The research conducted by the POSM Research Institute has three main aims:
The current research activities of the Institute are listed below.
Hamstring Tendon Autograft Versus Quadriceps Tendon Autograft for Anterior Cruciate Ligament Reconstruction: A Randomised Controlled Trial.
Dr Ross Radic, Dr Nicholas Calvert, Dr Jay Ebert
Patients are invited to participate in world leading research, aimed at improving our knowledge and understanding of graft behaviour in ACL Reconstruction. Currently, approximately 90% of ACL Reconstruction procedures in Australia are performed using a graft made from the patient’s hamstring tendons. There is evolving debate as to whether a graft made from the patients quadriceps tendons may result in better post-operative outcomes with greater patient satisfaction. This study aims to help answer these questions, with the use of gold-standard reconstructive techniques with strength and functional assessments from our clinical research team.
MotionLoc® screws study
This is a multi-centre randomised controlled study comparing conventional screws versus MotionLoc screws for distal femoral fractures in the elderly. MotionLoc screws allow about 1 mm of axial fracture motion and theoretically should accelerate fracture healing.
Kneeling after total knee arthroplasty and ACL reconstruction
This study aims to develop a kneeling test to quantify the kneeling abilities of normal healthy subjects in comparison to osteoarthritic knee joints, knee joints after total knee arthroplasty and knee joints after anterior cruciate ligament reconstruction. We are collecting 60 patients to each arm and will then retest 10 patients each for the validation of the test.
Once the kneeling test is validated we will perform a randomised controlled trial within the POSM group. 50 patients each will be randomised to a lateral skin incision and to a medial skin incision. The kneeling test will be performed preoperatively, after 6 weeks, 6 months and after 1 year. Ethical approval at Hollywood Hospital has been obtained.
Total knee arthroplasty +/- preoperative psychological coaching
The work of a psychology PhD student will randomise patients after total knee arthroplasty to either a normal pathway or a psychological coaching pathway. The aim is to see whether we can improve the outcome measured with forgotten joint score, length of stay and patient satisfaction. The study will employ preoperative psychological coaching similar to sports coaching. Ethical approval at Hollywood Hospital and Sir Charles Gairdner Hospital has been obtained.
Dr Ross Radic, Dr Elizabeth Garcia, Dr Davide Tomassoni, Dr Jay Ebert
Multi-ligament Injuries in the knee are a complex group of injuries which historically have less favourable long-term outcomes with higher rates of post-traumatic osteoarthritis, ongoing knee instability and a decreased functional capacity. They are best described as knee injuries with disruption of at least two of the four major knee ligament structures including Anterior Cruciate Ligament, Posterior Cruciate Ligament, Medial Collateral Ligament and/or Posteromedial Corner and Lateral Collateral Ligament and/or Posterolateral Corner.
Dr Ross Radic has a special interest in complex knee injuries. At Perth Orthopaedic and Sports Medicine Centre, together with his involvement at Royal Perth Hospital, housing the State Trauma Centre, Dr Radic often manages the most complex knee injuries. The POSM Research Institute are aiming to prospectively follow patients suffering these traumatic knee injuries assessing their long term outcomes and functional recovery.
Dr Abay Sundaram, Dr Mira Marinova, Ms Katie Holtham, Dr Jay Ebert, Dr Ross Radic.
Following ACL Reconstruction, patients are encouraged to engage in rehabilitation programs that rebuild muscle strength, proprioceptive control and regain joint mobility. One of the primary issues that limit the active rehabilitation of the patient is the early pain and swelling that comes with orthopaedic knee surgery. While elastic wraps and ice-packs are used most commonly in the application of post-operative cryotherapy, the Game Ready systems offers a novel method of administering constant cryotherapy, at a consistent temperature, with intermittent pneumatic compression. This study aims to investigate the functional outcomes of the use of the Game Ready system in the early post-operative period compared with a more traditional method of delivering cryotherapy and compression.
Dr Mira Marinova, Dr Abay Sundaram, Ms Katie Holtham, Dr Jay Ebert, Dr Ross Radic
Total Knee Replacement (TKA) is primarily performed to alleviate pain and improve function for patients with osteoarthritis of the knee. This is a major orthopaedic procedure, with expected pain, swelling and inflammation post-operatively. Reducing these measures with the use of cryotherapy and dynamic compression improves patient comfort, reduces swelling and allows patients to participate in a greater amount of post-operative rehabilitation. We aim to investigate the use of the Game Ready System, a novel tool allowing constant cryotherapy and intermittent compression, and assess its outcomes compared with a more traditional method of cryotherapy delivery.
This biomechanics study is being conducted at Royal Perth Hospital. The question is whether cabling around the femur can prevent crack propagation. We are comparing different cables and different setups, such as single cable versus double cables and also cables with differing tightness. This study is under way and first results should appear in a few weeks.
We’re partnering with Western Diagnostics to investigate whether enhanced culture improves the yield of positive cultures. During revision surgery at Hollywood Hospital, surgeons are taking 5 samples of tissue where one half of each sample is put into a normal empty container and sent to Western diagnostics for culture the other half of the sample is put into a container with thioglyconate already in the container. Hence the culturing process begins in the operating theatre.
A study looking at several cases where acetabulum osteolysis was so advanced that any surgery and reconstruction became extremely difficult. These were often well functioning prosthesis after 20 years and no follow up was performed on these patients. We will audit all revisions and see how many difficult revisions could have been avoided if regular follow-up was performed.
This randomised controlled trial is looking at accelerated versus standard rehabilitation post double-bundle remnant sparing anterior cruciate ligament reconstruction (ACLR).
Level 4 retrospective review of failure rates in double bundle remnant sparing ACLR in patients under 25 years of age.
A prospective cohort study of single bundle ACLR and accelerated rehabilitation.