C J Bulstrode's research while affiliated with Oxford University Hospitals NHS Trust and other places

Publications (28)

Article
A randomized trial designed to compare interferential therapy with motorized lumbar traction and massage management for low back pain in a primary care setting. To measure and compare the outcome of interferential therapy and management by motorized lumbar traction and massage. Management of low back pain by interferential therapy and motorized lum...
Article
Undisplaced fractures of the hip can occasionally be difficult to diagnose on radiographs. We performed MRI scans on 33 patients who had post-traumatic painful hips but negative radiographs. Forty per cent of the patients had sustained a fractured neck of femur, 15 per cent had sustained an intertrochanteric fracture and 11 per cent had sustained o...
Article
Full-text available
We have assessed the relative value of various outcome measures after THR, by the analysis of follow-up data from over 2000 patients. They had been reviewed clinically and radiologically six months after operation, at one year, and then every two years, some for 16 years. At each review their pain level, stiffness and opinion of progress were score...
Article
We have assessed the relative value of various outcome measures after THR, by the analysis of follow-up data from over 2000 patients. They had been reviewed clinically and radiologically six months after operation, at one year, and then every two years, some for 16 years. At each review their pain level, stiffness and opinion of progress were score...
Article
Full-text available
We reviewed the records of the long-term outcome of 208 Charnley and 982 Stanmore total hip replacements (THR) performed by or under the supervision of one surgeon from 1973 to 1987. The Stanmore implant had a better survival rate before revision at 14 years (86% to 79%, p = 0.004), but the difference only became apparent at ten years. The later St...
Article
Full-text available
We studied the migration of 58 cemented Hinek femoral components for total hip replacement,using roentgen stereophotogrammetric analysis over four years. The implants migrated faster during the first year than subsequently, and the pattern of migration in the second period was very different. During the first year they subsided, tilted into varus a...
Article
There are many conflicting actiological theories for adolescent idiopathic scoliosis. We present a simple new model of scoliosis and a mechanism by which it is initiated and progresses. This mechanism provides a final common pathway for the multiple aetiological factors. A simple model of the spine, incorporating its fundamental mechanical features...
Article
We studied the migration of 58 cemented Hinek femoral components for total hip replacement, using roentgen stereophotogrammetric analysis over four years. The implants migrated faster during the first year than subsequently, and the pattern of migration in the second period was very different. During the first year they subsided, tilted into varus...
Article
Full-text available
To assist surgeons to select a total hip replacement (THR) we present comparative information on all such implants on the market in the UK. We identified 62 different primary THRs, manufactured by 19 companies; half had been introduced in the last five years, and only 30% have any results published in peer-reviewed journals. The prices range from 2...
Article
To assist surgeons to select a total hip replacement (THR) we present comparative information on all such implants on the market in the UK. We identified 62 different primary THRs, manufactured by 19 companies; half had been introduced in the last five years, and only 30% have any results published in peer-reviewed journals. The prices range from 2...
Article
Over the past few years there have been enormous changes in orthopaedic and trauma surgery, but whether they are also advances is not known. Like every other clinical specialty this one desperately lacks the tools, the will, and the resources to assess whether each change is an advance or merely another passing fashion.In this article I will review...
Article
We have used linked hospital morbidity statistics to construct a basic profile of the demographic and epidemiological features of trauma and orthopaedic surgery in a defined population. This paper reports on this profile and illustrates trends in the specialty between 1976-86. During this period episode-based inpatient admission rates rose by about...
Article
A new Roentgen stereophotogrammetric analysis system, using a biplane technique, has been developed to determine the migration and rotation of total hip replacement (THR) femoral components in three dimensions. Stainless steel marker balls were injected into the femur during the operation. The patients stood within a calibration frame during the X-...
Article
Almost all doctors encounter difficulties in managing some patients. Previous studies have examined the characteristics of such patients: we have additionally studied the reasons why hospital doctors find these patients 'difficult to help'. Three clinics (two medical and one surgical) were studied. The consultants rated 60 (22%) of 293 attenders s...
Article
EDITOR, - The Antiplatelet Trialists' Collaboration has carried out an important meta-analysis of antiplatelet prophylaxis used to reduce venous thrombosis and pulmonary embolism.1 The results section of the abstract of the paper states: “Information on adding antiplatelet therapy to heparin was limited but, at least for pulmonary embolism, suggest...
Article
Full-text available
Survival analysis is a powerful tool for analysing the results of total joint replacement, but it has major drawbacks when the failure rates are very low. We have reviewed 35 recent survival analyses of joint replacements to assess the magnitude of these problems and make recommendations as to how they may be avoided.
Article
Survival analysis is a powerful tool for analysing the results of total joint replacement, but it has major drawbacks when the failure rates are very low. We have reviewed 35 recent survival analyses of joint replacements to assess the magnitude of these problems and make recommendations as to how they may be avoided.
Article
Full-text available
To report the incidence of elective total hip replacement and postoperative mortality, emergency readmission rates, and the demographic factors associated with these rates in a large defined population. Analysis of linked, routine abstracts of hospital inpatient records and death certificates. 10 hospitals in six districts in Oxford Regional Health...
Article
As part of an audit of clinical practice in an orthopaedic unit for elective surgery, a study was made of the causes of cancellation of operations. Despite careful liaison with general practitioners, and a booked admission policy, over 6% of patients were cancelled as unsuitable. The results of this study suggest that the number of cancellations on...
Article
We have reviewed 368 osteotomies carried out for osteoarthritis of the hip at the Nuffield Orthopaedic Centre. Survivorship analysis showed that 10 years after osteotomy 47% had required no further surgery, and even after 20 years 23% had still not had a hip replacement. Hips with moderate arthritic change showed significantly better results than t...
Article
Anatomical study: The common pathway to failure in total hip replacements is loosening of the acetabular and femoral components. The reliable diagnosis of this loosening is difficult. A non-invasive technique has been developed which analyses a vibration signal transmitted through the femur. This can distinguish between a femoral component which is...

Citations

... From a patient's perspective, implant survival may not be the best measure of surgery success. Instead, pain reduction, functional improvement and quality of life are important [1][2][3][4]. With this shift towards a more patient-centered perspective in health care, there is an increase in the use of Patient-Reported Outcome Measurements (PROMs) [5]. ...
... Encouraging results have recently been reported for uncemented titanium and cobalt chromium stems. However, there are few studies with long-term follow-up and the majority have analysed several models of uncemented stems due to their modifications over the years [3,8,10,17,18]. The improved stem design has greatly influenced the survival of the cementless prostheses. This is why unsatisfactory results have been reported with the first models of cementless prostheses. ...
... Life tables were produced with numbers of implants entering each year and yearly revisions and deaths, to give annual and cumulative survival rates (Table I). 13 Kaplan-Meier survival curves were then produced for both implants and patients ( Figure 1). ...
... Some papers (Kiss et al. 1995, 1996, Alfaro-Adrian et al. 1999, 2001, Catani et al. 2005) have included diagrams of a hip stem as viewed from different directions, and a resultant translation vector has been drawn at each of the measurement landmarks. The direction of the resultant has been determined from the mean (or median: Catani et al. 2005) displacement vector component in each of 2 axis directions. ...
... Patients undergoing TKA are at high risk of VTE if they do not receive anticoagulation as it is considered as the third most frequent cause for hospital readmission after TKA. 20 There is considerable debate regarding the appropriate post-operative prophylactic agent for patients undergoing primary TKA, 21-23 with many surgeons making decisions based on anecdotal evidence and historical precedent. As VTE is an uncommon event with reported rates of symptomatic VTEs within 90 days of TKA at less than 2%, 24,25 and the mortality rates from VTE following lower limb arthroplasty low (less than 1%), [25][26][27][28] it is difficult to acquire sufficient statistical power to discern differences between agents. ...
... All of the patients had poor superior and anterior coverage of femoral head, anterosupero-lateral localised pressure, spherical femoral head and mild or moderate (one patient) loss of joint space. Femoral osteotomy for osteoarthritis of the hip has been carried out since the 1920-1930s [2,24]. Between 1970 and 1980 total hip replacement was the first choice of many surgeons, and femoral osteotomy was partially abandoned. ...
... The output waveform of a well-fixed implant will match the sinusoidal nature of the input excitation and frequency analysis will reveal one major frequency. Conversely a loose implant will have a distorted output waveform and multiple harmonics will be present [32]. ...
... RSA studies are therefore only the first step, after preclinical testing, in the phased introduction as proposed by both Faro and Huiskes and Malchau (Faro and Huiskes 1992, Malchau 1995, 2000). Several authors have pleaded for a phased evidence-based market introduction of new prostheses comparable to the introduction of new drugs to the consumer market (Murray et al. 1995, Liow and Murray 1997, Muirhead-Allwood 1998, Malchau 2000). During phase A, multiple single-center RSA studies should be performed to determine the safety of the THA regarding the risk of revision for aseptic loosening and wear. ...
... The second is the Tranexamic Acid Mechanisms and Pharmacokinetics in Traumatic Injury (TAMPITI) trial from Washington University in Saint Louis, which will analyze coagulation and proinflammatory markers for those patients given TXA in trauma [12]. The last is the recently NIH-registered study of TXA in acute orthopedic fractures from the University of Tennessee [13]. Since early 2013, these RCT studies have been done to clarify the irregularities surrounding TXA use and to bridge the "knowledge gaps" that originated from the CRASH-2 trial. ...
... • Elimination of allocation bias via randomisation is the sine qua non of the 'gold standard' version of the experiment, yet the problems emerging from decay and degradation of randomised samples persist even in medicine, as members of active and control groups behave differently (see Britton et al., 1995;Wood et al., 2004;Verv€ olgyi, 2011). These problems are inevitably exaggerated in social research, given the agency of the actors. ...