Author: Harry Bigwood

Life in the Fast Lane

Published / by Harry Bigwood

Sep 25th, 2008 by sandnsurf

Very sorry to see one of the great radiology case resources being suspended due to a lack of posts. I have really enjoyed and the work Dr Laughlin Dawes has put into the site over the last few years. I am sure users will continue to enjoy the great archive of radiology cases and possible even resurrect this great service.

Alternative sources to maintain your daily radiology case review mix:

  • Journal of Radiology Case Reports

medbrains User Support

Published / by Harry Bigwood

You’ve just registered with medbrains and now you’re wondering how to start putting what you have to say online?

If so then you’ll find exactly what you’re looking for here. This section of our help guide has been created just for you and will show you everything you need to know to start publishing online with breathtaking results….so let’s get started.

The first part of medbrains that you’ll need to learn about is the Control Panel.

The Control Panel

The Control Panel is where everything happens. It’s where you carefully craft the articles that will appear on your blog and it’s also the location from which you can administer every aspect of your blog and your user profile. What other users see on your blog and how it’s displayed is quite simply as a result of what you have done in the control panel.

To access your control panel you must first be logged in, then you can either select the image of yourself on your network homepage or you can simply click on this link.

We’ll now go step by step through the use the Control Panel showing how to create articles and set the design of your blog. But before proceding let’s take a look at this video to get a feel for how the Control Panel works and the different options available.

Now that you’ve got an idea of the layout of the Control Panel and what you can do through it, it’s time to start doing something useful i.e. writing articles. In medbrains it’s possibile to write either Pages or Articles so first of all let’s clarify the difference between both.

Pages are for content such as “About Me,” “Contact Me,” etc. That is to say information that lives outside of the normal blog chronology. Pages are often used to present information about oneself or one’s site that is somehow timeless — information that is always applicable. When you create a new page, its title will be added to the title bar on your blog and the text you insert into the page will be visible when someone clicks on that link on the title bar. For example, pages were used to create the sections “Getting Started”, “Resources” & “All about blogs” in this help blog.

Posts are the entries that are displayed in reverse chronological order on the home page of your blog. In contrast to pages, posts usually have comments fields beneath them (where people can leave comments on your article) and are included in your site’s RSS feed. Posts are the bread and butter of blogging and are what you should use everytime you want to share information that isn’t sutiable for sharing using pages. You’ll generally find that posts generate the the vast majority (around 95%) of your blog content.

Now that you understand the difference between pages and posts have a look at the the following video how to go about writing an article.

Adding images

Now that you’ve learned how to write content it’s time to start spicing things up. First of all let’s look at how to insert images into your posts, then we’ll do the same with videos.

Before looking at the tutorial we must talk about a very important concept, image size; and by this we mean how many Kilobytes or Mega bytes your image is. When putting images onto the web it’s very important to make sure that you keep their dimensions as low as possible so that people who view your website don’t have to wait minutes to download the pictures in your article. You may have a fast internet connection but this is not true for everyone, especially those in developing countries.

It’s easy to immagine that reducing the size of your image will drastically reduce it’s quality, but this is not true. Images to be displayed online can reduced from 3Mbytes to 100Kbytes without any apparent loss of quality but with a huge difference in download time.

Many modern digital cameras produce images that are over 5Mbytes, so therefore these images will have to be resized before being uploaded to medbrains. This is also due to the fact that no internet browser can support uploads of over 2Mbytes.

Remember also that you have a limited amount of space for your blog and while you should have as much space as you ever need if you’re not careful about the size of images you put in your blog then you could find yourself running out of space quite rapidly.

Now, let’s have a look at the tutorial.

Ading Videos

The real difference of blog articles is their ability to seamlessly integrate all the different types of media thereby creating a wonderful means of communication. More than any other media, videos allow you to communicate in a few seconds a thousand word’s worth of information.

It is not possibile to upload your videos onto medbrains, this is due to space reasons and because there is a plethora of other video repositry sites available. Therefore to put your video in your blog article you simply upload it to one of these video repositry sites and create a link to it within your article….sound’s complicated? Once you’ve understood how it all works you’ll see that it’s as easy as pie. Below you’ll find 2 video tutorials, one explaining how to insert a video from a Video repositry website (YouTube into your post and the other explaining how to upload your video to YouTube.

Inserting a video into your article

Using YouTube

Look & Feel

So now you should be able to write pages and posts and embedd both images and videos in your articles, in fact you’re pretty much ready to start blogging. But before you begin you might want to learn some more about how you can control the look & feel of your your blog.

Blog design & Layout is actually quite simple, so let’s look at this video to get to grips with the concepts.

And that’s it! While there’s a lot more to blogging than what you’ve just seen, this is all you need to get started. We have many more resources to help you along in your blogging experience but you’ll find that one of the best ways to learn is experience. Therefore we encourage you to start writing before looking at any more of the tutorials so that you get a feel for how everything works.

Thanks & enjoy!

The medbrains team

Harry Bigwood Orthopod blogger

Published / by Harry Bigwood
  • Direct Anterior Approach

    18 Sep 2008 /  Hip replacement


    Just hours after Dr. Dick Wallin had his right hip replaced, he stood up. The next day, he used a walker to “cruise around the nurses’ station” at St. Mark’s Hospital, and shortly after that he learned to use crutches on a stair exercise machine.

    When he went home on day three, he needed only one crutch, which he discarded a week later. Within a couple of weeks, he was walking down his long driveway to retrieve the newspaper and the mail. He was also driving again.

    “I was all set up for living in a restricted fashion, but by the time I went home in three days, I could go upstairs to my bedroom. It has been a surprisingly good experience,” said Wallin of a new approach to hip-replacement surgery that’s said to spare muscle and ligaments, seems to reduce the risk of dislocation, produces less pain and shortens recovery time.

    The key to a “direct anterior approach” total hip replacement is the positioning of the patient during surgery and the location of the incision itself, according to Dr. E. Marc Mariani, a board certified orthopedic surgeon at St. Mark’s Hospital who with colleague Dr. Michael H. Bourne and Dr. Peter Novak of the Salt Lake Orthopaedic Center are the first three Utah surgeons using the technique — something they predict will soon change.

    Seems like I’m starting my blog with a chain of cripes but I really get annoyed at these type of news articles. The work that we perform shouldn’t be marketed commercially as patients are to easily swayed and to unknowing to be able to make an intelligent choice.

    I use the poster-lateral approach for my hips and I have many success stories as above, with low blood loss etc. Also being able to make a slightly larger incision than usual I’m able to see what I do and make less mistakes.

    I do accept the fact that I could be simply out of date and need to get brought up to speed. Is there anyone out there that has some relevant experience that they’d like to share?

    Thanks, Harry.

    Posted by harrybig @ 12:15

    Tags: Hip replacement, Mini Invasive

  • Orthopedics et al….

    Published / by Harry Bigwood


    The right kind of Patient Marketing

    Posted by tnystrom under: Uncategorized.

    Taking off from where Dr. Bigwood finished, I found this guy on YouTube. He’s all over the place, with videos on everything to do with Shoulder Surgery.
    I think that this is a good example of patient information. I mean the messages are clear and (in my humble opinion) correct. There’s allot of emotional music in […]

    Bridge on Orthopaedics

    Published / by Harry Bigwood

    21 September 2008

    A little bit of history

    Posted by thebridge under: Uncategorized .

    I don’t think that there’s an orthopedic surgeon around that hasn’t heard of DePuy, part of the Johnson & Johnson group and world leader in orthopedic solutions. What most people don’t know is that it all started with DePuy, in that they’re the oldest orthopedic company around. And even fewer people know that DePuy all started with just one man, Revra DePuy.

    Revra DePuy

    Revra DePuy was born in 1860 in Grand Rapids, Michigan.  His family moved to Canada shortly after his birth and later returned to the U.S. when his father died, settling in Illinois.  According to the DePuy family thread on Rootsweb, the family saw some hard times during this period.  Revra DePuy worked as a clerk in a drug store (as did Robert Wood Johnson the first) and the work interested him enough to cause him to take a course in chemistry at the University of Toronto in Canada, where he got his degree.  After graduation, DePuy got a job as a traveling salesman.

    According to the Warsaw Daily Times of October 10, 1921, referenced here, Revra DePuy was also a chemist during his early career, and is credited with inventing the formula for sugar coating pills.

    In the late 1800s, splints for broken limbs were distinctly unscientific, and were made out of barrel staves or other similar makeshift materials.  DePuy saw that there was a huge need for something better to help heal broken limbs, and he got the idea to start a business to produce specifically-designed splints that could be customized to fit patients, rather than the improvised splints that were commonly used.  DePuy decided to open his business in Warsaw, Indiana (where its headquarters remains today) after visiting the town as part of his job as a traveling salesman.

    The Hotel Hays, Headquarters of Revra DePuy’s New Company from 1895-1901

    Revra DePuy settled in, married the daughter of the local sheriff, and started building his new business.  The first DePuy plant was at the corner of Columbia and Center streets in Warsaw, and the company made specially constructed splints using fiber and wire.  Revra DePuy’s company, then called DePuy Manufacturing, was the first commercial orthopaedics manufacturer in the world.  [Update: DePuy Manufacturing, later DePuy, Inc., was founded in 1895.]

    Interestingly enough, in 1905 DePuy hired a man named Justin Zimmer as his first sales representative.  Six years after Revra DePuy died, in 1927, Zimmer left the company now run by DePuy’s widow to start his own orthopaedics company.

    Revra DePuy died in 1921.  The business he started revolutionized the way orthopaedic injuries and conditions were treated.  Not only did DePuy, Inc. manufacture the first state-of-the-art splints in the 19th century, the company almost 100 years later pioneered the first hip and knee joint replacement implants.

    A thread on Rootsweb quotes an unattributed obituary for Revra DePuy, which gives a small sense of what DePuy was like as a person:

    “Revra Depuy, who has manufactured wire splints for 25 years, was one of Warsaw’s substantial businessmen and his advice was frequently sought in a business way. He was a well-educated, self-made man and had a knowledge of nearly every subject far beyond the average.  He was generous and courteous and had many warm personal friends among those who knew him well.”

    Here’s another interesting bit of information about DePuy, Inc.:  in the 1950s, long before female chief executives were common, DePuy had a female president, Mrs. Amrette Hoopes.  Here’s an article about her, with pictures.

    Orthopod online and blogging

    Published / by Harry Bigwood

    18 September 2008

    Video on Cuff repair

    Posted by orthopodduffy under: Rotator Cuff; Uncategorized .

    As I’ve just started my new blog I’m getting carried away posting articles…oh well I guess I should enjoy myself before getting back to work.

    I’ve been reading the tutorials and so now I’m going to insert a pretty cool educational video on Rotor Cuff Repair. If I succeed you should see it below. Otherwise you won’t see anything!!

    Back to work!


    Published / by Harry Bigwood

    Click on the following Link, and scroll down to the Update Your Password section.

    Type in a new password in the two boxes provided.
    Click the UPDATE PROFILE button.

    Your new password takes effect immediately.


    Clicck sul Link seguente e vai in fondo la pagina.

    Scrivi il nuovo password nei spazi appositi.
    Clicca su Aggiorna Profilo.

    Il nuovo Password sarà attivo subito.

    Andreas Richards’ WeBlog

    Published / by Harry Bigwood

    The Proxima stem confronted with a Zweymuller type

    I found this article (aimed at patients) on the Proxima hip replacement. This hip has been somewhat of interest to me sine I seen it at a DePuy Symposium. I talked to Dr. Valverde from Spain and I must say that he pretty much convinced me of the product’s benefits.

    Essentially the hip’s proximal “lateral flare” gives the stem a wedge shape form that them gets blocked in the metafisis of the femur. This is essentially how it can work without the presence of a stem.

    I think that the benefits in terms of avoiding or at least reducing stress shielding and thigh pain that this product bring can’t be denied, I’m just a bit dubious on the difficulty of the surgical technique and the results.

    I know that there’s and Italian surgeon by the name of Santori that has (so I’ve been told) almost 11 years of follow up with some custom made stems very much like Proxima but I don’t feel that the clinical history of a custom made stem can be inherited by it’s commercial version.

    Does anyone information how the stem is performing in Europe and is maybe able to give me some insight to the first results that have been reported? I really look forward to seeing some good clinical results as I feel that they will be the key in making me start using Proxima. Right now I’m afraid of making the same mistake I made with resurfacing.

    Wozny’s Orthopaedic corner

    Published / by Harry Bigwood

    23 Sep 2008 /  Uncategorized

    Hip arthroscopy is being talked about more and more.

    Everytime I go to a congress there’s always a talk somewhere in the program, when I talk to friends they’re always more and more anxious to try it out.

    Personally I haven’t even thought of experimenting just yet, mainly for that reason i.e. it just feels to early on in the development of this new procedure to be able to use it on patients with a clear conscience. But then again that may just be me being too conservative and/or un-informed.

    I also get the feeling that some companies are pushing the new products that they’ve developed for Hip arthroscopy and so therefore we’re seeing it inserted as a topic in more and more congresses, we’re getting invited to company events on Hip Arthroscopy and to thier visitation centers.

    I also feel that we’ve become so good at regular arthroscopy that we’re now looking for the next challenge. This is what worries me the most as one could relate it to the trend in hip replacement towards mini incisions…and just look at the results obtained with the Zimmer double incision technique.

    I’m hoping that someone with good experience in this field will read this article and let me know their opinions. Until I have more proof and preferably some concrete clinical results I think I’m going to wait and see.

    I’ve included below some videos on the subject matter. I look forward to your comments!

    embedded by Embedded Video

    embedded by Embedded Video

    Posted by wozzer @ 2:37 pm

    Orthopaedics from Down under

    Published / by Harry Bigwood

    I wanted to share this press release the I foudn while surfing the net. I’ve already closed the window from which I pasted it in and I can’t remember the source site. For me the moral of this press release is that those of us who aren’t convinced or totally confident with mono-compartmental knees or hip resurfacing should leave them alone as we’re only putting our patients at risk.

    British researchers collecting and reviewing nationwide data on hip and knee replacements reported that one in 75 patients requires a revision of their joint replacement after 3 years.

    Although this compares favorably with the rest of the world, the study reinforces concerns about the new surgical techniques of hip resurfacing and unicondylar knee replacement, according to a press release.

    Hip and knee replacements are among the most frequent surgical operations conducted in the United Kingdom, with about 160,000 procedures performed in England and Wales in 2006. However, there is little evidence to compare the patient outcomes of hip and knee replacement with the many types of surgical techniques and prostheses used to replace the joint, Jan van der Meulen, PhD, said in the press release.

    He and his colleagues from the Royal College of Surgeons used records from the National Joint Registry (NJR) for England and Wales to address the lack of evidence comparing patient outcomes. Since April 2003, the NJR has collected data available immediately following surgery, including patient characteristics, the type of prostheses and the surgical technique used to replace the joint.

    In order to identify the revision rates, the researchers linked the NJR records with another database — the Hospital Episodes Statistics — which contains information on all admissions to National Health Service hospitals in England. They considered revisions for any reason in the 3 years following a hip or knee replacement.

    They also paid particular attention to hip resurfacing and unicondylar knee replacement, two techniques that are increasingly used but about which there is “little evidence” of their performance, van der Meulen said in the press release.

    Of the 167,076 procedures that could be linked between the two databases between April 2003 and September 2006, one in 75 patients required a revision of their joint replacement, van der Meulen said. As expected, the patients who had cemented prostheses had the lowest revision rates.

    For hip replacements, the highest revision rates were experienced by women who had undergone hip resurfacing rather than total joint replacement, according to the press release. Of patients who had undergone knee replacement operations, those who had unicondylar prostheses had the highest revision rates.

    Van der Meulen said there appears to be no connection between a patient’s age and his or her revision rate for a hip replacement, whereas revision rates after knee replacement decreased strongly with age.

    “This first national study on joint replacement does provide benchmark data for the further research that is needed to evaluate the performance of different procedures and types of implant,” he said in the press release.

    Do NOT follow this link or you will be banned from the site!