Chester Knee Clinic News 2013

CKC Research News

Updated on 20 October 2013

BioPoly™ RS Partial Resurfacing Knee Implant Clinical Trial

BioPoly™ is a next generation microcomposite orthopaedic biomaterial, combining Hyaluronic Acid (Bio) and ultra high molecular weight polyethylene (Poly). BioPoly Partal Resurfacing Implant is indicated for patients who present with a painful articular cartilage lesion of the femoral condyle and who is not a candidate for biological treatment (articular cartilage repair) or total joint replacement

We continue to recruit patients for this clinical trial based in Chester (please see a list of Inclusion and Exclusion Criteria). The first BioPoly implantation was done early in January 2012 by Mr Dinesh Nathwani at the London Clinic (for more information please see the article from The Telegraph). The first large BioPoly (the "racetrack", picture above) was implanted in April 2012 by Mr Mike McNicholas, at the Warrington Hospital.

Please be aware that we can not enter any potential candidates into the BioPoly clinical trial before they have been seen and examined in person at one of the sites by one of the investigators listed below. Email and telephone communications, however specific or detailed, are not sufficient for the assessment of suitability for this clinical trial.

Although the manufacturer of BioPoly implants will provide all implants free of charge for the duration of the clinical trial, your medical insurer or you will be responsible for all other costs (clinic appointments, imaging such as X-ray or MRI, the costs of the surgical procedure and hospital charges as well as perioperative physiotherapy). This does not apply if you enter the BioPoly clinical trial as an NHS patient (this option is available at Aintree Hospital Liverpool, the Imperial College London and RNOH Stanmore).

Participating Centres (in alphabetical order):

Aintree Hospital, Liverpool, contact: Mr Michael McNicholas, mike.mcnicholas@aintree.nhs.uk
Chester Knee Clinic at Chester Nuffield, contact: Mr Vladimir Bobic (principal investigator), office@kneeclinic.info
Royal National Orthopaedic Hospital, Stanmore, contact: Iva Hauptmannova, iva.hauptmannova@rnoh.nhs.uk
The London Clinic, contact: Mr Dinesh Nathwani, d.nathwani@precisionsurgery.co.uk

Further Information:

BioPoly general information: www.biolpolyortho.com
BioPoly Newsletter.
BioPoly video: http://youtu.be/MbzBSUz_82A
Clinical Trials (a service of the US NIH): ClinicalTrials.gov (clinical trial identifier: NCT01473199)
UKCTG - UK Clinical Trials Gateway (NHS National Institute for Health Research): BioPoly Registry Study

CKC Conference News

Updated on 28 November 2013

BioPoly RS Knee Registry Study Investigator Meeting

Ampersand Hotel, London, UK, 17 January 2013.

ConforMIS Symposium for Patient Specific PKR and TKR

Brooklands Hotel, Weybridge, Surrey, UK, 1 and 2 March 2013

8th Oswestry Cartilage Symposium

Institute of Orthopaedics, Oswestry, Shropshire, UK, 2 and 3 May 2013

Regenerative Medicine in Orthopaedics Forum

with Andrew McCaskie and James Richardson, Conference Centre, Oswestry, UK, 3 May 2013

Introductory Seminar on Autologous Stem Cell Therapies in Knee Orthopaedics

Nuffield Health, The Grosvenor Hospital Chester, UK, 27 June 2013. This introductory seminar will be run by Mr Vladimir Bobic. Guest speaker: Dr F V Scarrietta, Orthopaedic surgeon, Rome, Italy.

North of England Articular Cartilage Repair Symposium

Manchester, UK, 2 December 2013.

Stem Cells and Scaffolds: A New Frontier for Joint Regeneration. ICRS Focus Meeting 2013

Rizzoli Orthopaedic Institute, Bologna, Italy, 5 and 6 December 2013.

CKC Clinical News

Updated on 28 April 2013

Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards

Jeanne M. Farnan, MD, MHPE, et al.: Ann Intern Med. 2013;158(8):620-627.

Brief Summary of Recommendations on Email Communication and Established Patient-Doctor Relationships:

Reserve digital (e-mail) communication only for patients who maintain face-to-face follow up.
E-communication between patients and physicians with an existing relationship requires discussion and previous agreement before electronic exchange is initiated.
Guidelines* exist for interactions with patients via e-mail, including the appropriate type of information to share and the expectations about turnaround time.
The nature of e-mail communication ensures a written copy of the exchange, but patient confidentiality must be assured ...
Documentation of the patient's consent and awareness of the security and risks associated with the use of patient–physician e-mail should be included in the medical record.
Physicians should not use personal e-mail accounts for these communications but rather encrypted messages over secure network connections.
Physicians must maintain appropriate boundaries and recognize that electronic communication merely supplements face-to-face encounters.
Electronic communication with patients, if done in a systematic and thoughtful way, can improve patient care and outcomes.
It may also improve patient and physician satisfaction by increasing the actual or perceived time spent communicating and having questions answered.
As other Web tools begin to show promise, this communication is often not limited to standard e-mail. Physicians and patients should be discouraged from communicating on health matters through social media tools that are publicly viewable, do not ensure patient confidentiality, and are not readily recordable or admissible to the medical record.

* " Physicians who use e-mail should proceed carefully in responding to patient initiated emails and, preferably, should develop a clear policy regarding responding to such e-mails. An appropriate response might be a brief reply explaining that the physician cannot provide assistance through e-mail unless a proper patient-physician relationship is established through an in-person visit, therefore encouraging the patient to seek medical care through a personal encounter. However, a message that requests an appointment or information of a non-clinical nature, such as fees or hours, is considered administrative in nature and can be answered without ethical concern." Source: AMA CEJA Report 3-I-02: Ethical Guidelines for the Use of Electronic Mail between Patients and Physicians, 1 March 2013.

Recent Orthopaedic and Sport Injury News

Updated on 10 May 2013

Please follow @ChesterKnee on Twitter for most recent articles and news

Natural history of PCL injuries: Long-term results favorable with non-operative treatment

Shelbourne K. Paper #371. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.

Patients showed no arthritis or joint wear about 17 years after their PCL injuries were treated non-operatively, based on results of a study presented at the American Academy of Orthopaedic Surgeons Annual Meeting in Chicago.Shelbourne and colleagues treated 68 patients non-operatively after acute isolated PCL injury and prospectively followed them 17.6 years, average. Yearly, during the follow-up, the patients completed subjective surveys and underwent examinations to evaluate knee range of motion, effusion, quadriceps strength, PCL laxity. At the initial and follow-up time periods, the researchers found no significant differences in PCL laxity, but quadriceps strength was 97% of the opposite uninvolved leg, based on the results. All patients had normal knee range of motion.

In eight patients some mild effusion was detected in their involved knee and one patient had mild effusion in both knees. Two patients had osteophytes and there was medial joint space narrowing that exceeded 2 mm in five patients. The IKDC score was about 73 points and the modified Noyes knee score was about 81 points at 17.6 years follow-up. “This natural history study could serve as a baseline for treatments of other PCL injuries,” Shelbourne said.

Source: Orthopaedics today, 22 March 2013

Registry study links gender, skiing and snowboarding ability to injury rates

Ekeland Arne. Paper #FP29-442. Presented at: European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress; May 2-5, 2012; Geneva.

Women were twice as likely to suffer knee injuries while skiing or snowboarding than men, according to a study of ski and snowboard registry data. Although the men studied had more shoulder injuries than the women, women had a 31% knee injury rate among the 8,547 skiers recorded in the Norwegian Ski Lift Association database registry during the 2008 to 2009 and 2009 to 2010 winter seasons. The rate was twice as high as the 15% rate of knee injuries for men recorded in the same time period.

Alpine skiers had more knee injuries (27%) than the injuries snowboarders had (9%), however, wrist injuries accounted for 25% of injuries in snowboarders compared to skiers, who had a 5% wrist injury rate. Seventy percent of the skiers and snowboarders studied wore a helmet, however, “the prevalence of head injuries has dropped less than expected,” Ekeland said. “Head injuries with helmets need less physician and hospital admission than those without helmets" he said. Ekeland and colleagues also discovered that the prevalence of skiing injuries varied according to the athlete’s skill level and type of injury. They found that expert skiers were more likely to sustain head and shoulder injuries than beginners, but wrist and knee injuries were more common in beginners.

Source: Jeff Craven, Orthopaedics Today Europe, No 6, 1 December 2012.

Other CKC News

Updated on 11 April 2013

Mayrhofen and Hintertux Glacier, Austria

December 2012: At the end of a good year, all of us at Chester Knee Clinic dusted off our skis, checked our bindings and headed to the Zillertal valley in the Austrian Alps for for a ski trip over Christmas 2012. Easily accessible by road and rail, the valley hosts a vast ski area of several resorts collectively known as the Zillertal Arena, offering an impressive 670km of ski runs between them. The best known resort in the valley is Mayrhofen, which is home to the steepest slope in Austria, the aptly named Harakiri black run (unfortunately, or fortunately, closed during our visit due to hazardous conditions).

Despite each of us suffering from the pesky winter flu, we enjoyed exploring the extensive and varied selection of slopes in Mayrhofen and we are happy to report that we all skied well and avoided major injuries beyond the usual bumps and bruises. The biggest casualty of the week turned out to be a torn jacket thanks to the combination of a sharp new pair of skis and questionable judgement. The highlight of our trip was a visit to neighbouring Hintertux Glacier, which proved to be a hidden gem with excellent uncrowded slopes and challenging terrain. 15 minutes by car from Mayrhofen, the resort guarantees good snow conditions in the unpredictable early and late season, thanks to the Hintertux Glacier beneath the slopes and a top lift elevation of 3.250m. We are going back to Mayrhofen and Hintertux again in March and will report on our adventures when we return. This time, we are also planning to try out the challenging 6km run down to the base of Ahorn mountain if visibility allows.

In March 2013, the CKC team returned to the Zillertal valley for a week of Spring skiing, and we were lucky to have several mornings skiing on brand new snow under blue skies. Familiar with the mountains from our last trip in December, we wasted no time in exploring the ungroomed ski routes the Hintertux glacier, which was by far our favourite part of the trip. We also (somewhat reluctantly) braved -25°C temperatures on one particularly foggy and sunny day (in alternation!), to be rewarded with deep powder on uncrowded Hintertux glacier and Ahorn mountain.

We also tried the 6km descent down to Mayrhofen village, which more than lived up to its promise of spectacular views. We all progressed significantly with our skiing, spending some time in the snow park (against our better judgement), with no injuries aside from a few obstacle-induced bruises.

Page updated on: 28 November 2013

This page was launched on 1 March 2012. Last update: 12 October 2012.

Site last updated on: 28 March 2014

Disclaimer: This website is a source of information and education resource for health professionals and individuals with knee problems. Neither Chester Knee Clinic nor Vladimir Bobic make any warranties or guarantees that the information contained herein is accurate or complete, and are not responsible for any errors or omissions therein, or for the results obtained from the use of such information. Users of this information are encouraged to confirm the accuracy and applicability thereof with other sources. Not all knee conditions and treatment modalities are described on this website. The opinions and methods of diagnosis and treatment change inevitably and rapidly as new information becomes available, and therefore the information in this website does not necessarily represent the most current thoughts or methods. The content of this website is provided for information only and is not intended to be used for diagnosis or treatment or as a substitute for consultation with your own doctor or a specialist. Email addresses supplied are provided for basic enquiries and should not be used for urgent or emergency requests, treatment of any knee injuries or conditions or to transmit confidential or medical information. If you have sustained a knee injury or have a medical condition, you should promptly seek appropriate medical advice from your local doctor. Any opinions or information, unless otherwise stated, are those of Vladimir Bobic, and in no way claim to represent the views of any other medical professionals or institutions, including Nuffield Health and Spire Hospitals. Chester Knee Clinic will not be liable for any direct, indirect, consequential, special, exemplary, or other damages, loss or injury to persons which may occur by the user's reliance on any statements, information or advice contained in this website. Chester Knee Clinic is not responsible for the content of external websites.

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