Disorders of the skeletal system : osteoarthritis.

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

1 encoded moving image (45.09 min.) : sound, black and white.

00:45:09

University of London

Unrestricted

CC-BY-NC

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

In English

Presented by Dr SY Ali and Dr PD Byers, Institute of Orthopaedics, University of London. 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 Ali talks to camera and describes the scope of the lecture. He explains how osteoarthritis is often misdiagnosed as being due to 'wear and tear' of the bones and gives examples as to why this is not true. He explains the clinical reasons for a diagnosis of osteoarthritis in a patient and describes what a clinician should look for in X-ray studies when making this diagnosis. He then differentiates between primary and secondary osteoarthritis: primary is idiopathic with no antecedent cause whereas secondary has an antecedent cause such as a congenital dislocation of the hip or any kind of bone disease. Time start: 00:00:00:00 Time end: 00:05:10:14 Length: 00:05:10:14

Segment 2 Ali refers to a diagram of a knee joint in order to illustrate two theories of what leads to osteoarthritis. He refers specifically to cartilage, comparing its wear and tear to that of the wear and tear of rubber on a car tyre. He then introduces Dr Byers to talk in more detail about microscopic studies of normal and osteoarthritic tissues. Time start: 00:05:10:14 Time end: 00:10:39:17 Length: 00:05:29:03

Segment 3 Byers talks to camera and describes how one searches for indications of osteoarthritic tissues in a patient. Referring to slides and diagrams of femoral head specimens he explains what looks different in the cartilage tissues of these diseased joints. Time start: 00:10:39:17 Time end: 00:14:57:00 Length: 00:04:17:08

Segment 4 Byers continues to discuss the nature of diseased tissues in the femoral head. He shows a series of photomicrographs detailing the very fine details of cartilage surface. He then refers to a graph which shows the distribution over four key areas of damaged cartilage. Byers moves on to discuss osteoarthritis affecting a hip joint. He differentiates between limited and progressive osteoarthritis. Time start: 00:14:57:00 Time end: 00:20:27:18 Length: 00:05:30:18

Segment 5 Byers talks further on the subject of limited and progressive osteoarthritis, showing cartilage alterations of a femoral head and acetabulum. He gives details on how to differentiate between the two types of osteoarthritis and refers to a table in which the destructive mechanisms of each are plotted against each other in time. He hands back to Ali. Ali shows some electron micrographs of cartilage damaged by osteoarthritis. Time start: 00:20:27:18 Time end: 00:24:58:11 Length: 00:04:30:18

Segment 6 Ali continues to discuss the electron micrographs of damaged cartilage. He looks more and more deeply into the cellular structure of cartilage. He uses slides of water tanks to demonstrate different inlets and outlets which can be applied to an understanding of the chemistry changes in cartilage tissue during osteoarthritis. Time start: 00:24:58:11 Time end: 00:30:10:16 Length: 00:05:12:05

Segment 7 Ali describes how cartilage change is brought about largely by enzymes activated by hormones and other metabolites dependent on the cellular activity of the tissue. He refers to a photomicrograph of a rabbit joint which has been injected with papain, an enzyme designed to trigger osteoarthritis. Time start: 00:30:10:16 Time end: 00:35:34:00 Length: 00:05:23:09

Segment 8 Ali shows an example of cartilage tissue which is pre-osteoarthritic in which the earliest osteoarthritic changes can be detected. He refers to graphs measuring the levels of various enzymes in the pre-osteoarthritic tissue. Then, through a series of slides, Ali details the sequential changes in tissue during the development of osteoarthritis. Time start: 00:35:34:00 Time end: 00:40:10:00 Length: 00:04:36:00

Segment 9 Ali continues to go through the changes, step by step, in cartilage tissue as osteoarthritis develops, using slides to illustrate each stage. He then concludes the lecture by discussing what kind of treatments might be available for sufferers of osteoarthritis in the future. Time start: 00:40:10:00 Time end: 00:45:09:03 Length: 00:04:59:03