Publications
76 results found
Blake PL, Ali E, Reilly P, et al., 2012, To Sleep, Perchance to Dream: Ay, There's the Rub, Shoulder and Elbow, Vol: 4, Pages: 153-157, ISSN: 1758-5732
Sleep is a complex physiological process essential to sustain life. Very little is known about why we sleep, although evidence of the harmful effects of sleep disturbance to our health is rapidly emerging. Sleep disturbance is a distinct and debilitating symptom of shoulder pathology. The important relationship between sleep and pain is only beginning to be appreciated, and the physiological process underlying this feature in shoulder pain remains elusive. A number of theories have been explored; however, there is still no adequate solution to address this important symptom in painful conditions of the shoulder.
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
Analysis of the function of glenohumeral ligaments (GHLs) during physical joint manipulations is hindered by an inability to adequately image these tissues during the movements. This restricts functional biomechanics studies only to the manoeuvres that may be replicated cadaverically. There is, however, a clinical imperative to be able to investigate complex manoeuvres that exacerbate symptoms but cannot be easily conducted physically in the laboratory. The aim of this study was to develop and validate an algorithm for a computer simulation model that allows the quantification of glenohumeral ligament lengths during function. Datasets of the humerus and scapula pair were segmented to provide individual surface meshes of the bones and insertion points of each glenohumeral ligament on both bones. An algorithm was developed in which the glenohumeral ligament attachment-to-attachment length was divided into two straight lines, plus an arc overlaying the spherical wrapping portions. The model was validated by simulating two classical cadaveric studies from the literature and comparing results. Predictions from the model were qualitatively similar to the results of the two cadaveric studies by a factor of 91.7% and 81.8%, respectively. Algorithm application will allow investigation of functional loading of the glenohumeral ligaments during simulated complex motions. This could then be used to provide diagnostic understanding and thus, inform surgical reconstruction.
Thompson SM, Reilly P, Emery RJH, et 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
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- Citations: 9
Amadi HO, Fogg QA, Ugbolue UC, et 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
Functional biomechanics studies of the glenohumeral (GH) soft tissues require an understanding of their sites of bony attachment. Anatomical positions of GH capsular structures have often been quantified relative to the rims of the glenoid and humeral head (HH). The aim of this study was twofold: (1) to quantify the reliability of a set of protractors that directly fit on to the glenoid and HH rims and (2) to use this to determine direct angular position referencing of landmarks and soft tissue attachment points. Three assessors independently used the protractors to assess nine prescribed landmarks on 30 dry bone specimens (15 glenoids and 15 HHs) recording the angular positions of the structures relative to the glenoid and HH. The collected data showed high levels of validity as indicated by the protractor’s intra‐ and inter‐assessor reliabilities: 98.2 and 98.7% for the glenoid component, and 96.2 and 96.5% for the humeral component, respectively. The device could be useful in anatomical studies, description of defects and pathologies on glenohumeral articulation, and planning of scapular reconstructive surgery.
Baring TKA, Cashman PPM, Reilly P, et 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
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- Citations: 24
Majed A, Macleod I, Bull AMJ, et al., 2011, Proximal humeral fracture classification systems revisited, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 20, Pages: 1125-1132, ISSN: 1058-2746
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- Citations: 76
Thompson SM, Reilly P, Emery RJ, et 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
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- Citations: 13
Nanidis TG, Majed A, Liddle AD, et al., 2010, Conservative versus Operative Management of Complex Proximal Humeral Fractures: A Meta-analysis, Shoulder and Elbow, Vol: 2, Pages: 166-174, ISSN: 1758-5732
Background: The optimal management of complex proximal humeral fractures is debatable. The present study uses meta-analytical techniques to compare conservative and operative management of proximal humeral fractures with respect to morbidity and functional outcomes. Methods: Studies published between 1970 and 2007 comparing conservative and operative treatment of proximal humeral fractures were included. The end points evaluated were morbidity and functional outcomes. A random effects model was used and sensitivity analysis was performed to account for bias in patient selection. Results: Ten studies matched the selection criteria, reporting on 486 patients. Two hundred and nineteen (45%) were managed conservatively, 174 (36%) underwent operative fixation and 93 (19%) underwent hemiarthroplasty. Mean follow-up ranged from 6 months to 156 months. No significant difference was demonstrated in post-treatment Constant scores (weighted mean difference = 1.62, –7.12, 10.36), rate of avascular necrosis [odds ratio (OR) = 0.92, confidence interval (CI) = 0.37–2.30] ongoing pain or non-union (OR = 1.28, CI = 0.11–15.46) between the groups. These findings remained consistent when considering studies matched for three- and four-part fractures and fracture dislocations. Conclusion: On the basis of available comparative data, there is no demonstrable difference in outcomes between fractures managed surgically or conservatively. There is a need for large, randomised trials to guide management of these fractures.
Cashman PMM, Baring T, Reilly P, et 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.
Junaid S, Gupta S, Sanghavi S, et al., 2010, Failure mechanism of the all-polyethylene glenoid implant, JOURNAL OF BIOMECHANICS, Vol: 43, Pages: 714-719, ISSN: 0021-9290
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- Citations: 30
Gregory T, Hansen U, Taillieu F, et al., 2009, Glenoid Loosening after Total Shoulder Arthroplasty: An In Vitro CT-Scan Study, JOURNAL OF ORTHOPAEDIC RESEARCH, Vol: 27, Pages: 1589-1595, ISSN: 0736-0266
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- Citations: 33
Amadi HO, Majed A, Emery RJH, et 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
Hopkins AR, Hansen UN, Bull AM, et al., 2008, Fixation of the reversed shoulder prosthesis, J Shoulder and Elbow Surgery, 2008
Leong JJH, Leff DR, Das A, et 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
Brassart N, Sanghavi S, Hansen UN, et 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
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- Citations: 5
Clarkin CE, Emery RJ, Pitsillides AA, et 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
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- Citations: 119
Leong JJH, Atallah L, Mylonas GP, et 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
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- Citations: 4
Leong JJH, Nicolaou M, Emery RJ, et al., 2007, Visual search behaviour in skeletal radiographs: a cross-speciality study, CLINICAL RADIOLOGY, Vol: 62, Pages: 1069-1077, ISSN: 0009-9260
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- Citations: 32
Baring T, Emery R, Reilly P, 2007, Management of rotator cuff disease: specific treatment for specific disorders., Best Pract Res Clin Rheumatol, Vol: 21, Pages: 279-294, ISSN: 1521-6942
Disease of the rotator cuff is common. It is responsible for a high proportion of patients with shoulder pain presenting to general practice, causing work absenteeism and claims for sickness benefits. Rotator cuff disease (RCD) can often be managed in primary health care services, although some cases may require secondary referral. Both extrinsic and intrinsic factors to the cuff tendon are thought to be involved in the pathogenesis leading on to a spectrum of conditions ranging from sub-acromial bursitis to mechanical failure of the cuff tendon itself. Careful history and examination followed by pertinent investigation are essential to establish the correct diagnosis. The main aim of treatment is to improve symptoms and restore function of the affected shoulder. The majority of patients suffering from RCD can be managed by conservative means, but a shift in attitude has led to a significant number benefiting from invasive procedures ranging from decompression of the sub-acromial space to large, open procedures reconstructing the tendon itself.
Bethune R, Bull AMJ, Dickinson RJ, et 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
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- Citations: 8
Gregory T, Hansen U, Emery RJ, et 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
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- Citations: 19
Hopkins AR, Hansen UN, Amis AA, et al., 2007, Glenohumeral kinematics following total shoulder arthroplasty: A finite element investigation, JOURNAL OF ORTHOPAEDIC RESEARCH, Vol: 25, Pages: 108-115, ISSN: 0736-0266
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- Citations: 24
Reilly P, Macleod I, Macfarlane R, et 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.
Bull AMJ, Reilly P, Wallace AL, et 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
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- Citations: 18
Hopkins AR, Hansen UN, Amis AA, et al., 2004, The effects of glenoid component alignment variations on cement mantle stresses in total shoulder arthroplasty, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 13, Pages: 668-675, ISSN: 1058-2746
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- Citations: 103
Reilly P, Bull AMJ, Amis AA, et 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
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- Citations: 41
Reilly P, Amis AA, Wallace AL, et 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
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- Citations: 63
Reilly P, Bull AMJ, Amis AA, et al., 2003, Arthroscopically insertable force probes in the rotator cuff in vivo., Arthroscopy, Vol: 19
In vivo loading data for the rotator cuff would be of value to scientists and clinicians interested in the shoulder. The Arthroscopically Insertable Force Probe (AIFP; Microstrain, Burlington, VT) offers a potential method for collecting this information. A technique for insertion and retrieval of the AIFP from the subscapularis is described. The method was initially established in a cadaveric model. The AIFP was inserted into the subscapularis tendon in 3 volunteers during diagnostic shoulder arthroscopy. After the motor effects of interscalene block had worn off, dynamic data relating to subscapularis tendon loading was collected. The AIFPs were removed through a port site by traction on a 0 (3.5 metric) nylon suture without complications.
Reilly P, Amis AA, Wallace AL, et al., 2003, Supraspinatus tears: Propagation and strain alteration, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 12, Pages: 134-138, ISSN: 1058-2746
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- Citations: 73
Chambler AFW, Bull AMJ, Reilly P, et al., 2003, Coracoacromial ligament tension in vivo, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 12, Pages: 365-367, ISSN: 1058-2746
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- Citations: 21
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