Supported Research

Will a validated dynamic short-form outcome measure improve patient responsiveness: A National Anterior Cruciate Ligament (ACL) Injury Registry in Australia

Jon Anderson
Orthopaedic Surgeon
University of Queensland

This research comprises part of my PhD investigating ACL PROMs and the development of a new measure to improve patient responsiveness. The outline of my thesis was presented at the September AOA Queensland Branch meeting with the generous support of QORF.

Topical antibiotics in ankle fracture surgery (TAAFS) study

Grant Menegon
Training Registrar
Cairns Hospital/Townsville Hospital/RBWH

The topical antibiotics in ankle fracture surgery (TAAFS) pilot study is a multi-centre, prospective, double-blinded, placebo control, randomized controlled trial comparing standard surgical fixation of ankle fractures with and without local topical antibiotics administered at the time of wound closure.  The aims of this pilot study include determining the prevalence of both deep and superficial surgical site infection (SSI) according to the centre for disease control and prevention (CDC) definition as well as fracture related infection definition. 

The Royal Brisbane & Women’s Hospital, Cairns Hospital and The Townsville University Hospital are the 3 pilot sites. The sample size for this pilot study will consist of 332 patients, spread across the 3 sites. The authors thank the Queensland Orthopaedic Research Fund for funding this pilot study and making this research idea possible.

Analysis of Rapid Response Team calls within the Orthopaedic Department in a Queensland based Public Metro Hospital and Health Service: A retrospective cohort study

Alison McCarthy
PHO
Princess Alexandra Hospital

A retrospective analysis of RRT/MET calls in a major tertiary hospital over a three year period.  Aiming to identify and modifiable variables that can be addressed peri-operatively to reduce call rates.

Progress to date includes Ethics and SSA approval for the project.  We have identified all RRT calls for a three year period and are collating the data.  We have collated just under 200 points for the year 2020. 

Preliminary data is showing hypotension to be the most common cause for a RRT call.  86% of calls were in patients who had emergency admission over elective admissions. 

We are currently continuing to build the database and conducting an in depth statistical analysis of the datapoints.  

Antibiotic coated rods: a 15-year experience of Indications, Surgical Techniques and Clinical Outcomes

Andrew Foster
PHO
Royal Brisbane and Women's Hospital

Antibiotic coated rods (ACRs) composed of polymethyl methacrylate (PMMA) are used to osteomyelitis. This technique allows the application of local antibiotics while also providing a stable biomechanical environment to facilitate both infection eradication and bony union. Conway et al. have reported the largest case series to date, treating 110 patients in a single centre with a limb salvage rate of 100% for long bone osteomyelitis. Further data however is scarce, with the recent International Consensus Meeting on Musculoskeletal Infection giving a strong consensus that there is limited evidence regarding the indications and outcomes following the use of ACRs. The Royal Brisbane and Women’s Hospital (RBWH) has been using this technique over the past 15 years, which would represent the largest case series to date. Our aim is to describe the indications, surgical techniques and clinical outcomes following the use of an ACR.

Arthroplasty patient follow up - When should we stop?

Ahmed Mahmoud
PHO
Princess Alexandra Hospital

The project has passed major milestones in answering the research question. The team has completed data collection and has performed the data analysis. The project has gather interested from the orthopaedic community. The data from the project has helped change clinical practice at the Princess Alexandra hospital and is allowing early discharge of patients after arthroplasty procedures. The changes implemented led to improved patient care and major cost saving. The research has been presented at the Princess Alexandrea Hospital orthopaedic show case, the Queensland orthopaedic physiotherapy planning day (invited) and the Royal College of Surgery annual scientific meeting. The project has several arms:

1. Survey of orthopaedic surgeons: 44 Orthopaedic surgeons have completed the survey regarding their opinion of arthroplasty patient follow up. We found that most surgeons suggest discharging patient at the one-year mark post operatively (figure). The data has been presented as a poster at the RACS Annual Scientific Meeting 2022.
2. Retrospective review of arthroplasty clinic: The data collection was completed. The study demonstrated that most clinical reviews were of asymptomatic patients and did not change management. The data has been presented as a poster at the RACS Annual Scientific Meeting 2022.
    
3. The cost analysis of arthroplasty follow-up: The costs of individual clinical item numbers has been gathered and we are currently performing the data analysis.

Our next goal is to present the project at the AOA ASM and publication.

The Spectrum of Infective Organisms in Orthopaedic Surgery in Queensland – Geographic and Temporal Trends

Luke Visscher
PHO
Redcliffe Hospital, Queensland, Australia

This is a large-scale data collection and linkage project, that seeks to collect information about all procedures for infected hip, knee and shoulder arthroplasty and microbiology results in Queensland across all orthopaedic hospitals.

The study design has been finalised and ethics approval based on that plan has been approved, and revised a number of times.  The researchers have been working closely with the clinical excellence team on validating a method for data analysis and state wide collection in the back end of QLD health data silos. This has proven possible, although there have been some difficulty in prioritising software tweaks that would optimise the process. Given the scale of the project across all QLD hospitals, and the need for data export from state wide databases, the approval of 4 executive directors is required before progression to SSA and public health approval. The approval process for such a large scale study is rigorous. We are at the stage now where the method has been proven possible to execute, and are awaiting final approval before PHA submission. It has been shown that the method for the study is possible, and we should be able to rapidly progress once the final approval has been given. We look forward to gathering this data and presenting it at future local meetings.

Outcomes of the Latarjet Procedure With and Without Capsular Repair

Andrew McBride
Orthopaedic Surgeon
Gold Coast University Hospital, Queensland, Australia

Outcomes of the latarjet procedure with and without capsular repair is a multi-centered study that examines the clinical and radiological outcomes of the latarjet procedure comparing patients that have and have not had a capsular repair as part of that procedure.

Its primary outcome is range of motion however it also examines proprioception and a number of validated outcome scores.

Mid-term Outcomes of Pyrocarbon Humeral Resurfacing Arthroplasty

Andrew McBride
Orthopaedic Surgeon
Gold Coast University Hospital, Queensland, Australia

Mid-term outcomes of pyrocarbon resurfacing arthroplasty is a joint registry project that examines the survivorship of pyrocarbon resurfacing hemiarthroplasty in the shoulder compared to other classes of shoulder arthroplasty from data collected by the Australian Orthopaedic Association National Joint Replacement Registry.