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  1. Article: A case of missed unstable cervical injury during the COVID-19 pandemic.

    Archer, James E / Gardner, Adrian

    Journal of surgical case reports

    2020  Volume 2020, Issue 9, Page(s) rjaa293

    Abstract: This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings ... ...

    Abstract This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings and the subsequent management of the injury. The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine.
    Keywords covid19
    Language English
    Publishing date 2020-09-10
    Publishing country England
    Document type Case Reports
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjaa293
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A case of missed unstable cervical injury during the COVID-19 pandemic

    Archer, James E / Gardner, Adrian

    Journal of Surgical Case Reports

    2020  Volume 2020, Issue 9

    Abstract: Abstract This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging ... ...

    Abstract Abstract This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings and the subsequent management of the injury. The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine.
    Keywords covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ISSN 2042-8812
    DOI 10.1093/jscr/rjaa293
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: A case of missed unstable cervical injury during the COVID-19 pandemic

    Archer, James E / Gardner, Adrian

    Journal of Surgical Case Reports

    Abstract: This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury The report discusses the imaging findings and ...

    Abstract This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury The report discusses the imaging findings and the subsequent management of the injury The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #756928
    Database COVID19

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  4. Article ; Online: The anatomical growth of the thoracic cage in adolescents with specific reference to axial growth comparing the right and left hemithorax.

    Archer, James E / Dong, Huan / Berryman, Fiona / Pynsent, Paul / Gardner, Adrian

    Clinical anatomy (New York, N.Y.)

    2022  Volume 36, Issue 1, Page(s) 2–10

    Abstract: This study has demonstrated the changing volume of both the anterior and posterior thorax in normal adolescents (without spinal or thoracic deformity), differentiating for both sex and age, to further understand how the thorax grows, along with the ... ...

    Abstract This study has demonstrated the changing volume of both the anterior and posterior thorax in normal adolescents (without spinal or thoracic deformity), differentiating for both sex and age, to further understand how the thorax grows, along with the differences in growth between the anterior and posterior thorax. The thorax was measured on axial CT slices at every vertebral level from T3 to T12 in a series of scans previous taken for routine clinical care. Measurements taken were the anteroposterior thoracic distance and the area of the anterior and posterior rib prominences on either side of the thorax. Data was analyzed per vertebral level, differentiating for age and sex. There were 486 CT scans analyzed (257 males and 229 females) between the ages of 8 and 18 years. The analysis identified that for the anterior thorax, there are three phases of growth with an initial slow increase in volume, followed by a stabilization of little growth, followed by another phase of a more rapid increase in volume. For the posterior thorax, there was a gradual increase in area with increasing age. This study demonstrates that the shape of the thorax is age and sex dependent, with males having both a greater width and depth of thorax compared to females. Of particular note is the difference in patterns of growth between the anterior and posterior thorax. This information will add to the understanding of normal growth, which will aid in the management of conditions where that growth is disturbed.
    Language English
    Publishing date 2022-10-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1025505-9
    ISSN 1098-2353 ; 0897-3806
    ISSN (online) 1098-2353
    ISSN 0897-3806
    DOI 10.1002/ca.23971
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2592: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Evaluating measures of quality of life in adult scoliosis: a systematic review and narrative synthesis.

    Archer, James E / Baird, Charles / Gardner, Adrian / Rushton, Alison B / Heneghan, Nicola R

    Spine deformity

    2022  Volume 10, Issue 5, Page(s) 991–1002

    Abstract: Purpose: To systematically review and synthesise the evidence on the measurement properties of patient-reported outcome measure (PROMs) used to assess the quality of life in patients with adult scoliosis.: Method: Based on the COnsensus-based ... ...

    Abstract Purpose: To systematically review and synthesise the evidence on the measurement properties of patient-reported outcome measure (PROMs) used to assess the quality of life in patients with adult scoliosis.
    Method: Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and a published protocol, a two-stage search was conducted and reported in line with the Preferred Reporting Items for Systematic review and Meta-analysis (PRISMA). Stage one identified all studies of patients with adult scoliosis which included PROMs of health-related quality of life (HR-QOL). Databases including AMED, CINAHL, EMBASE, Medline, PsychINFO and Pubmed were searched from inception until 31st December 2020. This derived list of PROMs, was then utilised for a stage 2 search to identify studies which evaluated the measurement properties of the PROMs. Two reviewers independently performed the searches, study screening, selection and risk of bias assessment using the COSMIN tool. The overall quality of the evidence was assessed using a modified Grading of Recommendations Assessment, Development and Evaluation approach.
    Results: Stage one yielded 16 PROMs of HR-QOL with the Oswestry Disability Index (ODI) and Scoliosis Research Society-22 (SRS-22) the most used. Stage two identified three stage one PROMs that fulfilled eligibility criteria: SRS-22, ODI and SRS-22r; with five studies investigating measurement properties in an adult scoliosis population. The SRS-22 was the most comprehensively evaluated PROM in this cohort with very low-quality evidence indicating indeterminate reliability, sufficient construct validity and sufficient responsiveness of the SRS-22. There is very low-quality evidence indicating sufficient responsiveness of the ODI. There is very low-quality evidence indicating indeterminate cross-cultural validity for the SRS-22r. All other measurement properties in the SRS-22, ODI and SRS-22r have not been evaluated.
    Conclusion: A large number of PROMs are being utilised in the adult scoliosis population and of these, the most commonly utilised are the ODI and SRS-22. The SRS-22, ODI and SRS-22r are the only PROMs to have had their measurement properties evaluated in the adult scoliosis population. The findings of this systematic review are that there currently is not sufficient evidence on the measurement properties of any PROMs in adult scoliosis. Further research is now urgently required to assess the measurement properties of these PROMs.
    MeSH term(s) Adult ; Consensus ; Humans ; Quality of Life ; Reproducibility of Results ; Scoliosis ; Surveys and Questionnaires
    Language English
    Publishing date 2022-03-29
    Publishing country England
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-022-00498-5
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  6. Article ; Online: The British Orthopaedic Oncology Management (BOOM) audit.

    Archer, James E / Chauhan, Govind S / Dewan, Varun / Osman, Khabab / Thomson, Calum / Nandra, Rajpal S / Ashford, Robert U / Cool, Paul / Stevenson, Jonathan

    The bone & joint journal

    2023  Volume 105-B, Issue 10, Page(s) 1115–1122

    Abstract: Aims: Most patients with advanced malignancy suffer bone metastases, which pose a significant challenge to orthopaedic services and burden to the health economy. This study aimed to assess adherence to the British Orthopaedic Oncology Society (BOOS)/ ... ...

    Abstract Aims: Most patients with advanced malignancy suffer bone metastases, which pose a significant challenge to orthopaedic services and burden to the health economy. This study aimed to assess adherence to the British Orthopaedic Oncology Society (BOOS)/British Orthopaedic Association (BOA) guidelines on patients with metastatic bone disease (MBD) in the UK.
    Methods: A prospective, multicentre, national collaborative audit was designed and delivered by a trainee-led collaborative group. Data were collected over three months (1 April 2021 to 30 June 2021) for all patients presenting with MBD. A data collection tool allowed investigators at each hospital to compare practice against guidelines. Data were collated and analyzed centrally to quantify compliance from 84 hospitals in the UK for a total of 1,137 patients who were eligible for inclusion.
    Results: A total of 846 patients with pelvic and appendicular MBD were analyzed, after excluding those with only spinal metastatic disease. A designated MBD lead was not present in 39% of centres (33/84). Adequate radiographs were not performed in 19% of patients (160/846), and 29% (247/846) did not have an up-to-date CT of thorax, abdomen, and pelvis to stage their disease. Compliance was low obtaining an oncological opinion (69%; 584/846) and prognosis estimations (38%; 223/846). Surgery was performed in 38% of patients (319/846), with the rates of up-to-date radiological investigations and oncology input with prognosis below the expected standard. Of the 25% (215/846) presenting with a solitary metastasis, a tertiary opinion from a MBD centre and biopsy was sought in 60% (130/215).
    Conclusion: Current practice in the UK does not comply with national guidelines, especially regarding investigations prior to surgery and for patients with solitary metastases. This study highlights the need for investment and improvement in care. The recent publication of British Orthopaedic Association Standards for Trauma (BOAST) defines auditable standards to drive these improvements for this vulnerable patient group.
    MeSH term(s) Humans ; Orthopedics ; Prospective Studies ; Radiography ; Bone Neoplasms/surgery ; Bone Neoplasms/secondary ; Thorax
    Language English
    Publishing date 2023-10-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.105B10.BJJ-2023-0443.R1
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6989: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  7. Article: Minimising Tourniquet Time and Post-operative Pain During Carpal Tunnel Decompression.

    Ghani, Rafia / Archer, James E / Shah, Munawar

    Cureus

    2019  Volume 11, Issue 7, Page(s) e5146

    Abstract: Background Pain and discomfort at the tourniquet and wound site are recognised complications of carpal tunnel surgery. Studies have shown that longer tourniquet times lead to increased pain, local and systematic complications. We hypothesise that ... ...

    Abstract Background Pain and discomfort at the tourniquet and wound site are recognised complications of carpal tunnel surgery. Studies have shown that longer tourniquet times lead to increased pain, local and systematic complications. We hypothesise that minimising the intraoperative tourniquet time will reduce post-operative pain and complications. Objective Our aim is to present the results of our novel operative technique for carpal tunnel decompression which minimises tourniquet time. Method The study represented a prospective case series in which 55 consecutive and unselected patients with positive nerve conduction study results were operated on by a single surgeon at a single hospital site over a period of 12 months. The patients filled in a questionnaire based on a visual analogue score (VAS) (1-10) for pain at (1) first presentation at the clinic, (2) recovery in theatre post-operatively and (3) on discharge from care at 12 weeks post-operatively. Questions included the perception of pain at the tourniquet site and at the wound site. Results  A total of 55 (female 39 and male 16) patients participated in the study. The average tourniquet time was 5 minutes 50 seconds. 98% of patients had a VAS of 1 at both the wound and tourniquet site post-operatively. One patent had a score of 3 at the tourniquet site. Eleven patients had undergone contralateral carpal tunnel decompression surgery. Of the remaining 43 patients, all said they would have the other side operated on in the same way. Conclusion  We have demonstrated a safe and efficient technique to reduce post-operative pain by minimising tourniquet inflation time. Our patient cohort experienced no significant complications and minimal pain post-operatively.
    Language English
    Publishing date 2019-07-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.5146
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  8. Article ; Online: Traumatic hip dislocation in the paediatric population: A case series from a specialist centre.

    Archer, James E / Balakumar, Balasubramanian / Odeh, Abdulrahman / Bache, Christopher Edward / Dimitriou, Rozalia

    Injury

    2021  Volume 52, Issue 12, Page(s) 3660–3665

    Abstract: Introduction: Traumatic hip dislocation is a rare injury in the paediatric population. It can occur after high energy trauma, but also after lower energy injuries especially in younger children. Posterior dislocation is the most common pattern of hip ... ...

    Abstract Introduction: Traumatic hip dislocation is a rare injury in the paediatric population. It can occur after high energy trauma, but also after lower energy injuries especially in younger children. Posterior dislocation is the most common pattern of hip dislocation. In most cases, closed reduction is successful, but occasionally open reduction is required to achieve concentric reduction. The aim of our study was to present the 10-year experience from a Level-1 Trauma Paediatric Hospital and to comment on how our experience correlates with the current literature.
    Patients and methods: This is a retrospective case series of all paediatric patients (< 16 years old) with a traumatic hip dislocation presented and/or treated at our institution, between the 1
    Results: Thirteen cases of traumatic hip dislocation were identified. There were 7 females. The mean age was 9.8 years. Typically, younger patients were involved in lower energy injuries. The direction of hip dislocation was posterior in ten cases. Associated injuries were seen in eight patients. All cases underwent closed reduction, which was successful in nine cases. Mean time to reduction was 6.8 hours. Post reduction imaging with CT and/or MRI was performed in all cases. There was residual subluxation in three cases, requiring open reduction. In one case with unrecognised undisplaced physeal injury, closed reduction resulted in a Delbet type 1 hip fracture. Two cases developed avascular necrosis (AVN).
    Conclusions: Traumatic paediatric hip dislocation is a rare injury. A target of 6 hours for reduction should be employed as this will reduce the risk of AVN in those who have not permanently damaged the vessels at the time of injury. We advocate all attempts for closed reduction to be performed in an operating theatre with the use of an image intensifier to help identifying associated injuries and confirm concentric reduction. If closed reduction fails, open reduction is required. Post-reduction MRI is an important adjunct to recognise associated soft tissue injuries. Follow up of patients should continue for 2 years as a minimum to help detect AVN.
    MeSH term(s) Adolescent ; Child ; Female ; Hip Dislocation/diagnostic imaging ; Hip Dislocation/surgery ; Hip Fractures ; Humans ; Magnetic Resonance Imaging ; Open Fracture Reduction ; Retrospective Studies
    Language English
    Publishing date 2021-04-07
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2021.04.010
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 778: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 10: Show issues

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  9. Article ; Online: Evaluating measures of quality of life in adult scoliosis: a protocol for a systematic review and narrative synthesis.

    Archer, James E / Baird, Charles / Gardner, Adrian / Rushton, Alison B / Heneghan, Nicola R

    Systematic reviews

    2021  Volume 10, Issue 1, Page(s) 259

    Abstract: Background: Adult scoliosis represents a distinct subgroup of scoliosis patients for whom the diagnosis can have a large impact on their health-related quality of life (HR-QOL). Therefore, HR-QOL patient-reported outcome measures (PROMs) are essential ... ...

    Abstract Background: Adult scoliosis represents a distinct subgroup of scoliosis patients for whom the diagnosis can have a large impact on their health-related quality of life (HR-QOL). Therefore, HR-QOL patient-reported outcome measures (PROMs) are essential to assess disease progression and the impact of interventions. The objective of this systematic review is to evaluate the measurement properties of HR-QOL PROMs in adult scoliosis patients.
    Methods: We will conduct a literature search, from their inception onwards, of multiple electronic databases including AMED, CINAHL, EMBASE, Medline, PsychINFO and PubMed. The searches will be performed in two stages. For both stages of the search, participants will be aged 18 and over with a diagnosis of scoliosis. The primary outcome of interest in the stage one searches will be studies which use PROMs to investigate HR-QOL as defined by the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy, the secondary outcome will be to assess the frequency of use of the various PROMs. In stage two, the primary outcome of interest will be studies which assess the measurement properties of the HR-QOL PROMs identified in stage one. No specific measurement property will be given priority. No planned secondary outcomes have been identified but will be reported if discovered. In stage one, the only restriction on study design will be the exclusion of systematic reviews. In Stage two the only restriction on study design will be the exclusion of full-text articles not available in the English language. Two reviewers will independently screen all citations and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or risk of bias) will be appraised using the Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist. The overall strength of the body of evidence will then be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A narrative synthesis will be provided with information presented in the main text and tables to summarise and explain the characteristics and findings of the included studies. The narrative synthesis will explore the evidence for currently used PROMs in adult scoliosis patients and any areas that require further study.
    Discussion: The review will help clinicians and researchers identify a HR-QOL PROM for use in patients with adult scoliosis. Findings from the review will be published and disseminated through a peer-reviewed journal and conference presentations.
    Systematic review registration: This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), reference number: CRD42020219437.
    MeSH term(s) Adolescent ; Adult ; Checklist ; Humans ; Patient Reported Outcome Measures ; Quality of Life ; Scoliosis ; Systematic Reviews as Topic
    Language English
    Publishing date 2021-09-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2662257-9
    ISSN 2046-4053 ; 2046-4053
    ISSN (online) 2046-4053
    ISSN 2046-4053
    DOI 10.1186/s13643-021-01811-5
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  10. Article: Management of Native Joint Septic Arthritis, Serial Aspiration vs. Arthroscopic Washout During the COVID-19 Pandemic.

    Piper, Danielle / Smith, Gemma / Archer, James E / Woffenden, Hugo / Bose, Deepa

    Cureus

    2020  Volume 12, Issue 11, Page(s) e11391

    Abstract: Septic arthritis remains an orthopaedic emergency that requires prompt diagnosis and management. During the 2020 COVID-19 pandemic, British Orthopaedic Association (BOAST) guidelines dictated that medical treatment (closed-needle aspiration + antibiotic ... ...

    Abstract Septic arthritis remains an orthopaedic emergency that requires prompt diagnosis and management. During the 2020 COVID-19 pandemic, British Orthopaedic Association (BOAST) guidelines dictated that medical treatment (closed-needle aspiration + antibiotic therapy) should be offered to patients as first-line management, and operative treatment (arthroscopic joint washout +/- synovectomy) be reserved for patients exhibiting signs of sepsis. Literature has previously shown that for native joint septic arthritis, operative treatment is not superior to medical treatment. During the COVID-19 'lock-down' period (March 2020 to June 2020), we prospectively followed the presentation, diagnosis, management and outcome of a total of six patients who presented with confirmed native joint septic arthritis. All six patients underwent initial medical management of their septic arthritis following their diagnostic aspiration, which involved serial closed-needle aspirations and antibiotic therapy as advised by our microbiology team. Four patients went on to have an arthroscopic washout at an average of eight days following admission (mean 2.5), prior to a consultant-led decision to proceed to arthroscopic washout. The decision for operative management was the patient's clinical deterioration based on physiological (fever, tachycardia) and biochemical (C-reactive protein (CRP), white blood cell (WBC)) parameters. All of the four patients that proceeded to operative treatment failed to provide culture yield at the time of arthroscopic washout. The mean time to discharge was 15.6 days, whilst the mean time to discharge following operative intervention was 12 days. One patient passed away during admission and one patient required a second arthroscopic washout. Medical management of septic arthritis may play a role in symptom control in the palliative setting or in patients where a general anaesthetic is undesirable. We found operative management to be therapeutic clinically, haemodynamically and biochemically as well as facilitative of a faster recovery and shorter inpatient stay.
    Keywords covid19
    Language English
    Publishing date 2020-11-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.11391
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