The research conducted by the POSM Research Institute has three main aims:
The current research activities of the Institute are listed below.
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.
Preventative cabling for extended trochanteric ostomy
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.
Does enhanced culture improve yields?
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.
Acetabulum osteolysis in patients lost to long-term follow up
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.
Accelerated vs. standard rehab in ACL reconstruction
This randomised controlled trial is looking at accelerated versus standard rehabilitation post double-bundle remnant sparing anterior cruciate ligament reconstruction (ACLR).
Review of failure rates in ACLR
Level 4 retrospective review of failure rates in double bundle remnant sparing ACLR in patients under 25 years of age.
Prospective cohort study for ACLR rehab
A prospective cohort study of single bundle ACLR and accelerated rehabilitation.