Fresh-frozen vs irradiated allograft bone in orthopaedic reconstructive surgery

The use of allograft bone is increasingly common in orthopaedic reconstruction procedures. The optimal method of preparation of allograft bone is subject of great debate. Proponents of fresh-frozen graft cite improved biological and biomechanical characteristics relative to irradiated material, whereas fear of bacterial or viral transmission warrants some to favour irradiated graft. Careful review of the literature is necessary to appreciate the influence of processing techniques on bone quality. Whereas limited clinical trials are available to govern the selection of appropriate bone graft, this review presents the argument favouring the use of fresh-frozen bone allograft as compared to irradiated bone.

Gender and the Australian parliament

This dissertation by publication which focuses on gender and the Australian federal parliament has resulted in the submission of three refereed journal articles. Data for the study were obtained from 30 semi-structured interviews undertaken in 2006 with fifteen (15) male and fifteen (15) female members of the Australian parliament. The first of the articles is methodological and has been accepted for publication in the Australian Journal of Political Science. The paper argues that feminist political science is guided by five important principles. These are placing gender at the centre of the research, giving emphasis to women’s voice, challenging the public/private divide, using research to transform society and taking a reflexive approach to positionality. It is the latter principle, that of the importance of taking a reflexive approach to research which I explore in the paper. Through drawing on my own experiences as a member of the House of Representatives (Forde 1987-1996) I reflexively investigate the intersections between my background and my identity as a researcher. The second of the articles views the data through the lens of Acker’s (1990) notion of the ‘gendered organization’ which posits that there are four dimensions by which organizations are gendered. These are via the division of labour, through symbols, images and ideologies, by workplace interactions and through the gendered components of individual identity. In this paper which has been submitted to the British Journal of Political Science, each of Acker’s (1990) dimensions is examined in terms of the data from interviews with male and female politicians. The central question investigated is thus to what extent does the Australian parliament conform to Acker’s (1990) concept of the ‘gendered organization’? The third of the papers focuses specifically on data from interviews with the 15 male politicians and investigates how they view gender equality and the Australian parliament. The article, which has been submitted to the European Journal of Political Science asks to what extent contemporary male politicians view the Australian parliament as gendered? Discourse analysis that is ‘ways of viewing’ (Bacchi, 1999, p. 40) is used as an approach to analyse the data. Three discursive frameworks by which male politicians view gender in the Australian parliament are identified. These are: that the parliament is gendered as masculine but this is unavoidable; that the parliament is gendered as feminine and women are actually advantaged; and that the parliament is gender neutral and gender is irrelevant. It is argued that collectively these framing devices operate to mask the many constraints which exist to marginalise women from political participation and undermine attempts to address women’s political disadvantage as political participants. The article concludes by highlighting the significance of the paper beyond the Australian context and calling for further research which names and critiques political men and their discourses on gender and parliamentary practices and processes.

Orthopaedics and Trauma Queensland Annual Report 2008

Orthopaedics and Trauma Queensland is an internationally recognised research group that is developing into an international leader in research and education. It provides a stimulus for research, education and clinical application within the international orthopaedic and trauma communities. Orthopaedics and Trauma Queensland develops and promotes the innovative use of engineering and technology, in collaboration with surgeons, to provide new techniques, materials, procedures and medical devices. Its integration with clinical practice and strong links with hospitals ensure that the research will be translated into practical outcomes for patients. The group undertakes clinical practice in orthopaedics and trauma and applies core engineering, modelling and clinical skills to challenges in medicine. The research is built on a strong foundation of knowledge in biomedical engineering and incorporates expertise in cell biology, mathematical modelling, human anatomy and physiology and clinical medicine in orthopaedics and trauma. New knowledge is being developed and applied to the full range of orthopaedic diseases and injuries, such as knee and hip replacements, fractures and spinal deformities.

Linking early design decisions across multiple disciplines

The early stages of the building design process are when the most far reaching decisions are made regarding the configuration of the proposed project. This paper examines methods of providing decision support to building designers across multiple disciplines during the early stage of design. The level of detail supported is at the massing study stage where the basic envelope of the project is being defined. The block outlines on the building envelope are sliced into floors. Within a floor the only spatial divisions supported are the “user” space and the building core. The building core includes vertical transportation systems, emergency egress and vertical duct runs. The current focus of the project described in the paper is multi-storey mixed use office/residential buildings with car parking. This is a common type of building in redevelopment projects within and adjacent to the central business districts of major Australian cities. The key design parameters for system selection across the major systems in multi-storey building projects - architectural, structural, HVAC, vertical transportation, electrical distribution, fire protection, hydraulics and cost – are examined. These have been identified through literature research and discussions with building designers from various disciplines. This information is being encoded in decision support tools. The decision support tools communicate through a shared database to ensure that the relevant information is shared across all of the disciplines. An internal data model has been developed to support the very early design phase and the high level system descriptions required. A mapping to IFC 2x2 has also been defined to ensure that this early information is available at later stages of the design process.

The cost-effectiveness of routine follow-up after primary total hip arthroplasty

Routine postsurgery assessment of primary total hip arthroplasty (THA) is recommended in many countries. Whether the benefits of this activity are justified by the costs is not known. We used a decision-analytic Markov model to compare the costs and health outcomes of 3 different follow-up strategies after primary THA. If there is no routine follow-up of patients for 7 years after primary THA, there would be cost savings between AU$6.5 and $11.9 million and gains of between 1.8 and 8.8 quality-adjusted life years. Policy makers should investigate less resource-intensive alternatives to common routine postsurgical assessment.

Strategies for zonal cartilage repair using hydrogels

Articular cartilage is a highly hydrated tissue with depth-dependent cellular and matrix properties that provide low-friction load bearing in joints. However, the structure and function are frequently lost and there is insufficient repair response to regenerate high-quality cartilage. Several hydrogel-based tissue-engineering strategies have recently been developed to form constructs with biomimetic zonal variations to improve cartilage repair. Modular hydrogel systems allow for systematic control over hydrogel properties, and advanced fabrication techniques allow for control over construct organization. These technologies have great potential to address many unanswered questions involved in prescribing zonal properties to tissue-engineered constructs for cartilage repair.

Gender and the Australian parliament : putting the political scientist into the picture

This paper draws on a study of gender and politics in the Australian parliament in order to make a contribution to methodological debates in feminist political science. The paper begins by outlining the different dimensions of feminist political science methodology that have been identified in the literature. According to this literature five key principles can be seen to constitute feminist approaches to political science. These are: a focus on gender, a deconstruction of the public/private divide, giving voice to women, using research as a basis for transformation, and using reflexivity to critique researcher positionality. The next part of the paper focuses more specifically on reflexivity tracing arguments about its definition, usefulness and the criticisms it has attracted from researchers. Following this, I explore how my background as a member of the Australian House of Representatives from 1987 to 1996 provided an important academic resource in my doctoral study of gender and politics in the national parliament. Through this process I highlight the value of a reflexive approach to research.

The role of periosteum : a neglected aspect of osteoporosis

Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic activities occurring on endosteal surfaces, whereas the periosteal aspect is somewhat neglected. In terms of bone physiology, periosteum plays a determining role in de novo cortical bone formation and cortical bone expansion through periosteum is the most efficient way of increasing bone strength against fractures. Despite the important role of periosteum in the pathogenesis and treatment of osteoporosis, little is known about the structural and cellular features of periosteum in osteoporosis. This chapter will focus on the major changes occurring in the periosteum of osteoporosis and possible implications of these changes in the pathogenesis of osteoporosis. The changes identified in the periosteum of osteoporosis are mainly located in the metaphyseal compartment, which include: (a) much thicker and more cellular cambial layer; (b) increased number of TRAP (tartrate resistant acid phosphatase), VEGF (vascular endothelial growth factor) cells and the degree of vascularization; and (c) enhanced expression of sympathetic nerve fibers. The structural and cellular changes of osteoporotic periosteum indicate that periosteum plays an important role in the cortical bone resorption in metaphyseal areas and this pathological process may be regulated by the sympathetic nervous system.

Cellular senescence and longevity of osteophyte-derived mesenchymal stem cells compared to patient-matched bone marrow stromal cells

This study aimed to determine the cellular aging of osteophyte-derived mesenchymal cells (oMSCs) in comparison to patient-matched bone marrow stromal cells (bMSCs). Extensive expansion of the cell cultures was performed and early and late passage cells (passages 4 and 9, respectively) were used to study signs of cellular aging, telomere length, telomerase activity, and cell-cycle-related gene expression. Our results showed that cellular aging was more prominent in bMSCs than in oMSCs, and that oMSCs had longer telomere length in late passages compared with bMSCs, although there was no significant difference in telomere lengths in the early passages in either cell type. Telomerase activity was detectable only in early passage oMSCs and not in bMSCs. In osteophyte tissues telomerase-positive cells were found to be located perivascularly and were Stro-1 positive. Fifteen cell-cycle regulator genes were investigated and only three genes (APC, CCND2, and BMP2) were differentially expressed between bMSC and oMSC. Our results indicate that oMSCs retain a level of telomerase activity in vitro, which may account for the relatively greater longevity of these cells, compared with bMSCs, by preventing replicative senescence. J. Cell. Biochem. 108: 839-850, 2009. (c) 2009 Wiley-Liss, Inc.

Enhanced human bone marrow stromal cell affinity for modified poly(L-lactide) surfaces by the upregulation of adhesion molecular genes

To enhance and regulate cell affinity for poly (l-lactic acid) (PLLA) based materials, two hydrophilic ligands, poly (ethylene glycol) (PEG) and poly (l-lysine) (PLL), were used to develop triblock copolymers: methoxy-terminated poly (ethylene glycol)-block-poly (l-lactide)-block-poly (l-lysine) (MPEG-b-PLLA-b-PLL) in order to regulate protein absorption and cell adhesion. Bone marrow stromal cells (BMSCs) were cultured on different composition of MPEG-b-PLLA-b-PLL copolymer films to determine the effect of modified polymer surfaces on BMSC attachment. To understand the molecular mechanism governing the initial cell adhesion on difference polymer surfaces, the mRNA expression of 84 human extracellular matrix (ECM) and adhesion molecules was analysed using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). It was found that down regulation of adhesion molecules was responsible for the impaired BMSC attachment on PLLA surface. MPEG-b-PLLA-b-PLL copolymer films improved significantly the cell adhesion and cytoskeleton expression by upregulation of relevant molecule genes significantly. Six adhesion genes (CDH1, ITGL, NCAM1, SGCE, COL16A1, and LAMA3) were most significantly influenced by the modified PLLA surfaces. In summary, polymer surfaces altered adhesion molecule gene expression of BMSCs, which consequently regulated cell initial attachment on modified PLLA surfaces.

Biomechanical force displacement analysis of strength of fixation of tracker holding devices to bone in computer aided joint replacement

Computer aided joint replacement surgery has become very popular during recent years and is being done in increasing numbers all over the world. The accuracy of the system depends to a major extent, on accurate registration and immobility of the tracker attachment devices to the bone. This study was designed to asses the forces needed to displace the tracker attachment devices in the bone simulators. Bone simulators were used to maintain the uniformity of the bone structure during the study. The fixation devices tested were 3mm diameter self drilling, self tapping threaded pin, 4mm diameter self tapping cortical threaded pin, 5mm diameter self tapping cancellous threaded pin and a triplanar fixation device ‘ortholock’ used with three 3mm pins. All the devices were tested for pull out, translational and rotational forces in unicortical and bicortical fixation modes. Also tested was the normal bang strength and forces generated by leaning on the devices. The forces required to produce translation increased with the increasing diameter of the pins. These were 105N, 185N, and 225N for the unicortical fixations and 130N, 200N, 225N for the bicortical fixations for 3mm, 4mm and 5mm diameter pins respectively. The forces required to pull out the pins were 1475N, 1650N, 2050N for the unicortical, 1020N, 3044N and 3042N for the bicortical fixated 3mm, 4mm and 5mm diameter pins. The ortholock translational and pull out strength was tested to 900N and 920N respectively and still it did not fail. Rotatory forces required to displace the tracker on pins was to the magnitude of 30N before failure. The ortholock device had rotational forces applied up to 135N and still did not fail. The manual leaning forces and the sudden bang forces generated were of the magnitude of 210N and 150N respectively. The strength of the fixation pins increases with increasing diameter from three to five mm for the translational forces. There is no significant difference in pull out forces of four mm and five mm diameter pins though it is more that the three mm diameter pins. This is because of the failure of material at that stage rather than the fixation device. The rotatory forces required to displace the tracker are very small and much less that that can be produced by the surgeon or assistants in single pins. Although the ortholock device was tested to 135N in rotation without failing, one has to be very careful not to put any forces during the operation on the tracker devices to ensure the accuracy of the procedure.

21st Century politics : new faces/new spaces

Politics has been described as a man’s game and a man’s place. Further, the design of houses of politics also embeds this dominant masculine ethos. Traditional Chambers have been large with only limited seating arrangements ensuring that only privileged elite can participate and both officials and the public are located at some distance and separate from the elected officials. Such a Chamber ensures that Members need to face each other and the dominant interaction is adversarial. Within this system however, women have been able to carve out new spaces, or use existing ones in different ways, to become more involved with the mechanisms of parliament and provide alternative routes to leadership. In doing so, they have introduced elements of the private domain (nurturing, dialogue and inclusion) to the public domain. The way in which space is used is fundamental and its treatment has consequences for individuals, organizations and societies (Clegg and Kornberger 2006). Dale’s (2005) work emphasises the social character of architecture which recognises the impact which it has on the behaviours of individuals and nowhere is this more pertinent than the way the Australian Parliament House operates. This paper draws on the experiences of Australian parliamentarians to examine the way in which the new Australian Parliament House shapes the way in which the Australian political cultural norms and practices are shaped and maintained. It also seeks to explore the way the Members of Parliament (MPs) experience these spaces and how some MPs have been able to bring new ways of utilising the space to ensure it is more accommodating to the men and women who inhabit this building at the apex of Australia’s political life. In doing so, such MPs are seeking to ensure that the practices and processes of Australia’s political system are reflective of the men and women who inhabit this national institution in the beginning of the 21st century.