Publications
28 results found
Uemura K, Boughton O, Logishetty K, et al., 2019, A single-use, size-specific, nylon arthroplasty guide: a preliminary study, Hip International, ISSN: 1120-7000
Willmott H, Al-Wattar Z, Halewood C, et al., 2018, Evaluation of different shape-memory staple configurations against crossed screws for first metatarsophalangeal joint arthrodesis: A biomechanical study, Foot and Ankle Surgery, Vol: 24, Pages: 259-263, ISSN: 1268-7731
BACKGROUND: The first metatarsophalangeal joint may be fused in order to treat arthritis or instability. The use of shape-memory staples for fixation is well recognised, but little work has been done into the optimal configuration of staples. METHODS: The structural behaviour of first metatarsophalangeal joint (MTPJ) arthrodeses using shape-memory staples or crossed screws was studied using cadaveric porcine joints. Five fixation configurations were tested: single vertical or horizontal staple, paired staples in dorsal-medial configuration (0-90° to the sagittal plane), paired staples in oblique orthogonal configuration (45-135°); or two crossed screws. Specimens were loaded in cyclical dorsiflexion for 1000 cycles. Plantar gapping and shearing were measured. Specimens were then loaded to failure. RESULTS: Cyclic testing caused more shear in the 45-135° staples than the crossed screws (1.0mm±0.5mm compared to 0.14mm±0.4mm, p<0.01). No significant difference was found in plantar gap formation. Single vertical and horizontal single staples failed at 15N and 19. CONCLUSIONS: N, respectively. Paired 0-90° staples failed at 43N±9N, significantly lower than the 45-135° staples (141N±25N; p<0.001) and crossed screws (180N±67N; p<0.001). There was no significant difference between the 45-135° staples and crossed screws. Screws failed by sudden cortical fracture; staples displayed gradual pull-out and shearing. First MTPJ arthrodeses fixed with single staples are not recommended. Arthrodeses fixed with staples at 0-90° to the sagittal plane were significantly less strong than two crossed screws. However, positioning oblique staples at 45-135° significantly improved stability, creating a construct as strong as, crossed screws. None of the constructs was strong enough for immediate weight bearing.
Halewood C, Athwal KK, Amis A, 2018, Pre-clinical assessment of total knee replacement anterior-posterior constraint, Journal of Biomechanics, Vol: 73, Pages: 153-160, ISSN: 0021-9290
Pre-clinical, bench-top assessment of Total Knee Replacements (TKR) can provide information about the inherent constraint provided by a TKR, which does not depend on the condition of the patient undergoing the arthroplasty. However little guidance is given by the ASTM standard on test configurations such as medial-lateral (M:L) loading distribution, flexion angle or restriction of secondary motions. Using a purpose built rig for a materials testing machine, four TKRs currently in widespread clinical use, including medial-pivot and symmetrical condyle types, were tested for anterior-posterior translational constraint. Compressive joint loads from 710 to 2000 N, and a range of medial-lateral (M:L) load distributions, from 70:30% to 30:70% M:L, were applied at different flexion angles with secondary motions unconstrained. It was found that TKA constraint was significantly less at 60 and 90° flexion than at 0°, whilst increasing the compressive joint load increased the force required to translate the tibia to limits of AP constraint at all flexion angles tested. Additionally when M:L load distribution was shifted medially, a coupled internal rotation was observed with anterior translation and external rotation with posterior translation. This paper includes some recommendations for future development of pre-clinical testing methods.
Halewood C, Amis AA, 2016, Physiology: Biomechanics, Surgery of the Meniscus, Pages: 35-45, ISBN: 9783662491867
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Stephen JM, Halewood C, Kittl C, et al., 2016, Posteromedial Meniscocapsular Lesions Increase Tibiofemoral Joint Laxity With Anterior Cruciate Ligament Deficiency, and Their Repair Reduces Laxity, American Journal of Sports Medicine, Vol: 44, Pages: 400-408, ISSN: 0363-5465
Background:Injury to the posteromedial meniscocapsular junction has been identified after anterior cruciate ligament (ACL) rupture; however, there is a lack of objective evidence investigating how this affects knee kinematics or whether increased laxity can be restored by repair. Such injury is often overlooked at surgery, with possible compromise to results.Hypotheses:(1) Sectioning the posteromedial meniscocapsular junction in an ACL-deficient knee will result in increased anterior tibial translation and rotation. (2) Isolated ACL reconstruction in the presence of a posteromedial meniscocapsular junction lesion will not restore intact knee laxity. (3) Repair of the posteromedial capsule at the time of ACL reconstruction will reduce tibial translation and rotation to normal. (4) These changes will be clinically detectable.Study Design:Controlled laboratory study.Methods:Nine cadaveric knees were mounted in a test rig where knee kinematics were recorded from 0° to 100° of flexion by use of an optical tracking system. Measurements were recorded with the following loads: 90-N anterior-posterior tibial forces, 5-N·m internal-external tibial rotation torques, and combined 90-N anterior force and 5-N·m external rotation torque. Manual Rolimeter readings of anterior translation were taken at 30° and 90°. The knees were tested in the following conditions: intact, ACL deficient, ACL deficient and posteromedial meniscocapsular junction sectioned, ACL deficient and posteromedial meniscocapsular junction repaired, ACL patellar tendon reconstruction with posteromedial meniscocapsular junction repair, and ACL reconstructed and capsular lesion re-created. Statistical analysis used repeated-measures analysis of variance and post hoc paired t tests with Bonferroni correction.Results:Tibial anterior translation and external rotation were both significantly increased compared with the ACL-deficient knee after posterior meniscocapsular sectioning (P <
Masouros S, Halewood C, Bull A, et al., 2015, Biomechanics, Expertise orthopadie und unfallchirurgie: Knie, Editors: Kohn, ISBN: 978-3-1317500-1-3
Halewood C, Traynor A, Bellemans J, et al., 2015, Anteroposterior Laxity After Bicruciate-Retaining Total Knee Arthroplasty Is Closer to the Native Knee Than ACL-Resecting TKA: A Biomechanical Cadaver Study., Journal of Arthroplasty, ISSN: 1532-8406
The purpose of this study was to examine whether a bicruciate retaining (BCR) TKA would yield anteroposterior (AP) laxity closer to the native knee than a posterior cruciate ligament retaining (CR) TKA. A BCR TKA was designed and compared to CR TKA and the native knee using cadaver specimens. AP laxity with the CR TKA was greater than the native knee (P=0.006) and BCR TKA (P=0.039), but no difference was found between the BCR TKA and the native knee. No significant differences were found in rotations between the prostheses and the native knee. BCR TKA was shown to be surgically feasible, reduced AP laxity versus CR TKA, and may improve knee stability without using conforming geometry in the implant design.
Halewood C, Masouros S, Amis AA, 2015, Structure and function of the menisci, Meniscal Allograft Transplantation. A comprehensive review., Editors: Getgood, Spalding, Cole, Gersoff, Verdonk, ISBN: 978-0-9558873-5-2
Halewood C, Lumpaopong P, Stephen JM, et al., 2015, Functional Biomechanics with Cadaver Specimens, Experimental Research Methods in Orthopedics and Trauma, Editors: Simpson, Augat, Publisher: Thieme Medical Publishers, ISBN: 9783131731111
This book provides a comprehensive summary of all current research methodologies for translational and pre-clinical studies in biomechanics and orthopedic trauma surgery.
Halewood C, Amis AA, 2015, Clinically relevant biomechanics of the knee capsule and ligaments, Knee Surgery, Sports Traumatology, Arthroscopy, Vol: 23, Pages: 2789-2796, ISSN: 0942-2056
The paper describes the concepts of primary and secondary restraints to knee joint stability and explains systematically how the tibia is stabilised against translational forces and rotational torques in different directions and axes, and how those vary across the arc of flexion–extension. It also shows how the menisci act to stabilise the knee, in addition to load carrying across the joint. It compares the properties of the natural stabilising structures with the strength and stiffness of autogenous tissue grafts and relates those strengths to the strength of graft fixation devices. A good understanding of the biomechanical behaviour of these various structures in the knee will help the surgeon in the assessment and treatment of single and multi-ligament injuries.
Stephen JM, Halewood C, Kittl C, et al., 2015, The influence of posterior medial meniscocapsular lesions on tibiofemoral joint laxity in ACL deficient and reconstructed knees, British Association of Surgery of the Knee
Halewood C, 2015, Anteroposterior laxity after bicruciate-retaining total knee replacement is closer to the intact knee than conventional ACL-resecting TKR: a biomechanical cadaver study, BASK
Kittl C, Halewood C, Stephen JM, et al., 2015, Length change patterns in the lateral extra-articular structures of the knee and related reconstructions, American Journal of Sports Medicine, Vol: 43, Pages: 354-362, ISSN: 0363-5465
Background:Lateral extra-articular soft tissue reconstructions in the knee may be used as a combined procedure in revision anterior cruciate ligament surgery as well as in primary treatment for patients who demonstrate excessive anterolateral rotatory instability. Only a few studies examining length change patterns and isometry in lateral extra-articular reconstructions have been published.Purpose:To determine a recommended femoral insertion area and graft path for lateral extra-articular reconstructions by measuring length change patterns through a range of knee flexion angles of several combinations of tibial and femoral insertion points on the lateral side of the knee.Study Design:Controlled laboratory study.Methods:Eight fresh-frozen cadaveric knees were freed of skin and subcutaneous fat. The knee was then mounted in a kinematics rig that loaded the quadriceps muscles and simulated open-chain knee flexion. The length changes of several combinations of tibiofemoral points were measured at knee flexion angles between 0° and 90° by use of linear variable displacement transducers. The changes in length relative to the 0° measurement were recorded.Results:The anterior fiber region of the iliotibial tract displayed a significantly different (P < .001) length change pattern compared with the posterior fiber region. The reconstructions that had a femoral insertion site located proximal to the lateral epicondyle and with the grafts passed deep to the lateral collateral ligament displayed similar length change patterns to each other, with small length increases during knee extension. These reconstructions also showed a significantly lower total strain range compared with the reconstruction located anterior to the epicondyle (P < .001).Conclusion:These findings show that the selection of graft attachment points and graft course affects length change pattern during knee flexion. A graft attached proximal to the lateral femoral epicondyle and running deep
Halewood C, Risebury M, Thomas NP, et al., 2014, Kinematic behaviour and soft tissue management in guided motion total knee replacement, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 22, Pages: 3074-3082, ISSN: 0942-2056
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- Citations: 25
Halewood C, 2014, Pre-clinical stability assessment methods for total knee replacements, 2014 ESSKA Congress, Amsterdam
Halewood C, 2014, How to do a Proper Biomechanical Study, 2014 ESSKA Congress, Amsterdam
Halewood C, Samuelsson K, Kopf S, et al., 2014, How to do proper research, ESSKA Instructional Course Lecture Book Amsterdam 2014, Publisher: Springer, ISBN: 9783642539824
This book provides an update on a wide variety of hot topics in the field of knee surgery, sports trauma and arthroscopy, covering the latest developments in basic science and clinical and surgical methods.
Dodds AL, Halewood C, Gupte CM, et al., 2014, The anterolateral ligament ANATOMY, LENGTH CHANGES AND ASSOCIATION WITH THE SEGOND FRACTURE, BONE & JOINT JOURNAL, Vol: 96B, Pages: 325-331, ISSN: 2049-4394
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- Citations: 272
Halewood C, Luyckx T, Claes S, et al., 2013, ACL Retaining Total Knee Arthroplasty can Improve Knee Stability, ESB 2013
Halewood C, Nawabi DH, Amis AA, 2012, Development of a novel test method for intra-articular fatigue and wear testing of meniscal reconstructions, 15th ESSKA Congress, Publisher: Springer, Pages: S237-S238, ISSN: 0942-2056
Miyatake S, Kondo E, Tsai T-Y, et al., 2011, Biomechanical Comparisons Between 4-Strand and Modified Larson 2-Strand Procedures for Reconstruction of the Posterolateral Corner of the Knee, AMERICAN JOURNAL OF SPORTS MEDICINE, Vol: 39, Pages: 1462-1469, ISSN: 0363-5465
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- Citations: 23
Halewood C, Hirschmann MT, Newman S, et al., 2011, The fixation strength of a novel ACL soft-tissue graft fixation device compared with conventional interference screws: a biomechanical study in vitro, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 19, Pages: 559-567, ISSN: 0942-2056
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- Citations: 27
Castoldi F, Bonasia DE, Blonna D, et al., 2010, The stability of percutaneous fixation of proximal humeral fractures., Journal of Bone and Joint Surgery-American Volume, Vol: 92, Pages: 90-97
Miyatake S, Kondo E, Tsai T, et al., 2010, Biomechanical comparisons between 4-strand anatomic and modified Larson’s procedures for posterolateral corner reconstruction, 14th ESSKA Conference
Miyatake S, Kondo E, Tsai T, et al., 2010, Biomechanical Comparisons Between 4-Strand Anatomic and Modified Larson’s Procedures for Posterolateral Corner Reconstruction, 56th Annual Meeting of the Orthopaedic Research Society
Halewood C, Zakaria T, Amis A, 2009, ASTM Assessment Methods for Total Knee Replacements, IMechE. Knee Arthroplasty: From Early Intervention to Revision.
Halewood C, Zakaria T, Amis A, 2009, Measuring Constraint of Total Knee Replacements, 55th Annual Meeting of the Orthopaedic Research Society
Halewood C, 2008, Evaluation of polo helmets using the ENHAP testing and assessment protocols, PPR343, Wokingham, United Kingdom, Publisher: TRL
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