Disorders of the skeletal system : taking decisions in the treatment and diagnosis of bone tumours.

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

1 encoded moving image (47 min.) : sound, black and white.

00:47:00

University of London

Unrestricted

CC-BY-NC

Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

In English

Introduced by Mr. J.N. Wilson, Consultant Orthopaedic Surgeon, Royal National Orthopaedic Hospital. Produced by Trevor A. Scott.

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 Mr Wilson begins the televised meeting, first explaining the history of the bone tumour registry at the Royal National Orthopaedic Hospital. He introduces the members of the meeting and explains that they will consider case studies. The clinician will introduce the case history, followed by radiological and pathological reports and a general discussion. Time start: 00:00:00:00 Time end: 00:05:30:22 Length: 00:05:30:22

Segment 2 Mr Wilson presents the first patient, a 37-year-old woman with a bone tumour in the right knee. Her primary x-rays are shown, and Dr Chapman comments on them and says that the lesion is likely to be a primary giant cell tumour. Dr Stoker agrees. Dr Byers asks if they would consider an aneurysmal bone cyst. Time start: 00:05:30:22 Time end: 00:10:15:03 Length: 00:04:44:06

Segment 3 Mr Wilson thinks that the patient is too old to have an aneurysmal bone cyst. He then details the results of the biopsy, which did show that it was a giant cell tumour. More x-rays are shown from 2 1/2 years later, when the tumour 'was on the move again'. Dr Chapman comments on the x-rays and thinks that the tumour has recurred. Time start: 00:10:15:03 Time end: 00:15:02:00 Length: 00:04:47:22

Segment 4 The doctors continue to dicuss the recurrence. A scan of the area is shown, and Dr Emery comments on it. The tumour is spreading up the femur. The doctors discuss the boundaries of the tumour. Time start: 00:15:02:00 Time end: 00:20:28:00 Length: 00:05:26:00

Segment 5 Dr Byers takes the team through the histology reports. Lumps of tissue from the lesions were examined. Microscopic slides are shown and Byers describes the images. He says there is no evidence of aneurysmal bone cyst and talks about the possibility of hyperparathyroidism. However, he concludes that the recurrence is another giant cell tumour. Time start: 00:20:28:00 Time end: 00:25:05:21 Length: 00:04:34:21

Segment 6 The team discuss how to deal with giant cell tumours and Kemp says that orthopaedic surgeons can be too complacent about them. They talk about whether it is worth grading the tumours and what percentage of tumours metastasise. They discuss treatment options for the recurring tumour. Time start: 00:25:05:21 Time end: 00:30:10:10 Length: 00:05:04:14

Segment 7 The team are against amputation and excision, which could damage the joint. They discuss the possibility of a prosthetic replacement for the knee. Prof. Scales talks about how the procedure would work and demonstrates two prosthetic knee joints. The team talk about whether the implant can be made around the lump in the soft tissues of the knee. They accept that this might not happen and talk about preparing the patient for the possibility of amputation. Scales describes the x-rays necessary to make a prosthesis for this patient. Time start: 00:30:10:10 Time end: 00:34:50:00 Length: 00:04:39:15

Segment 8 Scales continues to talk about constructing the prosthesis and how it would be implanted. The team discuss the surgery that would be required. Kemp talks about whether any muscle would have to be sacrificed in the procedure. Wilson says that this is the technique that the team will probably advise for the patient. Emery discusses the possibility of deep x-ray therapy to treat the tumour and says that he does not advise it as it can either damage the knee or transform the tumour into a carcinogenic sarcoma. Time start: 00:34:50:00 Time end: 00:41:47:13 Length: 00:06:57:13

Segment 9 The team discuss the possibility of infection from the knee implant surgery. Emery says that he is 'dead against' radiotherapy as long as another treatment method is an option as it damages the joint and tissue. The meeting ends and Wilson says that he will send on the x-rays so that treatment can begin. Time start: 00:41:47:13 Time end: 00:47:00:00 Length: 00:05:13:12