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- Dr Andrew Lynn Receives European Award for University Spin-out Success.
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Publications
- A clinical review of cartilage repair techniques
- A review and user’s guide to measurement of rehabilitation adherence following anterior cruciate ligament reconstruction
- Antigenicity and immunogenicity of collagen
- Repair of defects in articular joints. Prospects for material-based solutions in tissue engineering
- Risk assessment of bovine spongiform encephalopathy transmission through bone graft material derived from bovine bone used for dental applications
A clinical review of cartilage repair techniques
Authors: Smith GD, Knutsen G, Richardson JB Journal: Journal of Bone and Joint Surgery (British Edition) 2005:87B(4); 445-449
Chondral injuries involving the knee are common. In a recent study of 993 consecutive arthroscopies scored using the International Cartilage Repair Society (ICRS) knee evaluation form, articular cartilage pathology was found in 66% of patients, while 11% had localised, full-thickness lesions which might have been suitable for cartilage repair procedures. Another review, of 31,000 arthroscopic procedures, found articular cartilage lesions in 64% and another reported the incidence of localised chondral and osteochondral lesions in 1,000 consecutive arthroscopies to be 19%. Debate still persists about the best treatment for symptomatic chondral defects. Here, we discuss the efficacy of the different surgical techniques that may be used to address these lesions.
A review and user’s guide to measurement of rehabilitation adherence following anterior cruciate ligament reconstruction
Authors: Shaw T, Williams MT, Chipchase LS Journal: Physical Therapy in Sport 2005:6 (1); 45-51
Rehabilitation programmes are considered essential following anterior cruciate ligament reconstruction to maximise the potential outcome of the surgery. Provision of a rehabilitation programme, however well intentioned, does not guarantee that patients will adhere to the programme. Failure of patients to comply with clinical rehabilitation may limit the effectiveness of the rehabilitation programme. Furthermore, failure of subjects to comply with experimental rehabilitation programmes may bias results obtained by research studies, limiting the strength of empirical evidence generated. The aim of this paper is to present clinicians and researchers with an overview, particularly with respect to reliability and validity, of a number of adherence measurement instruments that may potentially be administered to patients or subjects following anterior cruciate ligament reconstruction. © 2005 Elsevier Ltd. All rights reserved.
Antigenicity and immunogenicity of collagen
Authors: Lynn AK, Yannas IV, Bonfield W Journal: Journal of Biomedical Materials Research Part B: Applied Biomaterials 2004:71B(2); 343-354
Pertinent issues of collagen antigenicity and immunogenicity are concisely reviewed as they relate to the design and application of biomedical devices. A brief discussion of the fundamental concepts of collagen immunochemistry is presented, with a subsequent review of documented clinical responses to devices containing reconstituted soluble or solubilised collagen. The significance of atelocollagen, concerns regarding collagen-induced autoimmunity, and other relevant topics are also addressed in the context of current understanding of the human immune response to collagen. © 2004 Wiley Periodicals, Inc.
Repair of defects in articular joints. Prospects for material-based solutions in tissue engineering
Authors: Lynn AK, Brooks RA, Bonfield W, Rushton N Journal: Journal of Bone and Joint Surgery (British Edition) 2004:86B(8); 1093-1099
Each year, more than one million procedures to treat defects of articular cartilage are performed in the knee alone. While removal of loose bodies and the chondroplastic procedures of debridement and shaving account for approximately half of these, the remainder involve treatment of defects which are sufficiently severe to require the replacement or assisted regeneration of damaged hyaline cartilage. Over the past decade, methods based on the principles of tissue engineering and regenerative medicine have emerged as the most promising approaches for the repair of defects in articular joints. These make use of combinations of cells, signalling molecules and scaffolds to augment the natural regenerative capacity of the body, with the aim of restoring healthy structure and function to damage or diseased tissue. Tissue engineering has produced success in a number of soft-tissue applications, but the regeneration of articular surfaces poses a unique challenge, in that articular cartilage has a limited capacity for self-repair and mechanical stimuli play a large role in the structure and function of cartilage and subchondral bone. While these factors place special demands on all aspects of tissue engineering, scaffold design takes on a role of particular importance. This review addresses the design requirements for scaffolds used in the treatment of chondral and osteochondral defects. Particular emphasis is placed on recent trends in scaffold design and their potential for clinical application.
Risk assessment of bovine spongiform encephalopathy transmission through bone graft material derived from bovine bone used for dental applications
Authors: Sogal A, Tofe AJ Journal: Journal of Periodontology 1999:70(9); 1053-1063
Several commercial products are currently available for clinical application as bone graft substitutes. These products can be broadly classified into two categories: synthetic and natural. Bovine bone is a popular source for several of the natural bone substitutes. The availability of bovine derived xenogenic bone substitutes has made it possible to avoid traumatic and expensive secondary surgery to obtain autogenous bone once thought essential for effective bone replacement. While autogenous bone still remains the undisputed ‘gold standard’ in bone grafting, the realisation that bone requirement in several clinical applications is as effectively met by xenografts has led to their widespread use. But the convenience of using xenografts is tempered by the possibility of disease transmission from cattle to humans. The recent incidents of bovine spongiform encephalopathies (BSE) in humans have underscored this likelihood. In this paper, we report a risk analysis performed to assess the possibility of such disease transmission from a commercially available bone graft substitute (BGS) that is popularly used in clinical dentistry. METHODS: An extensive review of current literature on the status of risk assessment of BSE transmission was conducted, and two risk assessment models were identified as applicable to the present study. Risk assessment models developed by the German Federal Ministry of Health and by the Pharmaceutical Research and Manufacturers Association of America were applied to BGS. RESULTS: Results from the analyses conducted using both models showed that the risk of disease (BSE) transmission from BGS was negligible and could be attributed to the stringent protocols followed in sourcing and processing of the raw bovine bone used in the commercial product. CONCLUSIONS: Based on the risk analysis, it is evident that the risk of BSE infection from BGS is several orders of magnitude less than that posed by the risk of death related to lightning, tornadoes or similar remote events. However, this low risk can only be maintained as long as an effective and active risk management programme is implemented in operations that involve processing xenogenic tissue for human use.