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| HONORARY PROFESSOR McNICHOLAS |
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| CLINICAL EXPERIENCE |
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| PUBLICATIONS |
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| RESEARCH |
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| TEACHING |
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| TEACHING PRESENTATIONS |
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Research I have been elected as co-ordinator of a prospective multicentre study based on both the Warrington knee Injury Database of the results of complex ligament reconstruction and an audit of complications of anterior cruciate ligament (ACL) reconstruction by the 20.20 Club (a UK wide specialist knee surgeons group). Whilst working as my Fellow, Yioannis Pengas presented The development of the “Warrington Knee Injury Database” to the following knee surgery units who have agreed to participate: Glasgow Royal Infirmary & Western General, Glasgow (16th May 2005); Northern General Hospital, Sheffield (27th May 2005); Ipswich Hospital, Ipswich (10th June 2005). I have instigated a number of studies of knee arthroplasty using data from the University of Dundee Arthroplasty database. I have gained ethical approval and secured cost neutral funding for a prospective randomised controlled trial of the Hi-Flex knee versus a conventional prosthesis Nexgen LPS investigating differences in range of motion and early a late outcome measures. Independent peer review of the proposal was obtained prior to completion of the COREC ethics form. Proposed centres involved are Warrington Hospital, South Warwickshire Hospital, Ipswich Hospital and University of Dundee. The various centres are applying for Local Ethical Committee approval now. The study commenced in April 2006. I have been a supervisor for two University of Cardiff MSc theses entitled Posterolateral Corner Reconstruction In The Knee and Double Bundle Posterior Cruciate Ligament Reconstruction; a University of Salford, Biomechanics of the lower limb for health care professionals thesis entitled An investigation into the effects of physiotherapy and foot orthoses on the kinetics and the kinematics of the knee in subjects with anterior knee pain; a University of Bath Sports Medicine MSc and a University of Dundee MD Thesis project: Menisectomy in adolescence: a 40 year follow-up. The Swedish Ligament Reconstruction Audit Database is based in the Capio Arthroclinic (Karolinska Institute) which is now internet based with multi-centre international collaborations currently used for data collection in Sweden, Norway, Denmark and Italy. My Fellow, Yioannis Pengas was invited to present The development of the “Warrington Knee Injury Database” to their knee surgery unit on the 27th June 2005. We are working to incorporate elements of the Warrington knee Injury Database within their database, to enhance their dataset and encourage further international collaboration. As the Edinburgh knee fellow, I reviewed the unit’s experience of posterior cruciate ligament reconstruction and ran collaborative studies in clinical objective measurement of anteroposterior laxity of the knee with Prof. Jakob’s unit in Fribourg. I set up the Edinburgh part of a three-centre validation study of the stress radiographic assessment of posterior cruciate ligament damage using the PCL-Press device designed by Dr Assal of Geneva, Switzerland. He was awarded the Orthopaedics Today Technological Advancement Award for the PCL-Press at European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) in London, September 2000. The Rolimeter is a knee laxity measurement device and I have been involved in a number of validation studies of differing aspects of its use with results published as outlined below. My MD thesis "Meniscectomy and osteoarthritis" was based on work carried out during the year I spent as the Tayside Health British Orthopaedic Associationrd Research Fellow in Surgery, and Honorary Research Fellow of the University of Dundee. I studied aspects of the aetiology, pathophysiology, conservative and surgical treatments of osteoarthrosis in the knee. I carried out the thirty-year follow-up of Honorary Professor Smillie’s patients who underwent total meniscectomy before the age of 18. A Swedish research fellow had carried out the 17-year review; the thirty-year review was carried out in collaboration with the University of Lund, where he was then based. Synovial fluid, serum, and urine samples collected from these patients were investigated for various markers of osteoarthritis. I measured nitric oxide activity in the samples at the Glaxo-Wellcome Research Laboratories, in Beckenham, Kent. The results of these investigations have been related to radiological findings in my thesis. The cohort has also been investigated biomechanically, with radiological and three-dimensional gait analysis studies relating the external knee adduction moment to osteoarthritic changes and the type of meniscus excised. The cohort has now reached the 40 year review stage, ethical committee approval has been granted. I arranged funding for the clinical and radiological review and synovial fluid collection from both knees, by one of my former Knee Fellows, who has completed the reviews and sample collections. The collaboration with Lund University in Sweden continues and will enable further investigation of various cartilage metabolism markers. As a Clinical Trial Investigator for Inveresk Clinical Research Ltd., I ran a Clinic at Perth Royal Infirmary for patients with osteoarthritic knees. This was part of a multicentre double-blind placebo controlled trial of the effectiveness and tolerance of intra-articular injections of sodium hyaluronate. I studied Tayside’s experience with the Ilizarov external fixation system, and investigated the biomechanical effects of external fixation after upper tibial osteotomy for osteoarthritis. I have a long-standing interest in sports medicine. I was the sports injuries theme co-ordinator for the World Golf and Science III Congress held at St Andrews University in June 1998, and a member of the Scientific Committee of the World Golf and Science Trust. I am a member of the British Association of Sport and Exercise Medicine and an elected Fellow of the Faculty of Sports and Exercise Medicine of the Royal College of Surgeons in Ireland. During my Lectureship in Dundee I assisted other trainees in their clinical research; the first such paper was presented at the Scottish Orthopaedic Meeting in Stirling, June 1997, winning the Michael Turner Memorial Prize. www.mcnicholaskneeclinic.co.uk
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