its thickness within the range studied. The observed relationship between the diaphragm burst pressure and the generated shock pressure presents a noticeable difference compared to the theoretical ideal gas description. Furthermore, the duration of the primary shock decreased with the volume of the high-pressure charging gas. Computational modelling of the diaphragm breakage process was carried out using the ANSYS software package.

Journal article

Albrektsson T, Carlsson L, Jacobsson M, Macdonald W, Wennberg Set al., 2007, Femur Fixture and set of Femur Fixtures, 7156879

Patent

Carlsson LV, Albrektsson T, Albrektsson BE, Jacobsson CM, Macdonald W, Regner L, Weidenhielm LRet al., 2006, Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept--40 patients followed for 2 years, Acta Orthop, Vol: 77, Pages: 559-566

BACKGROUND: We have developed a bone-conserving commercially pure titanium hip replacement system using osseointegration principles: a metaphyseal loading proximal femoral component affixing into the retained neck and metaphysis only, leaving the femoral canal untouched. The acetabular cup closely fits a dual-geometry cavity, avoiding stress protection at the dome. PATIENTS AND METHODS: After extensive laboratory and clinical pilot trial investigations, the surface-engineered implants were submitted to a prospective randomized controlled clinical trial involving 40 patients (40 hips), in which they were compared to the cemented Spectron femoral component and cementless Trilogy cup as control implant. The following clinical measures were used to monitor progress at regular intervals for the first 2 postoperative years: radiostereometric analysis (RSA), Harris Hip Score, pain score, WOMAC, and SF-36. RESULTS: After 2 years of follow-up, no statistically significant differences were seen between the groups concerning rotation or translation along the cardinal axes. The patients receiving the Gothenburg osseointegrated titanium (GOT) system had significantly higher Harris Hip Score at 6 months, suggesting more rapid recovery. WOMAC, SF-36 and pain analysis were similar for the first 2 postoperative years. INTERPRETATION: Our RSA data suggest that osseointegration was achieved for all patients receiving the GOT hip system. This bone-conserving prosthesis may provide a good alternative, especially for young and active patients.

Journal article

Carlsson LV, Albrektsson BE, Albrektsson BG, Albrektsson TO, Jacobsson CM, Macdonald W, Regner L, Rostlund T, Weidenhielm LRet al., 2006, Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: I. Preliminary investigations--52 patients followed for 3 years, Acta Orthop, Vol: 77, Pages: 549-558

BACKGROUND: We developed a total hip system using osseointegration guidelines, a metaphyseal-loading proximal femoral replacement in the retained neck and a dual-geometry titanium shell in the acetabulum. PATIENTS AND METHODS: A randomized controlled clinical trial was undertaken in 52 patients (53 hips), using the cemented Spectron stem and cementless Harris-Galante II cup as control implants (24 patients in experimental group, 29 control patients). Clinical measures of Harris Hip Score (HHS), pain score and radiostereometric analysis (RSA) at regular intervals for up to three years were used to monitor progress. RESULTS: No statistically significant differences were found in HHS and pain score; the stability of the cementless experimental implant was also comparable to that of the cemented controls by RSA. 3 revisions were required for migration in the experimental group and 1 was required for component dislocation in the control group. INTERPRETATION: Our findings indicate the practicality of osseointegration of titanium implants, but suggest that current performance is inadequate for clinical introduction. However, the stable fixation achieved in the retained neck in the majority of patients is indicative of osseointegration. This finding will encourage technical and design improvements for enhancement of clinical osseointegration and should also encourage further study. Periprosthetic osteolysis might be avoided by the establishment and maintenance of direct implant-bone connection: "osseointegration".

Journal article

Macdonald W, 2005, Fracture Healing

Patent

Albrektsson T, Carlsson L, Jacobsson M, Macdonald W, Wennberg Set al., 2004, Implant, 6824568

Patent

Macdonald W, Styf J, Carlsson LV, Jacobsson CMet al., 2004, Improved tibial cutting accuracy in knee arthroplasty, Med Eng Phys, Vol: 26, Pages: 807-812

Initial stability and development of long-term fixation for cementless tibial components at the knee both depend on the accuracy of fit between implanted components and prepared bone surfaces. Tibial surfaces prepared for total knee replacement with conventional saw-blades and guides were shown by Toksvig-Larsen to vary by over 2 mm, from a flat surface at the point of maximum variation, and all points varied with a standard deviation of up to 0.4 mm. Surface cutting errors are caused by flexion of the saw-blade and blade angulation from the ideal alignment, due to poor guidance or control by the saw-block or guide. Most conventional knee instrumentation relies on flat surface or slotted cutting blocks, constraining the moving saw-blade against one or two guide surfaces. Improved cutting action was achieved by constraining the saw from the pivot point of the blade, and controlling motion of this constraint with parallel action slides. Using this saw-guide and an improved saw-blade, tibial cuts were made in mock arthroplasty procedures on twenty four cadaveric tibiae in mortuo. Analysis of Variance and Tukey's HSD test showed that the improved saw technique yielded significantly better flatness (p < 0.03) and greatly improved roughness (p < 0.0005).

Journal article

Macdonald W, Campbell P, Fisher J, Wennerberg Aet al., 2004, Variation in surface texture measurements, J Biomed Mater Res B Appl Biomater, Vol: 70, Pages: 262-269

Surface texture influences cellular response to implants, implant wear, and fixation, yet measurement and reporting of surface texture can be confusing and ambiguous. Seven specimens of widely different surface textures were submitted to three internationally renowned laboratories for surface texture characterization. The specimens were from dental implants, orthopedic implants, and femoral heads. Areas to be measured were clearly marked; simplified instructions were supplied but specific measurement parameters were not requested. Techniques used included contact profilometry, two- and three-dimensional laser profilometry, and atomic force microscopy. Four to thirteen parameters were reported, 2D or 3D, including R(a) or S(a); only three were common to all centers. The results varied by as much as +/-300-1000%, depending on technique and surface type. Some surfaces were not measurable by some techniques. One dental implant surface was reported with R(a) of 0.17, 0.85, 1.9, and 4.4 microm. The CoCr femoral head ranged from an R(a) of 0.011 to 0.10 microm; the zirconia head from 0.006 to 0.05 microm. Similar variability was reported for the other parameters. Useful surface texture characterization requires reporting of all measurement parameters. Comparisons between studies may be compromised if differences in technique are not considered.

Journal article

Macdonald W, Aspenberg A, Jacobsson CM, Carlsson LVet al., 2003, A novel liner locking mechanism enhances retention stability, Med Eng Phys, Vol: 25, Pages: 747-754, ISSN: 1350-4533

Acetabular liner retention of a novel design of liner locking was evaluated in static and cyclic endurance modes. The locking mechanism combines geometric form and accurate machining to give high conformity to the acetabular shell and minimise relative motion against the metal shell, minimising debris generation and escape or ingress. Using amended test liners with integral coupling, mean static pullout strength was determined to be 399+/-53 N and lever-out strength 28.03+/-2.8 N m. Cyclic loading of 5 N m for up to 10 million cycles caused no significant reduction in strength, no detectable fretting wear, and the sealing mechanism prevented particle access between the cup interior and the "effective joint space". The stability measured ensures secure and reliable in vivo retention of the liner, comparable with extant component designs using other liner locking mechanisms.

Journal article

Macdonald W, Carlsson LV, Jacobsson CM, Lee TQet al., 2003, A proximal femoral implant preserves physiological bone deformation: a biomechanical investigation in cadaveric bones, Proc Inst Mech Eng [H], Vol: 217, Pages: 41-48

The aim of this study was to compare the perturbances in bone deformation patterns of the proximal femur due to a conventional cemented femoral stem and a novel uncemented implant designed on the principles of osseointegration. Five matched pairs of fresh frozen human femora were mechanically tested. Bone deformation patterns, measured with a video digitizing system under 1.5 kN joint force, showed that the cemented Spectron femoral implant caused significant alterations to the proximal femoral deformation pattern, whereas the Gothenburg osseointegrated titanium femoral implant did not significantly alter the bone behaviour (p < 0.05). Vertical micromotions measured under 1 kN after 1000 cycles were within the threshold of movement tolerable for bone ingrowth (21 microm for the Gothenburg system and 26 microm for the cemented implant).

Journal article

Macdonald W, Carlsson LV, Gathercole N, Jacobsson CMet al., 2003, Fatigue testing of a proximal femoral hip component, Proc Inst Mech Eng [H], Vol: 217, Pages: 137-145, ISSN: 0954-4119

The Gothenburg Osseointegrated Titanium (GOT) implant is a novel total hip replacement including a metaphyseal loading proximal femoral component fixed in the retained femoral neck. Endurance testing was performed under conditions analogous to ISO 7206-4: 1989. The cement-free implant is not fixed distally within the intramedullary canal, so distal embedding (as specified in the standard) would have been unrealistic. Instead glass-fibre-reinforced epoxy (GFRE) bushings were used to model reduced bone support mid-length at the medial cortex and distally at the lateral cortex. Such support simulated proximal bone loss, realistically reproducing the effect of osteolysis or fixation failure. Under such conditions the component survived unbroken for 10 million cycles at 3.0 kN peak load.

Journal article

Albrektsson T, Jacobsson M, Wennberg S, Carlsson L, MacDonald Wet al., 2002, Femoral Fixture for a Hip Joint Prosthesis

Patent

Albrektsson T, Carlsson L, Jacobsson M, Macdonald W, Wennberg Set al., 2001, Implant

Patent

Albrektsson T, Carlsson L, Jacobsson M, Macdonald W, Wennberg Set al., 2001, Femur Fixture and set of femur fixtures

Patent

Macdonald W, Aspenberg A, Jacobsson CM, Carlsson LVet al., 2000, Friction in orthopaedic zirconia taper assemblies, Proc Inst Mech Eng [H], Vol: 214, Pages: 685-692, ISSN: 0954-4119

The torque resistance of zirconia ceramic heads/titanium taper trunnion junctions was tested in accordance with ISO 7206-9:1994(E); using twelve modified heads of 32 mm diameter under representative physiological conditions. Test parameters studied included assembly force, vertical load during test (test load) and head length. Mean torque resistances measured were 8.9 N m for a 1 kN test load and 15 N m at 4 kN test load. Coefficients of friction calculated for the torsional stability ranged from 0.06 to greater than 1.0. Multiple regression analysis confirmed that the failure torques measured were significantly dependent on test load (beta = 0.77; P < 0.001) whereas assembly force and head length played a lesser, insignificant, part in the variation. Data from push-on/pull-off tests were used to calculate coefficients of friction under axial loading, which were significantly correlated with taper angle and material. Torque testing shows greater variability than push-on/pull-off tests for similar combinations, and for zirconia heads on other tapers. The coefficients of friction measured (0.16-0.31) are significantly different from values typically used in stress analyses.

Journal article

Macdonald W, Carlsson LV, Charnley GJ, Jacobsson CM, Johansson CBet al., 1999, Inaccuracy of acetabular reaming under surgical conditions, J Arthroplasty, Vol: 14, Pages: 730-737, ISSN: 0883-5403

Press-fit uncemented acetabular components require accurate implant-bone cavity fit. Ten cavities produced during actual hip arthroplasty using debris-retaining reamers were replicated in dental alginate. An experimental reamer with better cutting prepared 12 acetabulae in mortuo under similar conditions. Positives in dental stone were measured on a coordinate measuring center. Spheres of best-fit and variation of each point from these spheres were calculated. Control cavities in polyurethane foam were measured to estimate casting errors. Diametral errors of conventionally reamed cavities averaged 2.1%, whereas experimental reamers' cavities varied by 0.5% (P < .005). Overall surface variation from hemispheric form in conventionally reamed cavities exceeded the experimental reamer's results (P < .005). Conventional acetabular reamers cut bone inaccurately. Reamers designed for improved bone cutting reduce cavity errors.

Journal article

Macdonald W, Carlsson LV, Charnley GJ, Jacobsson CMet al., 1999, Press-fit acetabular cup fixation: principles and testing, Proc Inst Mech Eng [H], Vol: 213, Pages: 33-39, ISSN: 0954-4119

Pre-clinical testing of the fixation of press-fit acetabular components of total hip prostheses relies on cadaver or synthetic bone, but the properties and geometry of bone models differ from those of physiological bone. Cup designs use varied mechanisms for initial stability in bone; therefore, using different analogues and tests is appropriate. Press-fit cup stability was tested in the following: firstly, polyurethane (PU) foam modelling cancellous support; secondly, glass-fibre reinforced epoxide (GFRE) tubes modelling acetabular cortical support; thirdly, cadaveric acetabula. Three commercial cups [Harris-Galante II (H-G-II), Zimmer; Optifix, Smith & Nephew, Richards; porous coated anatomic (PCA), Howmedica] and an experimental cup with enhanced rim fixation were tested in three modes: direct pull-out, lever-out and axial torque. The fixation stabilities measured in the PU and the GFRE models showed trends consistent with those in cadaver bone, differing in the oversizing and cup geometry. The experimental cup was significantly more secure in most modes than other cups; the H-G II and Optifix cups showed similar stabilities, lower than that of the experimental cup but greater than that of the PCA cup (analysis of variance and Tukey's highly significant test; p < 0.001). The stabilities measured in cadaver bone more closely approximated those in GFRE. The use of several bone analogues enables separation of fixation mechanisms, allowing more accurate prediction of in vivo performance.

Journal article

Albrektsson T, Carlsson LV, Jacobsson M, Macdonald Wet al., 1998, Gothenburg osseointegrated hip arthroplasty. Experience with a novel type of hip design, Clin Orthop Relat Res, Vol: 352, Pages: 81-94, ISSN: 0009-921X

The culmination of more than 10 years of laboratory and clinical research has been the clinical trial of a novel hip arthroplasty for osseointegration. The femoral component of this Gothenburg hip is a neck retaining, threaded fixture with rotational symmetry, produced in commercially pure titanium with a specific surface texture. Proximally, a standard orthopaedic taper trunnion mates with a 28-mm diameter zirconia head that articulates against the acetabular component. The latter is also of textured commercially pure titanium, encapsulating a thick ultra high molecular weight polyethylene liner. Dedicated alignment guides and cutting instruments ensure accurate bone preparation and implant placement. Limited clinical trials commenced in 1992 and expanded to multicenter clinical trials in 1997. Every hip has been monitored with radiostereometry to measure migration to an accuracy of 0.1 mm. All calcar implanted femoral components show excellent function at 4 to 5 years followup, with no migration revealed by radiostereometry.

Journal article

Macdonald W, Swarts E, Beaver R, 1993, Penetration and shear strength of cement-bone interfaces in vivo, Clin Orthop Relat Res, Vol: 286, Pages: 283-288, ISSN: 0009-921X

Using sham replacement of the proximal femur in adult mongrel dogs, shear strength at the interface between polymethylmethacrylate bone cement and cancellous bone has been found to be linearly dependent on the depth of penetration of the cement into the bone. Shear strength at the interface was increased by 82% and penetration by 74% when distal bone plugging, pressure lavage, and pressurized insertion of cement were employed. Use of a lower-viscosity cement gave a further 18% increase in penetration and shear strength. There was no film of blood at the cement-bone interface with pressurized insertion of Simplex P and Palacos R cements.

Journal article

Rosenstein A, Macdonald W, Iliadis A, McLardy-Smith Pet al., 1992, Revision of cemented fixation and cement-bone interface strength, Proc Inst Mech Eng [H], Vol: 206, Pages: 47-49

Interfacial shear strength between poly(methyl methacrylate) (PMMA) bone cement and cancellous bone was measured in bone samples from human proximal femora. Samples were prepared with fresh cement-bone, fresh cement inside a mantle of existing cement and with fresh cement-revised bone surfaces. Push-out tests to measure shear strength caused failure only at bone-cement interfaces; revised bone interfaces were 30 per cent weaker (P < 0.02) than primary interfaces. The clinical relevance is that revision of cemented joint arthroplasties may necessitate removal of components with sound cement-bone fixation. The practice of removing all traces of PMMA cement may not yield the optimal fixation; adhesion of fresh cement to freshly prepared surfaces of the existing cement might also be considered where circumstances are favourable.

Journal article

Macdonald W, Atkins RM, 1990, An algometer for the automated measurement of pain threshold, Brit. J. Rheumatol, Vol: 29, Pages: 454-455

Journal article

Macdonald W, Skirving AP, Scull ER, 1988, A device for producing experimental fractures., Acta Orthop Scand, Vol: 59, Pages: 542-544

Journal article

Macdonald W, Owen JW, 1988, The effect of total hip replacement on driving reactions, Journal of Bone and Joint Surgery, Vol: 70-B, Pages: 202-205

The driving reactions of 25 patients were assessed before and after operation for hip replacement. Driving reactions were tested by monitoring the delay and force of brake application after an emergency signal, using a simulated driving control system. Fifteen normal subjects were also tested. Statistical analysis demonstrated significant differences between patients with either left or right hip replacement and between pre- and postoperative testing. Most patients improved by the eighth week, but some had deteriorated and did not recover until re-tested eight months after operation. It is concluded that for most patients eight weeks' delay for return to driving is appropriate, but for a minority of patients with right hip replacement recovery of reaction speed requires longer rehabilitation.

Journal article

Skirving AP, Day R, Macdonald W, McLaren Ret al., 1987, Carbon fiber reinforced plastic (CFRP) plates versus stainless steel dynamic compression plates in the treatment of fractures of the tibiae in dogs, Clin Orthop Relat Res, Vol: 224, Pages: 117-124

In a series of 14 dogs, fractures of both tibiae were caused by a "bone-breaker" designed in the authors' department and observed to produce a consistent and realistic canine fracture. One tibia was plated with a carbon fiber reinforced plastic (CFRP) plate and the other with a dynamic compression (DC) plate. Roentgenographic examination demonstrated healing of the CFRP-plated tibiae with abundant callus, and almost total remodeling of the fracture callus between ten and 20 weeks. Biomechanical testing by three-point bending revealed little difference between the strength of union of the fractures at 12-16 weeks. At 20 weeks, although the numbers were too small for statistical confirmation, the CFRP-plated tibiae were consistently stronger than the DC-plated tibiae.

Journal article

Macdonald W, Thrum CB, Hamilton SG, 1986, Designing an implant by CT scanning and solid modelling. Arthrodesis of the shoulder after excision of the upper humerus, Journal of Bone & Joint Surgery (British), Vol: 68-B, Pages: 208-212, ISSN: 0301-620X

Techniques are described by which metal implants can be designed and produced to fit precisely a bony site at a subsequent operation. CT scans and solid modelling were used to produce an accurate three-dimensional representation of the surface of the bone. These techniques were applied to the production of an internal fixation device for shoulder arthrodesis after the resection of a neoplasm of the proximal humerus. The reconstruction utilised a free vascularised fibular graft between the scapula and the distal humeral remnant, fixation being secured with the custom-made implant.

Journal article

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