Elsayed Morsi - Academia.edu (original) (raw)
Papers by Elsayed Morsi
Summary Statement This work proved by prospective clinical and radiological controlled study that... more Summary Statement This work proved by prospective clinical and radiological controlled study that the best regimen for treatment of early KOA is combination of NSAIDS, physiotherapy, vasoprotective and vasodilator drugs, and alendronate. Introduction There is controversy in the literatures regarding the best treatment for early knee osteoarthritis because there is a more controversy regarding the initiating factor of KOA The Objectives of this work were to evaluate the efficacy of various treatment regimens for the prevention of progression of early knee osteoarthritis (KOA). Also, to elucidate the factors for initiation and progression of KOA Patients and Methods Four groups of 50 patients with early KOA were treated with four treatment regimens. The first group (control) received analgesics as needed for one year. The second group received non steroidal anti-inflammatory drugs (NSAIDS) plus physiotherapy for one month; with analgesics as needed for the rest of the year. The third ...
The Egyptian Orthopaedic Journal, 2017
Background Sacroiliac joint diastases from high-energy trauma are always complicated by pain and ... more Background Sacroiliac joint diastases from high-energy trauma are always complicated by pain and disability. Open reduction and anterior stabilization with a plate are biomechanically advanced because of direct reduction and stabilization. We report our experience of managing 15 patients with sacroiliac disruption by anterior double plates. The purpose of this study was to evaluate the effectiveness of anterior pelvic plating for these complicated fractures. Patients and methods This study included 15 patients who sustained sacroiliac disruption from January 2008 to March 2012 at Menoufia University Hospital. All patients were treated by anterior double plates through an anterolateral approach with transiliac osteotomy. All patients were males. Results The average age was 34 years with a range of 20–49 years. The mean follow-up period was 20 months with a range of 12–36 months. The average healing period was 16 weeks. The clinical results according to the Coles pelvic score revealed...
Journal of Orthopaedics and Sports Medicine, 2021
The Journal of Arthroplasty, 2020
BACKGROUND Total hip replacement (THR) after failed internal fixation of intertrochanteric femora... more BACKGROUND Total hip replacement (THR) after failed internal fixation of intertrochanteric femoral fractures is challenging. The aim of this study is to show the reliability of using standard cemented femoral stems in this operation. METHODS This work included 107 THRs performed in 107 patients after failed treatment of intertrochanteric femoral fractures. The etiology of failure included 67 cases of failure of fixation, 16 cases of nonunion, 15 cases of avascular necrosis, and 9 cases of post-traumatic osteoarthritis. There were 48 males and 59 females. The mean age was 66 years (range 58-81). Failed dynamic hip screws were removed at the time of THR, and the screw holes were blocked with cement. All cases had cemented standard stem femoral prostheses. RESULTS At an average 7.4 years with a minimum of 5 years of follow-up, 102 cases had good clinical and radiological outcomes and 5 cases had fair outcomes. One patient was infected and required 2 stages of revision arthroplasty. Two cases had intraoperative proximal femoral crack, and were treated by cerclage wires. Two patients had early postoperative dislocations. No patients had late periprosthetic femoral fractures or implant loosening. CONCLUSION Standard cemented femoral stems are reliable and cost-effective prostheses in such cases. It is not necessary to bypass the distal screw hole by doubling the femoral canal diameter as long as the bone holes are covered by cement.
The Journal of Bone and Joint Surgery. British volume, 1996
We report 11 patients having revision of total hip arthroplasty using massive structural allograf... more We report 11 patients having revision of total hip arthroplasty using massive structural allografts for failure due to sepsis and associated bone loss. All patients had a two-stage reconstruction and the mean follow-up was 47.8 months (24 to 72). Positive cultures were obtained at the first stage in nine of the 11 patients, with Staphylococcus epidermidis being the most common organism. The other two patients had draining sinuses with negative cultures. There was no recurrence of infection in any patient. The mean increase in the modified Harris hip score was 45 and all the grafts appeared to have united to host bone. Two patients required additional procedures, but only one was related to the allograft. Complications included an incomplete sciatic nerve palsy and one case of graft resorption. Our results support the use of massive allografts in failed septic hip arthroplasty in which there is associated bone loss.
The Journal of Bone & Joint Surgery, 1996
The results of the placement of a massive structural acetabular allograft in conjunction with a r... more The results of the placement of a massive structural acetabular allograft in conjunction with a revision total hip arthroplasty in thirty-two patients (thirty-tree hips) were evaluated at a minimum of five years. The graft supported more than 50 percent of the cup in all of the patients. The goals of a revision operation in a hip that has massive loss of bone are to provide support for the cup, to approximate the normal anatomy, to restore the length of the lower limb, and to restore bone stock should a future revision be necessary. Clinical and radiographic review at an average of seven years (range, five to eleven years) after the revision revealed that eighteen hips had needed no additional operation, seven hips had needed a repeat revision but the structural allograft was intact and had been used to support the cup at the repeat revision, and eight hips had had failure of both the prosthesis and the allograft. The result was considered a clinical and radiographic success when the hip score had increased at least 20 points, the cup was stable, the allograft had united, and no additional operation was necessary. According to these criteria, the rate of success was 55 percent (eighteen of thirty-three hips.) The only factor that was found to be clinically important with respect to outcome was the method of reconstruction. Seven of the eight hips that had been reconstructed with use of a roof-reinforcement ring and a structural allograft had a successful result at an average of 7.5 years (range, five to eleven years). The findings of the present study support the use of a structural allograft in the presence of massive loss of bone in order to achieve the goals of a revision hip replacement. Because of the high rate of success with acetabular reinforcement rings, we now use this method of reconstruction whenever a massive allograft is employed on the acetabular side.
The Journal of Bone & Joint Surgery, 1988
Her major research interest is the history of race since the late Enlightenment, focusing on the ... more Her major research interest is the history of race since the late Enlightenment, focusing on the interface of metropolitan discourses, field encounters, and local agency in the representation and classification of indigenous Oceanian people. She also has longstanding interests in the intersections of Christianity and gender in Melanesia and the colonial history of New Caledonia and Vanuatu.
Journal of Orthopaedics, 2016
Background: Many types of failed hemiarthroplasties have been reported, but there is no classific... more Background: Many types of failed hemiarthroplasties have been reported, but there is no classification of these failures. Patients and methods: Revisions of 217 cases of failed hemiarthroplasty were studied with an average follow-up of 6.2 years. Classification system based on site of problem, mode of failure, and type of revision, was introduced. Results: In most cases, the intra-operative assessment of failure correlated with the preoperative classification (99%). At the last follow-up, there were 15/217 re-revisions; giving a success rate of 93%. Conclusion: This classification helps in choosing the appropriate revision method, leading to acceptable results.
The Journal of Bone Joint Surgery, Mar 1, 1998
The Journal of Arthroplasty, 2014
The Foot, 2007
Background: The sesamoids of the great toe play an integral part of the dynamic function of the f... more Background: The sesamoids of the great toe play an integral part of the dynamic function of the foot and any disorder affecting them leads to significant disability. Objectives: The purpose of this study was to evaluate the clinical and radiological results of tibial sesamoidectomy in heavy manual workers. Material and methods: Thirteen cases of tibial (medial) sesamoiditis underwent surgical excision after failure of conservative treatment. All patients were males and were heavy manual workers in steel company. The age ranged from 20 to 38 years. All cases were unilateral; six left and seven right. Patients were evaluated clinically and radiologically; pre-and post-operatively. Post-operative evaluation included time to return to work, pain, range of motion, deformity, subluxation of lateral sesamoid and any complication. The average follow-up period was 3.6 years (range 2-5). Results: All patients were able to return to their heavy work at a mean time of 12.5 weeks. Twelve patients had no pain and 1 had mild pain on standing on tip toe. Two patients had limitation of motion of the great toe. Conclusion: Medial sesamoidectomy is a successful operation in manual workers who can return to work as early as 9 weeks.
Journal of Bone and Joint Surgery - British Volume, 2007
This paper describes the technique and results of an acetabuloplasty in which the false acetabulu... more This paper describes the technique and results of an acetabuloplasty in which the false acetabulum is turned down to augment the dysplastic true acetabulum at its most defective part. This operation was performed in 17 hips (16 children), with congenital dislocation and false acetabula. The mean age at operation was 5.1 years (4 to 8). The patients were followed clinically and radiologically for a mean of 6.3 years (5 to 10). A total of 16 hips had excellent results and there was one fair result due to avascular necrosis. The centre-edge angles and the obliquity of the acetabular roof improved in all cases, from a mean of −15.9° (−19° to 3°) and 42.6° (33° to 46°) to a mean of 29.5° (20° to 34°) and 11.9° (9° to 19°), respectively. The technique is not complex and is stable without internal fixation. It provides a near-normal acetabulum that requires minimal remodelling, and allows early mobilisation.
The Journal of Arthroplasty, 2002
Cryotherapy is widely used as an emergency treatment of sports trauma and postoperatively especia... more Cryotherapy is widely used as an emergency treatment of sports trauma and postoperatively especially after anterior cruciate ligament reconstruction. Studies in the literature on the effect of cryotherapy after total knee arthroplasty (TKA) have been limited and controversial. In this prospective study, 60 primary TKAs were done on 30 patients (all staged bilateral TKAs). For every patient, 1 TKA had a continuous-flow cooling device applied over the surgical dressing immediately postoperatively. The other TKA in the same patient (control TKA) was done 6 weeks later and had no cooling device. The study compared the range of motion, the volume of hemovac output and blood loss, visual analog pain score, analgesic consumption, and wound healing in the 2 limbs of the same patient. This study showed that continuous-flow cold therapy is advantageous after TKA because it provides better results in all the areas compared.
The Journal of Arthroplasty, 2007
Conversion of an arthrodesed or fused hip to total hip arthroplasty (THA) is a challenging orthop... more Conversion of an arthrodesed or fused hip to total hip arthroplasty (THA) is a challenging orthopedic problem due to the effects of previous operations, the altered anatomy, atrophy of the muscles, arthritis of neighboring joints, and limb length discrepancy. This prospective work included conversion of 19 arthrodesed hips to THA. The failure rate was 5% after an average follow-up period of 7 years. Specific preoperative planning and refined techniques have been elucidated to achieve a success rate nearly similar to that of primary THA.
The Journal of Arthroplasty, 1996
A series of 29 shelf (< 50% of the acetabulum) structural allografts were done in conjunction wit... more A series of 29 shelf (< 50% of the acetabulum) structural allografts were done in conjunction with acetabular revision with a minimum follow-up period of 5 years (average, 7.1 years). At the latest follow-up examination, 86% of the hips were successful both clinically and radiologically. Only four patients required further surgery, with two of these being revised with no additional grafts. The use of bulk allograft in conjunction with acetabular revision is supported, provided that at least 50% support of the cup can be obtained with host-bone. This type of reconstruction provides support for the cup and restores anatomy, leg length, and bone stock should future revision be necessary. Key words: shelf bulk allografts, revision. With the increasing number of total hip arthroplasties (THAs) being done, the number requiring revision surgery is also increasing. Revision hip surgery on the acetabular side is a challenging procedure, especially when associated with severe bone stock loss. This loss of bone stock is an ever-increasing problem, especially in the multiply revised patient. Loss of bone stock is due to both wear particles and abrasive action of bone-cement. 1-6 Restoration of bone stock may be necessary to provide suitable bone support for the cup. In addition, bone-grafting will help to restore anatomy and leg lengths, making future revisions possible. Also, bone-grafting makes the use of conventional implants possible. The use of bulk allografts to achieve the above goals continues to be controversial. There are only two long-term studies in the literature that address the problem of bulk allografting in acetabular reconstruction; one supports allografts, v whereas the other discourages their use.8
The Journal of Arthroplasty, 1996
A series of 33 hips treated with cementless cups and structural autograft or allograft were revie... more A series of 33 hips treated with cementless cups and structural autograft or allograft were reviewed at a minimum follow-up period of 5 years. Seventeen hips received a shelf autograft during primary hip arthroplasty and 16 received an allograft at revision. In the hips receiving autografts, the average preoperative hip score was 45.1 and the score at final review was 87.5, whereas in the revisions reconstructed with allografts, the average preoperative hip score was 44.4 and the score at final review was 82. Overall, only 2 of 33 hips were considered failures, giving a success rate of 94% at an average follow-up period of 6.6 years. Leg-length discrepancy greater than 2 cm was seen in 27 of 33 hips, and at final review only 4 of 33 hips had a leg-length discrepancy greater than 2 cm. All grafts united to host-bone. Resorption, when seen, was minor, with only three grafts showing moderate resorption. Our data support the use of cementless cups with structural allografts and autografts, provided the graft supports less than 50% of the cup.
International Orthopaedics, 2002
Clinical Orthopaedics and Related Research, 1995
Although co-teaching has become a popular approach to special education service provision in incl... more Although co-teaching has become a popular approach to special education service provision in inclusive classrooms, practitioners have struggled to carry it out well. One suggestion for improvement has been to provide co-teachers with training that includes coaching. In this study, we used single-case (ABAB) withdrawal design, to investigate the effects of eCoaching, delivered through online bug-in-ear technology, on co-teachers as they planned and carried out co-teaching. Participants included three co-teaching dyads (n = 6); each comprised of one general and one special educator. Visual inspection of graphed data along with quantitative analysis (i.e., percentage of non-overlapping data) confirmed that eCoaching increased participants' use of varied co-teaching models and student-specific accommodations, while coteachers' interviews and students' time samples verified social validity. Taken together, these findings lead to better understanding of the benefits and limitations of eCoaching with coteachers. Keywords: eCoaching | bug in ear | co-teaching | professional development | planning and instruction | teacher preparation policy/service delivery Article: In an era of increased inclusive practices and teacher accountability, the number of general and special education teachers partnering in efforts to improve students with disabilities' access, progress, and achievement in the general curriculum continues to rise. Volonino and Zigmond (2007) noted that co-teaching has been identified as the most common approach to special education service provision in inclusive classrooms. L. Cook and Friend (1995) define coteaching as "two or more professionals jointly delivering substantive instruction to a diverse, or blended, group of students in a single physical space" (p. 1). Although co-teaching has gained popularity, two published syntheses-one quantitative (Murawski & Swanson, 2001) and one qualitative (Scruggs, Mastropieri, & McDuffie, 2007)-confirm only moderate success, prompting many to question the quality with which it has been implemented (Spooner, Algozzine, Wood, & Hicks, 2010). The Role of Training in Co-Teaching Friend, Cook, Hurley-Chamberlain, and Shamberger (2010) provided specific recommendations for co-teaching training. Dettmer, Thurston, and Dyck (2005) pointed out that one of the greatest obstacles co-teachers face is lack of training and preparation for their new roles. Teachers also identified the lack of training (Dettmer et al., 2005; Keefe & Moore, 2004), the need for greater skill development (Curtin, 1998), and the need for different training methods (Scruggs et al., 2007) as problems adversely affecting co-teaching practice. Thus, efforts to improve the quality and success of co-teaching may hinge, in part, on training (Murawski, 2008). Pancsofar and Petroff (2013) found positive relationships between the frequency of co-teaching training and desired teacher outcomes. Teachers who had more in-service opportunities demonstrated higher levels of interest in co-teaching, held more positive attitudes toward coteaching, and reported greater confidence in their co-teaching abilities. Although preliminary, these findings confirm that frequent in-service training may alleviate some longstanding attitudinal barriers encountered by co-teachers. Characteristics of Effective Co-Teaching Training In general, effective professional development offers teachers not only explicit instruction in evidence-based practices through modeling and demonstration but also opportunities for guided practice with feedback (Joyce & Showers, 2002). The latter of which includes coaching provided by experts (Leko & Brownell, 2009; Sindelar, Brownell, & Billingsley, 2010). Unfortunately, current approaches to in-service training often do not include guided practice with feedback or coaching. Instead, workshops and webinars remain popular approaches, stuffed into teachers' busy schedules like "mortar into bricks," just enough to put pieces together yet not enough to give the training strength or meaning in practice (Rooney, 2007). Specifically, traditional professional development without coaching means little to no transfer to practice yet with coaching the transfer to practice is high (Joyce & Showers, 2002). Specific to training in co-teaching, Friend et al. (2010) also suggest that professional development should include joint participation and coaching. Regrettably, Fennick and Liddy (2001) found that when co-teachers did receive training, the benefits often went unrealized because it was too brief and too limited. Taken together, one can conclude that professional development for co-teachers should include intensive training and feedback in situ. A practice frequently referred to as job embedded professional development (Croft, Coggshall, Dolan, Powers, & Killion, 2010). Research Question 1: How does eCoaching influence how co-teachers plan for and carry out varied co-teaching models, student-specific accommodations and modifications, and PBIS? Research Question 2: How does eCoaching impact (i.e., benefit or disrupt) coteachers and their P-6 students? Method
Clinical Orthopaedics and Related Research, 1996
Revision acetabular surgery with bone stock loss is a difficult problem. Defects are classified i... more Revision acetabular surgery with bone stock loss is a difficult problem. Defects are classified into contained cavitary (Type-1) defects and noncontained defects (Type 2A and 2B) based on preoperative radiographs and intraoperative findings. Fifty-four hips with Type-1 defects were treated with morsellized allograft. The overall success rate was 90% at 6.78 year followup. Type-2 defects are reconstructed with structural grafts. Twenty-nine hips with Type-2A defects (the allograft supports <50% of the cup) were reviewed at 7.1 years' followup. The success rate was 90)%. In all but 1 case the allograft united to host bone. No resorption or minor resorption was seen in 26 of 29 hips with minor column structural grafts. Type-2B defects all had structural allografts that supported >50% of the cup. There were 33 hips in this group observed for an average of 7.1 years. The rerevision rate in this group was 45%. However, 7 of 15 hips were reconstructed without additional graft at rerevision. The only factor that was clinically significant for success in Type-2B defects was choice of acetabular component. In hips that received roof rings with cemented cups, the success rate was 100% (excluding 1 infection). The authors support the use of allograft bone in revision acetabular surgery. When structural grafts are required, every attempt should be made to achieve >50% support from host bone. If this is not possible, then a roof reinforcement ring with a cemented cup is the acetabular component of choice.
Clinical Orthopaedics and Related Research, 1996
A consecutive series of 30 dysplastic hips were treated with total hip arthroplasty using femoral... more A consecutive series of 30 dysplastic hips were treated with total hip arthroplasty using femoral head autograft shelf reconstruction and were reviewed. Cemented cups were used in 13 hips and uncemented cups were used in 17 hips. The average followup was 8.1 years (range, 5.2-13.3 years). In the cemented group, the average preoperative Harris Hip Score was 44.8 points (range, 22-82 points), and in the uncemented group, it was 45 points (range, 23-61 points). At the final review, the average clinical score was 71.5 points (range, 46-98 points) in the cemented group, and in the uncemented group it was 87.5 points (range, 63-100 points). Of the 30 cases, only 3 had unsuccessful results, giving a success rate of 90%. In terms of the autograft, all united to host bone. Resorption, when seen in either cemented or uncemented cups, was minor and restricted to the lateral nonweightbearing part of the graft. The present study supports using shelf autografts to reconstruct dysplastic hips at the time of total hip arthroplasty. In this series, cemented and uncemented cups performed equally well.
Summary Statement This work proved by prospective clinical and radiological controlled study that... more Summary Statement This work proved by prospective clinical and radiological controlled study that the best regimen for treatment of early KOA is combination of NSAIDS, physiotherapy, vasoprotective and vasodilator drugs, and alendronate. Introduction There is controversy in the literatures regarding the best treatment for early knee osteoarthritis because there is a more controversy regarding the initiating factor of KOA The Objectives of this work were to evaluate the efficacy of various treatment regimens for the prevention of progression of early knee osteoarthritis (KOA). Also, to elucidate the factors for initiation and progression of KOA Patients and Methods Four groups of 50 patients with early KOA were treated with four treatment regimens. The first group (control) received analgesics as needed for one year. The second group received non steroidal anti-inflammatory drugs (NSAIDS) plus physiotherapy for one month; with analgesics as needed for the rest of the year. The third ...
The Egyptian Orthopaedic Journal, 2017
Background Sacroiliac joint diastases from high-energy trauma are always complicated by pain and ... more Background Sacroiliac joint diastases from high-energy trauma are always complicated by pain and disability. Open reduction and anterior stabilization with a plate are biomechanically advanced because of direct reduction and stabilization. We report our experience of managing 15 patients with sacroiliac disruption by anterior double plates. The purpose of this study was to evaluate the effectiveness of anterior pelvic plating for these complicated fractures. Patients and methods This study included 15 patients who sustained sacroiliac disruption from January 2008 to March 2012 at Menoufia University Hospital. All patients were treated by anterior double plates through an anterolateral approach with transiliac osteotomy. All patients were males. Results The average age was 34 years with a range of 20–49 years. The mean follow-up period was 20 months with a range of 12–36 months. The average healing period was 16 weeks. The clinical results according to the Coles pelvic score revealed...
Journal of Orthopaedics and Sports Medicine, 2021
The Journal of Arthroplasty, 2020
BACKGROUND Total hip replacement (THR) after failed internal fixation of intertrochanteric femora... more BACKGROUND Total hip replacement (THR) after failed internal fixation of intertrochanteric femoral fractures is challenging. The aim of this study is to show the reliability of using standard cemented femoral stems in this operation. METHODS This work included 107 THRs performed in 107 patients after failed treatment of intertrochanteric femoral fractures. The etiology of failure included 67 cases of failure of fixation, 16 cases of nonunion, 15 cases of avascular necrosis, and 9 cases of post-traumatic osteoarthritis. There were 48 males and 59 females. The mean age was 66 years (range 58-81). Failed dynamic hip screws were removed at the time of THR, and the screw holes were blocked with cement. All cases had cemented standard stem femoral prostheses. RESULTS At an average 7.4 years with a minimum of 5 years of follow-up, 102 cases had good clinical and radiological outcomes and 5 cases had fair outcomes. One patient was infected and required 2 stages of revision arthroplasty. Two cases had intraoperative proximal femoral crack, and were treated by cerclage wires. Two patients had early postoperative dislocations. No patients had late periprosthetic femoral fractures or implant loosening. CONCLUSION Standard cemented femoral stems are reliable and cost-effective prostheses in such cases. It is not necessary to bypass the distal screw hole by doubling the femoral canal diameter as long as the bone holes are covered by cement.
The Journal of Bone and Joint Surgery. British volume, 1996
We report 11 patients having revision of total hip arthroplasty using massive structural allograf... more We report 11 patients having revision of total hip arthroplasty using massive structural allografts for failure due to sepsis and associated bone loss. All patients had a two-stage reconstruction and the mean follow-up was 47.8 months (24 to 72). Positive cultures were obtained at the first stage in nine of the 11 patients, with Staphylococcus epidermidis being the most common organism. The other two patients had draining sinuses with negative cultures. There was no recurrence of infection in any patient. The mean increase in the modified Harris hip score was 45 and all the grafts appeared to have united to host bone. Two patients required additional procedures, but only one was related to the allograft. Complications included an incomplete sciatic nerve palsy and one case of graft resorption. Our results support the use of massive allografts in failed septic hip arthroplasty in which there is associated bone loss.
The Journal of Bone & Joint Surgery, 1996
The results of the placement of a massive structural acetabular allograft in conjunction with a r... more The results of the placement of a massive structural acetabular allograft in conjunction with a revision total hip arthroplasty in thirty-two patients (thirty-tree hips) were evaluated at a minimum of five years. The graft supported more than 50 percent of the cup in all of the patients. The goals of a revision operation in a hip that has massive loss of bone are to provide support for the cup, to approximate the normal anatomy, to restore the length of the lower limb, and to restore bone stock should a future revision be necessary. Clinical and radiographic review at an average of seven years (range, five to eleven years) after the revision revealed that eighteen hips had needed no additional operation, seven hips had needed a repeat revision but the structural allograft was intact and had been used to support the cup at the repeat revision, and eight hips had had failure of both the prosthesis and the allograft. The result was considered a clinical and radiographic success when the hip score had increased at least 20 points, the cup was stable, the allograft had united, and no additional operation was necessary. According to these criteria, the rate of success was 55 percent (eighteen of thirty-three hips.) The only factor that was found to be clinically important with respect to outcome was the method of reconstruction. Seven of the eight hips that had been reconstructed with use of a roof-reinforcement ring and a structural allograft had a successful result at an average of 7.5 years (range, five to eleven years). The findings of the present study support the use of a structural allograft in the presence of massive loss of bone in order to achieve the goals of a revision hip replacement. Because of the high rate of success with acetabular reinforcement rings, we now use this method of reconstruction whenever a massive allograft is employed on the acetabular side.
The Journal of Bone & Joint Surgery, 1988
Her major research interest is the history of race since the late Enlightenment, focusing on the ... more Her major research interest is the history of race since the late Enlightenment, focusing on the interface of metropolitan discourses, field encounters, and local agency in the representation and classification of indigenous Oceanian people. She also has longstanding interests in the intersections of Christianity and gender in Melanesia and the colonial history of New Caledonia and Vanuatu.
Journal of Orthopaedics, 2016
Background: Many types of failed hemiarthroplasties have been reported, but there is no classific... more Background: Many types of failed hemiarthroplasties have been reported, but there is no classification of these failures. Patients and methods: Revisions of 217 cases of failed hemiarthroplasty were studied with an average follow-up of 6.2 years. Classification system based on site of problem, mode of failure, and type of revision, was introduced. Results: In most cases, the intra-operative assessment of failure correlated with the preoperative classification (99%). At the last follow-up, there were 15/217 re-revisions; giving a success rate of 93%. Conclusion: This classification helps in choosing the appropriate revision method, leading to acceptable results.
The Journal of Bone Joint Surgery, Mar 1, 1998
The Journal of Arthroplasty, 2014
The Foot, 2007
Background: The sesamoids of the great toe play an integral part of the dynamic function of the f... more Background: The sesamoids of the great toe play an integral part of the dynamic function of the foot and any disorder affecting them leads to significant disability. Objectives: The purpose of this study was to evaluate the clinical and radiological results of tibial sesamoidectomy in heavy manual workers. Material and methods: Thirteen cases of tibial (medial) sesamoiditis underwent surgical excision after failure of conservative treatment. All patients were males and were heavy manual workers in steel company. The age ranged from 20 to 38 years. All cases were unilateral; six left and seven right. Patients were evaluated clinically and radiologically; pre-and post-operatively. Post-operative evaluation included time to return to work, pain, range of motion, deformity, subluxation of lateral sesamoid and any complication. The average follow-up period was 3.6 years (range 2-5). Results: All patients were able to return to their heavy work at a mean time of 12.5 weeks. Twelve patients had no pain and 1 had mild pain on standing on tip toe. Two patients had limitation of motion of the great toe. Conclusion: Medial sesamoidectomy is a successful operation in manual workers who can return to work as early as 9 weeks.
Journal of Bone and Joint Surgery - British Volume, 2007
This paper describes the technique and results of an acetabuloplasty in which the false acetabulu... more This paper describes the technique and results of an acetabuloplasty in which the false acetabulum is turned down to augment the dysplastic true acetabulum at its most defective part. This operation was performed in 17 hips (16 children), with congenital dislocation and false acetabula. The mean age at operation was 5.1 years (4 to 8). The patients were followed clinically and radiologically for a mean of 6.3 years (5 to 10). A total of 16 hips had excellent results and there was one fair result due to avascular necrosis. The centre-edge angles and the obliquity of the acetabular roof improved in all cases, from a mean of −15.9° (−19° to 3°) and 42.6° (33° to 46°) to a mean of 29.5° (20° to 34°) and 11.9° (9° to 19°), respectively. The technique is not complex and is stable without internal fixation. It provides a near-normal acetabulum that requires minimal remodelling, and allows early mobilisation.
The Journal of Arthroplasty, 2002
Cryotherapy is widely used as an emergency treatment of sports trauma and postoperatively especia... more Cryotherapy is widely used as an emergency treatment of sports trauma and postoperatively especially after anterior cruciate ligament reconstruction. Studies in the literature on the effect of cryotherapy after total knee arthroplasty (TKA) have been limited and controversial. In this prospective study, 60 primary TKAs were done on 30 patients (all staged bilateral TKAs). For every patient, 1 TKA had a continuous-flow cooling device applied over the surgical dressing immediately postoperatively. The other TKA in the same patient (control TKA) was done 6 weeks later and had no cooling device. The study compared the range of motion, the volume of hemovac output and blood loss, visual analog pain score, analgesic consumption, and wound healing in the 2 limbs of the same patient. This study showed that continuous-flow cold therapy is advantageous after TKA because it provides better results in all the areas compared.
The Journal of Arthroplasty, 2007
Conversion of an arthrodesed or fused hip to total hip arthroplasty (THA) is a challenging orthop... more Conversion of an arthrodesed or fused hip to total hip arthroplasty (THA) is a challenging orthopedic problem due to the effects of previous operations, the altered anatomy, atrophy of the muscles, arthritis of neighboring joints, and limb length discrepancy. This prospective work included conversion of 19 arthrodesed hips to THA. The failure rate was 5% after an average follow-up period of 7 years. Specific preoperative planning and refined techniques have been elucidated to achieve a success rate nearly similar to that of primary THA.
The Journal of Arthroplasty, 1996
A series of 29 shelf (< 50% of the acetabulum) structural allografts were done in conjunction wit... more A series of 29 shelf (< 50% of the acetabulum) structural allografts were done in conjunction with acetabular revision with a minimum follow-up period of 5 years (average, 7.1 years). At the latest follow-up examination, 86% of the hips were successful both clinically and radiologically. Only four patients required further surgery, with two of these being revised with no additional grafts. The use of bulk allograft in conjunction with acetabular revision is supported, provided that at least 50% support of the cup can be obtained with host-bone. This type of reconstruction provides support for the cup and restores anatomy, leg length, and bone stock should future revision be necessary. Key words: shelf bulk allografts, revision. With the increasing number of total hip arthroplasties (THAs) being done, the number requiring revision surgery is also increasing. Revision hip surgery on the acetabular side is a challenging procedure, especially when associated with severe bone stock loss. This loss of bone stock is an ever-increasing problem, especially in the multiply revised patient. Loss of bone stock is due to both wear particles and abrasive action of bone-cement. 1-6 Restoration of bone stock may be necessary to provide suitable bone support for the cup. In addition, bone-grafting will help to restore anatomy and leg lengths, making future revisions possible. Also, bone-grafting makes the use of conventional implants possible. The use of bulk allografts to achieve the above goals continues to be controversial. There are only two long-term studies in the literature that address the problem of bulk allografting in acetabular reconstruction; one supports allografts, v whereas the other discourages their use.8
The Journal of Arthroplasty, 1996
A series of 33 hips treated with cementless cups and structural autograft or allograft were revie... more A series of 33 hips treated with cementless cups and structural autograft or allograft were reviewed at a minimum follow-up period of 5 years. Seventeen hips received a shelf autograft during primary hip arthroplasty and 16 received an allograft at revision. In the hips receiving autografts, the average preoperative hip score was 45.1 and the score at final review was 87.5, whereas in the revisions reconstructed with allografts, the average preoperative hip score was 44.4 and the score at final review was 82. Overall, only 2 of 33 hips were considered failures, giving a success rate of 94% at an average follow-up period of 6.6 years. Leg-length discrepancy greater than 2 cm was seen in 27 of 33 hips, and at final review only 4 of 33 hips had a leg-length discrepancy greater than 2 cm. All grafts united to host-bone. Resorption, when seen, was minor, with only three grafts showing moderate resorption. Our data support the use of cementless cups with structural allografts and autografts, provided the graft supports less than 50% of the cup.
International Orthopaedics, 2002
Clinical Orthopaedics and Related Research, 1995
Although co-teaching has become a popular approach to special education service provision in incl... more Although co-teaching has become a popular approach to special education service provision in inclusive classrooms, practitioners have struggled to carry it out well. One suggestion for improvement has been to provide co-teachers with training that includes coaching. In this study, we used single-case (ABAB) withdrawal design, to investigate the effects of eCoaching, delivered through online bug-in-ear technology, on co-teachers as they planned and carried out co-teaching. Participants included three co-teaching dyads (n = 6); each comprised of one general and one special educator. Visual inspection of graphed data along with quantitative analysis (i.e., percentage of non-overlapping data) confirmed that eCoaching increased participants' use of varied co-teaching models and student-specific accommodations, while coteachers' interviews and students' time samples verified social validity. Taken together, these findings lead to better understanding of the benefits and limitations of eCoaching with coteachers. Keywords: eCoaching | bug in ear | co-teaching | professional development | planning and instruction | teacher preparation policy/service delivery Article: In an era of increased inclusive practices and teacher accountability, the number of general and special education teachers partnering in efforts to improve students with disabilities' access, progress, and achievement in the general curriculum continues to rise. Volonino and Zigmond (2007) noted that co-teaching has been identified as the most common approach to special education service provision in inclusive classrooms. L. Cook and Friend (1995) define coteaching as "two or more professionals jointly delivering substantive instruction to a diverse, or blended, group of students in a single physical space" (p. 1). Although co-teaching has gained popularity, two published syntheses-one quantitative (Murawski & Swanson, 2001) and one qualitative (Scruggs, Mastropieri, & McDuffie, 2007)-confirm only moderate success, prompting many to question the quality with which it has been implemented (Spooner, Algozzine, Wood, & Hicks, 2010). The Role of Training in Co-Teaching Friend, Cook, Hurley-Chamberlain, and Shamberger (2010) provided specific recommendations for co-teaching training. Dettmer, Thurston, and Dyck (2005) pointed out that one of the greatest obstacles co-teachers face is lack of training and preparation for their new roles. Teachers also identified the lack of training (Dettmer et al., 2005; Keefe & Moore, 2004), the need for greater skill development (Curtin, 1998), and the need for different training methods (Scruggs et al., 2007) as problems adversely affecting co-teaching practice. Thus, efforts to improve the quality and success of co-teaching may hinge, in part, on training (Murawski, 2008). Pancsofar and Petroff (2013) found positive relationships between the frequency of co-teaching training and desired teacher outcomes. Teachers who had more in-service opportunities demonstrated higher levels of interest in co-teaching, held more positive attitudes toward coteaching, and reported greater confidence in their co-teaching abilities. Although preliminary, these findings confirm that frequent in-service training may alleviate some longstanding attitudinal barriers encountered by co-teachers. Characteristics of Effective Co-Teaching Training In general, effective professional development offers teachers not only explicit instruction in evidence-based practices through modeling and demonstration but also opportunities for guided practice with feedback (Joyce & Showers, 2002). The latter of which includes coaching provided by experts (Leko & Brownell, 2009; Sindelar, Brownell, & Billingsley, 2010). Unfortunately, current approaches to in-service training often do not include guided practice with feedback or coaching. Instead, workshops and webinars remain popular approaches, stuffed into teachers' busy schedules like "mortar into bricks," just enough to put pieces together yet not enough to give the training strength or meaning in practice (Rooney, 2007). Specifically, traditional professional development without coaching means little to no transfer to practice yet with coaching the transfer to practice is high (Joyce & Showers, 2002). Specific to training in co-teaching, Friend et al. (2010) also suggest that professional development should include joint participation and coaching. Regrettably, Fennick and Liddy (2001) found that when co-teachers did receive training, the benefits often went unrealized because it was too brief and too limited. Taken together, one can conclude that professional development for co-teachers should include intensive training and feedback in situ. A practice frequently referred to as job embedded professional development (Croft, Coggshall, Dolan, Powers, & Killion, 2010). Research Question 1: How does eCoaching influence how co-teachers plan for and carry out varied co-teaching models, student-specific accommodations and modifications, and PBIS? Research Question 2: How does eCoaching impact (i.e., benefit or disrupt) coteachers and their P-6 students? Method
Clinical Orthopaedics and Related Research, 1996
Revision acetabular surgery with bone stock loss is a difficult problem. Defects are classified i... more Revision acetabular surgery with bone stock loss is a difficult problem. Defects are classified into contained cavitary (Type-1) defects and noncontained defects (Type 2A and 2B) based on preoperative radiographs and intraoperative findings. Fifty-four hips with Type-1 defects were treated with morsellized allograft. The overall success rate was 90% at 6.78 year followup. Type-2 defects are reconstructed with structural grafts. Twenty-nine hips with Type-2A defects (the allograft supports <50% of the cup) were reviewed at 7.1 years' followup. The success rate was 90)%. In all but 1 case the allograft united to host bone. No resorption or minor resorption was seen in 26 of 29 hips with minor column structural grafts. Type-2B defects all had structural allografts that supported >50% of the cup. There were 33 hips in this group observed for an average of 7.1 years. The rerevision rate in this group was 45%. However, 7 of 15 hips were reconstructed without additional graft at rerevision. The only factor that was clinically significant for success in Type-2B defects was choice of acetabular component. In hips that received roof rings with cemented cups, the success rate was 100% (excluding 1 infection). The authors support the use of allograft bone in revision acetabular surgery. When structural grafts are required, every attempt should be made to achieve >50% support from host bone. If this is not possible, then a roof reinforcement ring with a cemented cup is the acetabular component of choice.
Clinical Orthopaedics and Related Research, 1996
A consecutive series of 30 dysplastic hips were treated with total hip arthroplasty using femoral... more A consecutive series of 30 dysplastic hips were treated with total hip arthroplasty using femoral head autograft shelf reconstruction and were reviewed. Cemented cups were used in 13 hips and uncemented cups were used in 17 hips. The average followup was 8.1 years (range, 5.2-13.3 years). In the cemented group, the average preoperative Harris Hip Score was 44.8 points (range, 22-82 points), and in the uncemented group, it was 45 points (range, 23-61 points). At the final review, the average clinical score was 71.5 points (range, 46-98 points) in the cemented group, and in the uncemented group it was 87.5 points (range, 63-100 points). Of the 30 cases, only 3 had unsuccessful results, giving a success rate of 90%. In terms of the autograft, all united to host bone. Resorption, when seen in either cemented or uncemented cups, was minor and restricted to the lateral nonweightbearing part of the graft. The present study supports using shelf autografts to reconstruct dysplastic hips at the time of total hip arthroplasty. In this series, cemented and uncemented cups performed equally well.