An RCT To Determine The Optimum Frequency Of Botulinum Toxin Injections To The Calf In Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$286,358.00
Summary
Cerebral Palsy (CP) is the most common cause of disability amongst children across the developed world. There are about 1800 children with CP in Victoria alone. It is caused by damage to the brain in early childhood. Children with CP have difficulty controlling how their muscles work. Muscles are often spastic, which means that they are switched on all the time, and this makes walking and performing other tasks difficult. As the child grows the spastic muscles can become too short and this occur ....Cerebral Palsy (CP) is the most common cause of disability amongst children across the developed world. There are about 1800 children with CP in Victoria alone. It is caused by damage to the brain in early childhood. Children with CP have difficulty controlling how their muscles work. Muscles are often spastic, which means that they are switched on all the time, and this makes walking and performing other tasks difficult. As the child grows the spastic muscles can become too short and this occurs can only be corrected by orthopaedic surgery. The spasticity in particular muscles can be reduced by injecting them with Botulinum Toxin (commonly known as Botox and used cosmetically to remove wrinkles). The effects of a single injection have been closely studied and we know that the effect of the toxin wears off. Children are thus offered repeat injections but there have been no studies to investigate what is the most appropriate interval between injections. The aim of this study is to determine this. In routine clinical practice children tend to get injections approximately once a year. A consideration of what we know about how the toxin acts, however, suggests that injections every 4 months might be expected to be more effective. This study will thus randomly allocate children to receive injections either every twelve months or every four months over a two year period. During the study both groups will be monitored to see if there are differences in how easily they can walk and perform other functions and in their overall quality of life. After the study the children will also be assessed to see whether there is any difference in the length of the spastic muscles. There have been no other studies to investigate the most appropriate interval between injections. This study will thus be the first anywhere and will be the foundation for guidelines for the ongoing use of botulinum toxin in children with cerebral palsy in Australia and throughout the world.Read moreRead less
Understanding The Association Between Low Back Pain And Risk Factors For Chronic Disease
Funder
National Health and Medical Research Council
Funding Amount
$314,644.00
Summary
Being overweight or obese and smoking are believed to be significant contributors to the development of long term back pain. However we know little about the relationship between low back pain and these risks for chronic disease. This research aims to understand these relationships by testing if weight and smoking programs reduce low back pain disability in overweight or smoking patients, and secondly if back pain also influences risk factors for chronic disease.
A Randomised Controlled Trial Examining Stability Of New Types Of Highly Porous Surfaced Acetabular Components In Total Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$216,490.00
Summary
Numbers of total hip replacements are steadily increasing. The most common complication of hip replacement is late implant loosening, which can be predicted by early migration. We will examine early migration of a trabecular metal acetabular cup without screws, compared to a titanium fibre metal acetabular cup fixed with screws. Ideally, an acetabular cup would achieve a level of initial stability by press-fit alone without screws, as screws increase the risk of bone loss around the prosthesis.
Randomised Trial Of Ibuprofen For The Prevention Of Ectopic Bone-related Pain And Disability After Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$364,217.00
Summary
Joint replacement is a well-established treatment for severe osteoarthritis of the hip. While most patients benefit substantially from the procedure, many still experience some pain and disability after surgery. New evidence suggests that one important cause of this pain and disability may be abnormal bone deposits that form in the muscles around the hip (ectopic bone formation) during the first few months after surgery. Ectopic bone formation is seen in about 40% of all patients with hip replac ....Joint replacement is a well-established treatment for severe osteoarthritis of the hip. While most patients benefit substantially from the procedure, many still experience some pain and disability after surgery. New evidence suggests that one important cause of this pain and disability may be abnormal bone deposits that form in the muscles around the hip (ectopic bone formation) during the first few months after surgery. Ectopic bone formation is seen in about 40% of all patients with hip replacements. If the formation is extensive, all movement of the hip is lost and revision surgery is necessary. However, even when the formation is less severe, movement at the hip can be restricted resulting in pain and disability. There is growing evidence that treatment with a non-steroidal anti-inflammatory drug at the time of surgery may halve the risk of ectopic bone formation. While this would be expected to decrease the risk and severity of post-operative pain and disability, there is little evidence available about the long-term effects of these drugs after hip replacement. For this reason, together with concerns about possible side-effect of these drugs, orthopaedic surgeons have generally been reluctant to prescribe these drugs routinely for the prevention of ectopic bone formation. Ibuprofen appears to be the non-steroidal anti-inflammatory drug with the lowest risk of side effects. If it was shown to be effective in reducing the incidence of pain and disability associated with ectopic bone formation after hip replacement, it may well be considered worthwhile by doctors and patients alike. If such benefits were realised, this preventive strategy is likely to be a highly cost-effective way to improve long-term outcome among the rapidly growing numbers of patients that receive hip replacements. This study will provide reliable evidence about the short and long-term effects of ibuprofen among 1,000 patients receiving hip replacements in Australia.Read moreRead less
CROSSFIRE: Combined Randomised And Observational Study Of Surgery For Fractures In The Distal Radius In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$551,077.00
Summary
Fractures (breaks) near the wrist are the most common fractures treated. Treatment previously consisted of straightening and plaster casting in the emergency department, but standard treatment now includes admission to hospital and surgery to apply a plate and screws to the bone. The best evidence we have (which is limited) is that surgical plating does not provide important benefits over plastering. We aim to perform a multicentre trial comparing plating to plaster for these common fractures.
Radiostereometric Analysis Of The Effect Of A Large Articulation On Prosthetic Wear And Migration After Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$192,186.00
Summary
At total hip replacement, there has been a recent trend to use prostheses with a larger ball and liner in the socket. This may decrease the risk of post-operative dislocation, but may also increase the amount of wear, leading to bone loss and loosening of prostheses, which may then require replacement. This project will use a special type of x-ray to determine whether wear and movement of these new prostheses is clinically acceptable, so that they can be used with confidence in patients.