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OBJECTIVES Septic arthritis of native hip joints is an uncommon condition in adults in Western Europe, but continues to present a challenge to medical and surgical management. We set out to study the natural history and bacteriology of the disease in this group, with a particular focus on patients requiring excision arthroplasty (EA). METHODS We(More)
If a patient asks 'why does my shoulder hurt?' the conversation will quickly turn to scientific theory and sometimes unsubstantiated conjecture. Frequently, the clinician becomes aware of the limits of the scientific basis of their explanation, demonstrating the incompleteness of our understanding of the nature of shoulder pain. This review takes a(More)
The regulatory mechanisms involved in tendon homeostasis and repair are not fully understood. Accumulating data, however, demonstrate that the nervous system, in addition to afferent (sensory) functions, through efferent pathways plays an active role in regulating pain, inflammation, and tissue repair. In normal-, healing- and tendinopathic tendons three(More)
INTRODUCTION The pathogenesis of rotator cuff disease (RCD) is complex and not fully understood. This systematic review set out to summarise the histological and molecular changes that occur throughout the spectrum of RCD. METHODS We conducted a systematic review of the scientific literature with specific inclusion and exclusion criteria. RESULTS A(More)
BACKGROUND Glucocorticoid injection (GCI) and surgical rotator cuff repair are two widely used treatments for rotator cuff tendinopathy. Little is known about the way in which medical and surgical treatments affect the human rotator cuff tendon in vivo. We assessed the histological and immunohistochemical effects of these common treatments on the rotator(More)
I read the studies by Albert et al. [1, 2] with great interest. Of note both studies were published in 2013 and both clearly state ‘no competing interests’. The MAST (Modic Antibiotic Spine Therapy) Medical (http://www.mastmedical.com) website demonstrates that three of the study’s authors are members of the ‘MAST Academy’. Of note MAST Medical accepts(More)
I read the study by Albert et al. [1] with great interest and the authors must be commended for their excellent piece of work. I do, however, feel there is a danger in applying these results to all patients with chronic low back pain and vertebral bone oedema (Modic type 1 changes). The reason for this is that around 50 % of the study patients had had(More)
OBJECTIVE To investigate whether placebo controls should be used in the evaluation of surgical interventions. DESIGN Systematic review. DATA SOURCES We searched Medline, Embase, and the Cochrane Controlled Trials Register from their inception to November 2013. STUDY SELECTION Randomised clinical trials comparing any surgical intervention with placebo.(More)
OBJECTIVES An online workplace-based assessment tool, the Intercollegiate Surgical Curriculum Programme (ISCP), has become mandatory for all British surgical trainees appointed since August 2007. A compulsory pound125 annual trainee fee has also been introduced to fund its running costs. The study sought to evaluate user satisfaction with the ISCP. DESIGN(More)
Improved understanding of the role of inflammation in tendon disease is required to facilitate therapeutic target discovery. We studied supraspinatus tendons from patients experiencing pain before and after surgical subacromial decompression treatment. Tendons were classified as having early, intermediate, or advanced disease, and inflammation was(More)