Disorders of the skeletal system : new perspectives in bone grafting.

London : University of London Audio-Visual Centre, 1976.

1 encoded moving image (51.33 min.) : sound, black and white.

00:51:33

University of London

Restricted

In English

Presented by M HBS Kemp, Mr CW Manning, Dr MW Elves, Institute of Orthopaedics (University of London), Royal National Orthopaedic Hospital. Directed by Trevor A Scott. Made by University of London, Audio-Visual Centre.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Kemp talks to camera and explains what a bone graft is, differentiating between the different types (the autograft, the homograft and the allograft) which he illustrates in slides and X-rays. Time start: 00:00:00:00 Time end: 00:05:29:00 Length: 00:05:29:00

Segment 2 Kemp talks specifically about autografts and shows an X-ray of a fractured femur which needed an autograft to help it heal. He then shows an X-ray of a bone graft onto a patient's spine and describes in detail which sort of bone works best to treat a spinal fracture. He hands over to Manning. Time start: 00:05:29:00 Time end: 00:10:14:00 Length: 00:04:45:00

Segment 3 Manning discusses bone grafting in patients with scoliosis. He shows an illustration of a female with a spinal deformity due to scoliosis. Then, over the course of a series of photographs, Manning describes the surgical procedures used to help a girl with scoliosis. He talks about each stage of the process in depth. Time start: 00:10:14:00 Time end: 00:16:35:00 Length: 00:06:11:00

Segment 4 Manning hands over to Elves. Elves discusses ways in which bone can be modified for use in specific patients and the response of the host to new grafts can be influenced into accepting the graft. Time start: 00:16:35:00 Time end: 00:20:18:00 Length: 00:03:43:00

Segment 5 Elves talks about how new bone formation in the graft can be estimated. He talks about the radioactive tracer compound strotium-85 and describes, referring to detailed diagrams, how this can work to detail the extent of new bone growth following a graft. Time start: 00:20:18:00 Time end: 00:25:14:16 Length: 00:05:04:16

Segment 6 Elves looks at photomicrographs of homografted bone between 1 and 8 weeks following grafting. He describes in detail what can be seen as evidence of new bone growth and refers to a graph which details the osteogenic activity patterns. He then shows how, in a graft made from frozen autologous bone taken from a bone bank, no growth can be seen to have occurred. Time start: 00:25:14:16 Time end: 00:31:25:14 Length: 00:06:10:23

Segment 7 Elves moves on to discussing the immune responses of the body to homografts. He shows slides of different grafts and describes how their progression from 1 to 8 weeks relates to the amount of antibodies in the blood of the grafted patient, thus reflecting the strength of the immune response. Time start: 00:31:25:14 Time end: 00:35:02:00 Length: 00:03:36:11

Segment 8 Elves continues to discuss the immune response to bone grafts. He refers to the leukocyte migration inhibition assay technique used to detect immune responses and shows graphs and photomicrographs to illustrate it. The results show that fresh bone grafts are far more likely to be accepted by the host than grafts from frozen bone material. Time start: 00:35:02:00 Time end: 00:41:16:00 Length: 00:06:14:00

Segment 9 Elves shows slides which detail osteogenesis in homograft bone grafts. He compares them with osteogenesis in autografts. He concludes that for homografts and allografts, a first stage of bone regeneration always begins but often quickly stops. Time start: 00:41:16:00 Time end: 00:46:37:00 Length: 00:05:21:00

Segment 10 Elves concludes the lecture by showing slides which summarise the various conclusions covered. These show the importance of osteogenic cells, fresh bone rather than frozen, immune response to the graft and immunosuppressing drugs. In relation to the latter, immunosuppressive measures would only need to occur during the first phase of the graft as the new bone only serves as a scaffold upon which the host's own bone can grow. Time start: 00:46:37:00 Time end: 00:51:33:16 Length: 00:04:56:16