
William Or Bill RibbansUniversity of Northampton | UN · School of Health
William Or Bill Ribbans
BSc, MB, BS, MChOrth, PhD, FRCS, FRCS(Tr and Orth), FFSEM(UK)
About
163
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January 1991 - December 1995
January 1996 - March 2012
April 2005 - present
Publications
Publications (163)
Background: Concussion is the most common neurological disorder affecting millions of people globally each year. Identifying epigenetic mechanisms influencing concussion incidence, severity and recovery could provide diagnostic and prognostic insight into this injury. Objectives: This systematic review aims to identify the epigenetic mechanisms und...
The book analyses the way Covid-19 brought global sport to its knees. It charts sport’s response to lockdowns, recovery planning, the obstacles faced and the modifications required to re-emerge.
The pandemic reminded us of the importance of sport in our national life. The response of society to its triumphs, trials and transgressions informed us o...
Injuries to the spring ligament can produce pain, instability and ultimately deformity. They can occur as isolated injuries but more commonly as part of a pathological complex leading to adult acquired flatfoot deformity (AAFD). This chapter examines the anatomy, biomechanics, clinical features and imaging of this static medial foot restraint. Ther...
Despite several established benefits of Whole Body Cryotherapy (WBC) for post-exercise recovery, there is a scarcity of research which has identified the optimum WBC protocol for this purpose. This study investigated the influence of WBC treatment timing on physiological and functional responses following a downhill running bout. An additional purp...
A significant proportion of patients requiring musculoskeletal management present with tendon and ligament pathology. Our understanding of the intrinsic and extrinsic mechanisms that lead to such disabilities is increasing. However, the complexity underpinning these interactive multifactorial elements is still not fully characterised. Evidence high...
Despite its potential merit in sport and exercise recovery, the implications of repetitive Whole Body Cryotherapy (WBC) during training programmes require further review due to the possibility of repetitive cold interfering with long term adaptations. This study investigated the impact of two weekly 3 min WBC sessions (30 s at −60 • C, 150 s at −12...
Approximately 1% of anterior cruciate ligament reconstruction (ACLR) procedures develop septic arthritis despite intravenous antibiotic prophylaxis and other preventive measures. Infection is most commonly due to contamination during autograft harvest and preparation introducing bacteria into the knee during graft insertion. Pre-soaking anterior cr...
Despite several established benefits of Whole Body
Cryotherapy (WBC) for post-exercise recovery, there is
a scarcity of research which has identified the optimum
WBC protocol for this purpose. This study investigated the
influence of WBC treatment timing on responses following
a bout of downhill running, an eccentrically biased muscle
damagin...
Background:
Hand trauma is a frequent and disabling injury in cricket. However, there is limited published data on its impact on the sport at the elite level.
Objectives:
This study investigated the incidence and mechanism of hand injuries in professional cricket over a decade and the impact of these injuries upon player availability.
Methods:...
This study explored the effects of age and body fat content on responses to whole body cryotherapy (WBC) following a downhill running bout. Forty-one male participants (mean ± SD age 42.0 ± 13.7 years, body mass 75.2 ± 10.8 kg) were allocated into WBC (n = 26) and control (CON, n = 15) groups. WBC participants were divided into old (OLD, ≥45 years,...
Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of 'bioavailable' vitamin to the cells. Vitamin D should be regarded as a hormone and influences b...
A semi-autobiographical, semi-commentary book of the author's 40 years experience of looking after sports people from Olympic champions to weekend joggers.
Studies have reported the association of the COL1A1 Sp1 binding site variant (rs1800012) with the risk of acute musculoskeletal soft tissue injuries. An interaction with the COL1A1 promoter variant (rs1107946) has also been proposed to modulate acute injury risk. Conversely, neither of these loci have been associated with chronic musculoskeletal so...
Objectives:
The aim of this case control genetic association study was to explore whether two variants within the inducible nitric oxide synthase (iNOS) gene, rs2779249 (C/A) and rs2248814 (A/G), influenced the risk of Achilles tendinopathy in a British population.
Design:
Candidate gene, case control association study.
Method:
We recruited 14...
Background:
Vitamin D deficiency is a worldwide health concern. Hypovitaminosis D may adversely affect recovery from bone injury. The authors aimed to perform an audit of the Vitamin D status of patients in three centres in the United Kingdom presenting with foot and ankle osseous damage.
Methods:
Serum 25-hydroxyvitamin-D (vitamin D) levels wer...
Review article on the use of Cryotherapy for recovery from exercise
Background:
Vitamin D deficiency is a global concern impacting upon large communities and certain disease populations. It can adversely affect the outcome of orthopaedic operations. We aimed to perform an audit of the Vitamin D status of patients in two centres in the United Kingdom undergoing elective foot and ankle surgery.
Methods:
Serum 25-h...
Lesson
The first case of bilateral distal tibiofibular joint fusions for osteochondromas is reported with excellent long-term outcomes.
Minimally invasive and percutaneous Achilles tendon repair technique allows direct visualization of end-to-end apposition of the ruptured tendon ends whilst minimizing risks of wound breakdown and infection and improving cosmesis. Although they have these advantages, traditional percutaneous repair techniques have been estimated to have half the st...
Background
FTO gene variants have been associated with obesity phenotypes in sedentary and obese populations, but rarely with skeletal muscle and elite athlete phenotypes.
Methods
In 1089 participants, comprising 530 elite rugby athletes and 559 non-athletes, DNA was collected and genotyped for the FTO rs9939609 variant using real-time PCR. In a s...
Sport and Exercise Medicine is one of the important subspecialties of 21st century healthcare contributing to improving the physical function, health, and vitality of populations while reducing the prevalence of lifestyle-related diseases. Moreover, sport and exercise are associated with injuries such as Achilles tendinopathy, which is a common ten...
Several genetic loci have been associated with risk of Achilles tendon pathology (ATP) within South African and Australian populations. The aim of this study was, therefore, to evaluate eight previously implicated genetic variants in an independent British population. A total of 130 asymptomatic controls (CON) and 112 participants clinically diagno...
We aimed to quantify the ACE I/D and ACTN3 R577X (rs1815739) genetic variants in elite rugby athletes (rugby union and league), compare genotype frequencies to controls and between playing positions. The rugby athlete cohort consisted of 507 Caucasian men, including 431 rugby union athletes that for some analyses were divided into backs and forward...
Variants within the MMP3 (rs679620) and TIMP2 (rs4789932) genes have been associated with the risk of Achilles tendon pathology (ATP) in populations from South Africa and Australia. This study aimed to determine whether these variants were associated with the risk of ATP in British Caucasians. We recruited 118 cases with ATP, including a subset of...
This article describes the augmentation of a Brostrom anatomic repair for ankle lateral ligament instability by the use of the internal brace. The paper describes the role of the internal brace in allowing the natural tissues to progressively strengthen while encouraging early rehabilitation. The surgical technique is outlined and the early clinica...
Legal problems with foot and ankle surgery
Achilles tendon pathology (ATP) is a degenerative condition which exhibits excessive tenocyte apoptosis. Tumour necrosis factor receptor 1 (TNFR1), caspase-3 (CASP3) and caspase-8 (CASP8) are important regulators of apoptosis. To date, the effect of variation within the genes for TNFR1 and CASP3 as risk factors for ATP have not been described. Ther...
Background: Within sport, mitigation of risk of injury through the use of comprehensive specialist sports medicine provision is commonplace. Dance participation, through its athletic nature can also introduce risk of injury, but unlike sport, is not always recognised that specialist medicinal provision will assist in the mitigation of that risk.
Ob...
A literature review has been undertaken to assess the efficacy of management of Posterior Ankle Impingement Syndrome with an emphasis on sport. The evidence is confined to Level IV and V studies. There is a lack of prospective studies on the natural history of this condition and the outcomes of conservative treatment. Dance dominates the literature...
Background Achilles tendon pathologies (ATPs) such as Achilles tendinopathy and Achilles tendon ruptures have been identified as debilitating conditions resulting from either acute or repetitive overuse loading mechanisms. ATP is a multifactorial condition for which several genetic risk factors have been identified. Notably, the COL5A1 rs12722 gene...
Introduction Achilles tendon pathology (ATP) encompasses a range of tendon overuse injuries that can be sub-classified into separate pathologies [Weinfeld, 2014]. To date, a number of single nucleotide polymorphisms (SNPs) have been associated with ATP [Raleigh and Collins, 2012] but, with the exception of the COL5A1 rs12722 variant, limited work h...
According to consensus definitions for football surveillance, injury severity is classified from 'slight' to 'career ending', based on number of days absence from participation.
To examine whether different definitions of return to participation (RTP), and playing in matches while injured, affect groupings of injury severity in professional footbal...
Football surveillance classifications
This study aimed to analyze the frequency, nature, and consequences of footballers playing matches while injured, and to examine the impact on injury surveillance findings. High levels of inter-rater reliability and content validity were established for a tool designed to document players who were already injured at the start of a match. The tool w...
The tibialis posterior tendon and the spring and deltoid ligament complexes combine to provide dynamic and passive stabilization on the medial side of the ankle and hindfoot. Some of the injuries will involve acute injury to previous healthy structures, but many will develop insidiously. The clinician must be aware of new treatment strategies and t...
A number of psychological and sociocultural factors have been suggested to influence athletes’ willingness to play despite being injured. Investigation of this phenomenon is undertaken optimally at the time when athletes are injured; however, many studies have relied upon retrospective recall of feelings in individuals following recovery. This stud...
The incidence of acute and chronic conditions of the tendo Achillis appear to be increasing. Causation is multifactorial but the role of inherited genetic elements and the influence of environmental factors altering gene expression are increasingly being recognised. Certain individuals’ tendons carry specific variations of genetic sequence that may...
Objective:
To analyse athletes' medical information disclosed by English newspapers.
Methods:
Ten daily national newspapers, nine Sunday newspapers and one local newspaper were studied during March 2010 for media releases relating to the medical conditions of athletes.
Results:
Three hundred and thirty-three newspapers were reviewed revealing...
The Accessory Postero-Lateral (AccPL) portal has recently been described to improve the visualisation for the endoscopic debridement of Haglund's tubercle. The safety of using this portal has been considered previously for posterior ankle arthroscopy. We performed a study to determine the proximity of the AccPL portal to the sural nerve.
We compare...
Achilles tendon pathology (ATP) is a multifactorial condition for which genetic risk factors have been identified. The type V collagen gene (COL5A1), among other genes, has been associated with risk of ATP in two independent populations. The ADAMTS (A Disintegrin And Metalloproteinase with Thrombospondin Motifs) enzymes are important regulators of...
Background
Anterior cruciate ligament (ACL) rupture is a complex disorder for which several risk factors, including genetic factors, have been established.
Objective
As matrix metalloproteinases (MMPs) are critical to ligament homeostasis and integrity, the primary aim of this study was to investigate if four selected polymorphisms within four MMP...
Posterior ankle impingement syndrome is the term attributed to the clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. In this review article, we discuss the anatomy, aetiology, clinical and radiological features of posterior ankle impingement syndrome and consider the conservative and surgical management...
Achilles tendon pathology is a multifactorial condition for which various risk factors, including genetic factors, have been identified. Gene transfection of two members of the TGF-β family, TGF-β1 and growth/differentiation factor-5 (GDF-5), have been shown to enhance tendon repair and mechanical strength within animal Achilles tendon injury model...
A recent heritability study has demonstrated that human range of motion (ROM) has a substantial genetic component. Furthermore, the COL5A1BstUI RFLP has now been identified as the first gene variant to be associated with human ROM. Interestingly, this variant is known to interact with a functional variant within the MMP3 gene (rs679620) to increase...
This article reviews the musculoskeletal problems of dancers. An over-view of the benefits of dance is given and background problems increasing injury risk explained. The article follows dancers from infancy to retirement through the 'five orthopaedic ages of a dancer' and highlights some of the orthopaedic problems commonly encountered at each age...
To compare versions 8 and 10 of the Orchard Sports Injury Classification System (OSICS) to determine whether the revised version of OSICS has improved its use in a sports medicine setting, and to assess the inter-rater reliability of OSICS-10.
Injury surveillance data, gathered over a 2 year period in professional football, cricket and rugby union...
Hallux rigidus (HR) is a common condition with history and physical examination used to help evaluate pathology, grade clinical changes and to inform treatment.
A cross-sectional study was undertaken to evaluate the demographics of and clinical parameters encountered in HR. In 110 subjects (180 feet) aged 18-70 years (mean 52 years) a standardized...
Hallux rigidus (HR) is a common condition with X-rays used to evaluate its pathology, grade joint changes and to inform treatment.
A cross-sectional study was undertaken to evaluate radiological foot parameters in HR. In 110 subjects (180 feet) aged 18-70 years (mean 52 years) standard weight-bearing X-rays were examined using dorsal plantar and la...
Sequence variation within the COL5A1 and TNC genes are known to associate with Achilles tendinopathy. The primary aim of this case-control genetic association study was to investigate whether variants within the matrix metalloproteinase 3 (MMP3) gene also contributed to both Achilles tendinopathy and Achilles tendon rupture in a Caucasian populatio...
The first comprehensive report on the interprofessional relationships between foot and ankle surgeons in the UK is presented.
A questionnaire was sent to orthopaedic surgeons with membership of the British Foot and Ankle Surgery Society (BOFAS), orthopaedic surgeons not affiliated to the specialist BOFAS and podiatrists specialising in foot surgery...
Hallux rigidus (HR) is one of the most common causes of forefoot pain. A number of classification systems have been developed to evaluate HR. These systems are based on either radiological parameters alone or a combination of radiological and clinical features. The purpose of this paper is to critically evaluate HR classification systems by underta...
Background:
Hallux rigidus (HR) is one of the most common causes of forefoot pain. A number of classification systems have been developed to evaluate HR. These systems are based on either radiological parameters alone or a combination of radiological and clinical features. The purpose of this paper is to critically evaluate HR classification syste...
We report an 86-year-old female who sustained a closed, type III intra-articular calcaneal fracture in combination with talonavicular subluxation. This is a rare injury. This case is unusual with respect to the advanced age of the patient, the absence of proximal injuries and associated moderate energy impact. This is the only reported case to have...
An investigation of clinical indicators of Hallux Rigidus
The coding polymorphism (rs1130866) within the surfactant protein B gene is known to associate with certain respiratory abnormalities. We investigated, using spirometry and fluorescence-based PCR, whether this variant influenced pulmonary function in healthy, nonsmoking men. We found no association of pulmonary function with genotype at the rs11308...
Twenty-four patients (33 feet) underwent metatarsophalangeal joint arthrodesis using a vitallium plate with an additional oblique screw. The mean age was 55 years (range, 37–68) with a mean follow up of 28 months (range, 16–45). Patients were evaluated using the American Foot and Ankle Society clinical and radiographic guidelines. Twenty-three pati...
Fractures of the foot in children usually have a good prognosis and generally are treated nonoperatively. Displaced fractures of the talus and calcaneus and tarsometatarsal dislocations are rare in children and their outcome is generally good in the younger child. Older adolescents with these injuries need treatment similar to how an adult would be...
To illustrate the types of injuries seen by the accident and emergency department as a result of the use of non-motorized 'microscooters' in children, and to increase awareness of scooter-related triplane fractures of the ankle.
A retrospective study conducted in an accident and emergency department of a district general hospital on all children wh...
This audit was set up to quantify the effect of implementing the Ottawa ankle rules in a district general hospital that relies on both medical and nursing radiography requests. Data were collected prospectively on 207 patients who presented with an acute ankle injury between August 2001 and February 2002. The department's activity was recorded befo...