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Current research

Perth Hip & Knee will be undertaking research in the following areas in 2016:

Topic

Initial Registry of Stryker Mako Robotic procedures undertaken at SJOG Subiaco.

Study aim

  • To assess the introduction of this new technology into the operating room.

Methods

  • Identify all patients undergoing partial knee replacement utilizing the Stryker Mako Robot.
  • Record all operative data.
  • All data part of multicentre database.
  • Report on reliability, learning curve, complications and immediate surgical outcome.

Topic

Outcome Measures of Patients undergoing Partial Knee Replacement with Stryker Mako Robot.

Study aim

  • Demonstrate survivorship and outcome measures of case series of    patients with 100% follow up at 2 and 5 years.

Methods

  • Utilise Perth Hip and Knee Clinical database to obtain information obtained through standard clinical follow up of this patient cohort
  • Analyse and collate data for publication.

Topic

RCT comparing bicompartmental knee replacement with total knee replacement in patients with bicompartmental disease requiring joint replacement.

Study aim

  • Investigate if bicompartmental knee replacement offers functional advantages compared to total knee replacement.
  • To investigate survivorship of bicompartmental knee replacement in the longer term.

Methods

  • Collect surgical data, radiographic images, clinical outcome data and PROMs pre-operatively and then at 3months, 1 year, 2, 5, and 10 years post operatively.
  • Gait Analysis to determine if bicompartmental knee replacement more closely restores a normal gait post surgery than total knee replacement.

Topic

RCT comparing robotically assisted THR with standard surgical technique.

Study aim

  • Investigate if any clinical benefit of robotically assisted THR
  • Investigate health economics of the procedure due to relevance to costs Australia wide.

Method

  • Enrol THR patients into trial
  • Collect surgical, radiographic, clinical data and health economics prospectively.

Topic

Analysis of effect of pre-operative kinematics on the outcome of TKR with different alignment principles.

Study aim

  • Comparing outcomes of subgroups of patients with differing pre-operative kinematics as identified with computer navigation. This will also investigate the effect of the use of kinematic axis compared to the standard mechanical axis alignment.

Methods

  • Data from existing databases with pre-operative, intra-operative and 2 year postop clinical outcomes.

Topic

Anatomical study of the basis for differing pre-operative kinematics.

Study aim

  • Investigate the anatomical basis for observed differences in pre-operative knee kinematics.

Methods

  • Compare pre-operative MR, intra-operative computer navigation files and post-operative CT looking for Anatomical consistency between subgroups.

Topic

Initial Cohort study for Robotic Assisted TKR.

Study Aim

  • SJG Subiaco will be one of the first sites in the world to undertake TKR utilizing the Stryker Mako robotic arm. It will require close monitoring for accuracy, precision, reliability and reproducibility as part of the limited market release.

Methods

  • Patients recruited following ethics approval and informed consent.
  • Operative data and alignment recorded.
  • Post-operative alignment assessed with Perth Ct Protocol.
  • Clinical outcomes recorded.

Topic

Analysis of benefits of undertaking all pre-admission procedures and education within the private rooms.

Study Aim

  • To demonstrate any differences in patient satisfaction and LOS with coordinated patient education and pre-operative assessment together with discharge planning from private rooms.

Method

  • Comparing patient satisfaction and LOS for TKR and THR for the six months prior and six months post commencement of the new rooms
  • Topic: RSA Analysis Accolade 2 Stem.
  • Study Aim: To demonstrate initial stability of the Accolade 2 titanium alloy femoral stem.
  • Tantulum RSA beads implanted at time of surgery with post-op and 2 years RSA analysis undertaken.

Topic

RSA analysis of 3D printed Titanium uncemented tibial base plate.

Study Aim

  • To demonstrate whether this implant shows early signs of subsidence. The presence of subsidence is an early indicator of progression to loosening and these studies prevent the need for larger cohort studies to demonstrate early failures in new implants.

Methods

  • Cohort study with RSA beads implanted at time of surgery. RSA analysis post-op and 2 years post-op.

Topic

Evaluation of next generation Titanium in-growth Trident Acetabular component.

Study Aims

  • Clinical and radiographic analysis of this new release 3D porous titanium acetabular shell.

Methods

  • Study design pending but will include surgical data, clinical outcomes, longevity and registry data, X-ray analysis and possible RSA analysis.

Topic

RCT evaluating quality of sleep and its influence on rehab after TJA.

Study Aim

  • Investigating whether improved sleep improves clinical outcomes in the immediate and short term post-operatively.

Topic

Factors influencing limb swelling after TKR.

Study Aim

  • Limb swelling contributes to pain and impedes healing and range of motion. This study would aim to determine which factors contribute to the swelling significantly.

Methods

  • Likely to require multiple sequential RCTs with adequate power to investigate the differences in such area as:
    • Tourniquet vs. no tourniquet.
    • TEA vs. no TEA  (? Local vs. parenteral).
    • Patella eversion vs. inversion.