Friday, 18 March 2011

Clinical Senior Lecturer in Sports and Exercise Medicine - Vacancy

WILLIAM HARVEY RESEARCH INSTITUTE


Centre for Sports and Exercise Medicine and NEWHAM UNIVERSITY HOSPITAL TRUST

Clinical Senior Lecturer in Sports and Exercise Medicine

This post, the first of its kind in the UK, sits within the Centre for Sports and Exercise Medicine, William Harvey Research Institute at Barts and The London School of Medicine and Dentistry (SMD), part of Queen Mary University of London, and Newham University Hospital NHS Trust. The SMD is a leading medical and dental school that offers international levels of excellence in research and teaching as well as providing clinical services for a population of unrivalled ethnic diversity in East London and the wider Thames Gateway. Newham University Hospital NHS Trust is a 379 bed Acute Trust, serving one of Britain’s most diverse, fastest growing and youngest populations.

The academic duties will be discharged within the Centre for Sports and Exercise Medicine (CSEM). CSEM is the oldest and largest sports and exercise medicine (SEM) training centre in the UK, and has dedicated facilities, the oldest MSc in SEM in the UK, the only intercalated BSc in SEM in the UK, £1.5m of current research funding and a high publication rate with 80 peer reviewed publications in the last 15 months. It is a growing multi-disciplinary team that has trained many of the elite SEM clinicians working with elite sports governing bodies in the UK, including the chief medical officers for both the Olympic and Paralympic games. CSEM staff are fully involved with delivery of the 2012 activity and realisation of the legacy. Lead by Prof Nicola Maffulli, CSEM staff includes two clinical senior lecturers, a centre administrator, three post-graduate researchers, and a trial manager.

The clinical duties will be discharged at Newham University Hospital Trust. At Newham University Hospital, the successful candidate will be part of a vibrant team committed to all aspects of Sports and Exercise Medicine, with close links with the community and with the local medical units.

The successful candidate will have a high level of competence in Sports and Exercise Medicine, with experience in exercise prescription, be able to work independently and with other consultant colleagues, and be able to work as part of the wider multidisciplinary team to deliver high quality patient care. SEM unit have strong links with the Trauma and Orthopaedic unit for the management of sports related injuries. The successful candidate is expected to develop clinical links with other units (Rheumatology and Cardiology) to facilitate the delivery of wide aspect of services within the Sports and Exercise Medicine. You must have an appropriate specialist qualification and be on the Specialist Register. Sports and Exercise Medicine is part of the Trauma & Orthopaedics – SEM division lead by Mr Mustafa El-Zebdeh.

A postgraduate degree in an appropriate discipline is highly desirable. The postholder should also have experience in health and scientific research relevant to our research strategy including writing applications for research grants and a suitable track record of research evidenced by an appropriate publication record. The appointee will need demonstrable experience of postgraduate teaching, and contribute to teaching and student supervision as appropriate.

This is a part time, permanent appointment and is available to start as soon as possible. Starting salary will be made in the range of £76,665 - £102,607 (inclusive of London allowance) pro-rata, per annum. Benefits include 30 days annual leave (pro rata), final salary pension scheme and interest-free season ticket loan.

Candidates must be able to demonstrate their eligibility to work in the UK in accordance with the Immigration, Asylum and Nationality Act 2006. Where required this may include entry clearance or continued leave to remain under the Points Based Immigration Scheme.

Informal enquiries about the post can be addressed to Professor Nicola Maffulli on

020-8223 8459 or to n.maffulli@qmul.ac.uk, and to Mr M. El-Zebdeh on 0207 363 8061 or to mustafa.elzebdeh@newhamhealth.nhs.uk

Application enquiries should be directed to the recruitment at;

csq-recruit@qmul.ac.uk

Further information about Barts and The London School of Medicine and Dentistry (SMD) can be found at www.smd.qmul.ac.uk and the William Harvey Research Institute at www.whri.qmul.ac.uk

To apply, please visit the Human Resources website on http://www.hr.qmul.ac.uk/vacancies and search for reference QMUL0356

The closing date is 14 April 2011

Interviews are expected to be held in April 2011.

Valuing Diversity and Committed to Equality

Wednesday, 16 March 2011

Athletic Participation After Hip and Knee - Arthroplasty


The issue of athletic participation after hip and knee arthroplasty has become more relevant in recent years, with an increase in the number of young and active patients receiving joint replacements. This article reviews patient-, surgery-, implant-, and sports-related factors, and discusses currently available guidelines that should be considered by the physician when counseling patients regarding a return to athletic activity after total joint arthroplasty. Current evidence regarding appropriate athletic participation after total hip arthroplasty, resurfacing hip arthroplasty, total knee arthroplasty, and unicondylar knee arthroplasty is reviewed.

Management of Focal Cartilage Defects in the Knee - Is ACI the Answer?


Injuries to the articular cartilage of the knee are common. They alter the normal distribution of weightbearing forces and predispose patients to the development of degenerative joint disease. The management of focal chondral lesions continues to be problematic for the treating orthopaedic surgeon. Although many treatment options are currently available, none fulfll the criteria for an ideal repair solution: a hyaline repair tissue that completely flls the defect and integrates well with the surrounding normal cartilage. Autologous chondrocyte implantation (ACI) is a relatively new cell-based treatment method for full-thickness cartilage injuries that in recent years has increased in popularity, with early studies showing promising results. The current article reviews the nature of cartilage lesions in the knee and the treatment modalities utilized in their management, focusing on the role ACI plays in the surgical treatment of these complex injuries.

Osteochondroses and apophyseal injuries of the foot in the young athlete.

Curr Sports Med Rep. 2010 Sep-Oct;9(5):265-8.

Gillespie H.

Division of Sports Medicine, Department of Family Medicine, University of California, Los Angeles, CA 90095-1683, USA. hgillespie@mednet.ucla.edu

Abstract

With an increase in involvement in sports activities by children and adolescents, there has been a concomitant increase in both acute and overuse injuries. The pediatric skeleton lends itself to injuries unique to the young athlete, including various apophysites and osteochondroses. It is important for primary care and sports physicians treating the athlete to be aware of normal and abnormal variations in the pediatric skeleton, as well as common sites of injury in the pediatric foot. This article provides an overview of some of the most common skeletal foot injuries in the pediatric athlete, including Freiberg's infraction, Sever's disease, Kohler's disease, os navicularis, and Iselin's disease.

The asthmatic athlete: inhaled Beta-2 agonists, sport performance, and doping.

Clin J Sport Med. 2011 Jan;21(1):46-50.
Division of Sports Medicine, School of Human Kinetics, The University of British Columbia, 3055 Wesbrook Mall, Vancouver, BC, Canada. don.mckenzie@shaw.ca

Abstract

The asthmatic athlete has a long history in competitive sport in terms of success in performance and issues related to doping. Well documented are detailed objective tests used to evaluate the athlete with symptoms of asthma or airway hyperresponsiveness and the medical management. Initiated at the 2002 Salt Lake City Games, the International Olympic Committee's Independent Asthma Panel required testing to justify the use of inhaled beta-2 agonists (IBAs) in Olympic athletes and has provided valuable guidelines to the practicing physician. This program was educational and documented the variability in prevalence of asthma and/or airway hyperresponsiveness and IBA use between different sports and different countries. It provided a standard of care for the athlete with respiratory symptoms and led to the discovery that asthmatic Olympic athletes outperformed their peers at both Summer and Winter Olympic Games from 2002 to 2010. Changes to the World Anti-Doping Agency's Prohibited List in 2010 permitted the use of 2 IBA produced by the same pharmaceutical company. All others remain prohibited. However, there is no pharmacological difference between the permitted and prohibited IBAs. As a result of these changes, asthmatic athletes are being managed differently based on a World Anti-Doping Agency directive that has no foundation in pharmacological science or in clinical practice.

Hip pain referral patterns in patients with labral tears: analysis based on intra-articular anesthetic injections, hip arthroscopy, and a new pain "circle" diagram.

Phys Sportsmed. 2011 Feb;39(1):29-35.

Arnold DR, Keene JS, Blankenbaker DG, Desmet AA.

Division of Sports Medicine, Department of Orthopaedic Surgery, University of Wisconsin-Madison, Madison, WI.

Abstract

Background: Fluoroscopically guided intra-articular (FGIA) anesthetic hip joint injections have been used to determine whether the hip joint is the source of a patient's hip pain. However, there have been no reports documenting the efficacy of their use for defining the pain referral patterns (PRPs) of patients with labral tears. The aim of this study was to determine the PRPs of patients with labral tears and evaluate a new pain "circle" diagram (PCD) developed for this analysis. Methods: Fifty-two patients were evaluated at our institution who had: 1) a preoperative FGIA anesthetic hip joint injection; 2) completed our PCD and a visual analog pain scale pre- and postinjection; 3) significant (≥ 80%) pain reduction after their FGIA injection; and 4) a labral tear and minimal (≤ grade II) degenerative joint disease, as documented by hip arthroscopy. The PCD had circles in which patients put an "X" in to indicate pain in the following locations: anterior superior spine, lateral peritrochanteric area, central groin, symphysis pubis, proximal inner thigh, anterior thigh, posterior iliac crest, sacroiliac joint, sciatic notch, and ischial tuberosity. Results: Based on the percentage of patients with significant (≥ 80%) pain reduction after administration of FGIA, 2 areas demonstrated substantially more and consistent presence of pain, which improved after injection. These were the central groin (P < 0.001) and the lateral peritrochanteric area (P = 0.02). Conclusion: The most common locations of pain were the central groin and the lateral peritrochanteric area. The least common were the ischial tuberosity and the anterior thigh, which are 2 areas often associated with osteoarthritis of the hip. The use of the PCD combined with an FGIA anesthetic injection may help physicians reconcile the expectations of those patients with labral tears who believe that hip arthroscopy will treat their multiple areas of "hip" pain.

Sunday, 13 March 2011

A return-to-sport algorithm for acute hamstring injuries

Phys Ther Sport. 2011 Feb;12(1):2-14. Epub 2010 Aug 21.

Head of Rehabilitation Department at Athletic Club de Bilbao, Garaioltza 147 CP:48196, Lezama (Bizkaia), Spain. jurdan24@hotmail.com

Abstract

Acute hamstring injuries are the most prevalent muscle injuries reported in sport. Despite a thorough and concentrated effort to prevent and rehabilitate hamstring injuries, injury occurrence and re-injury rates have not improved over the past 28 years. This failure is most likely due to the following: 1) an over-reliance on treating the symptoms of injury, such as subjective measures of "pain", with drugs and interventions; 2) the risk factors investigated for hamstring injuries have not been related to the actual movements that cause hamstring injuries i.e. not functional; and, 3) a multi-factorial approach to assessment and treatment has not been utilized. The purpose of this clinical commentary is to introduce a model for progression through a return-to-sport rehabilitation following an acute hamstring injury. This model is developed from objective and quantifiable tests (i.e. clinical and functional tests) that are structured into a step-by-step algorithm. In addition, each step in the algorithm includes a treatment protocol. These protocols are meant to help the athlete to improve through each phase safely so that they can achieve the desired goals and progress through the algorithm and back to their chosen sport. We hope that this algorithm can serve as a foundation for future evidence based research and aid in the development of new objective and quantifiable testing methods.

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