Improving The Functional Outcomes Of Lower Limb Orthopaedic Surgery
Funder
National Health and Medical Research Council
Funding Amount
$425,048.00
Summary
While orthopaedic surgery usually achieves pain relief and improves function somewhat, it can often leave a patient unable to perform certain activities. And these abnormal movement patterns are likely to cause further problems. This project will objectively measure post-surgical function, in order to improve the surgery and rehabilitation of some of the most complex orthopaedic conditions. The goal is that patients receive the maximum benefit from surgery.
Manipulating The Anabolic And Catabolic Responses For Bone Tissue Engineering
Funder
National Health and Medical Research Council
Funding Amount
$58,202.00
Summary
The repair of large bone defects represents a significant clinical problem. Evolving tissue engineering technologies may lead to significant improvements in orthopaedic treatments for these problems. We plan to compare novel biological approaches designed to maximise new bone formation while preventing bone resorption with existing synthetic graft materials. Our research data will be readily translated from the laboratory to a clinical setting.
Biomechanics of the human spine measured using magnetic resonance imaging. Statistics show that 80% of the population suffer back pain at some time. However, because the spine is very complex our understanding of its mechanics and the causes of back pain are still limited. This project will investigate the anatomy and activity of the spinal muscles and the behaviour of the intervertebral disc in living subjects using innovative Magnetic Resonance Imaging techniques. Significant outcomes will be ....Biomechanics of the human spine measured using magnetic resonance imaging. Statistics show that 80% of the population suffer back pain at some time. However, because the spine is very complex our understanding of its mechanics and the causes of back pain are still limited. This project will investigate the anatomy and activity of the spinal muscles and the behaviour of the intervertebral disc in living subjects using innovative Magnetic Resonance Imaging techniques. Significant outcomes will be new definitive descriptions of the detailed anatomy of the spine and its mechanisms. This will enhance the accuracy and detail of models under development for predicting spinal function following disease, injury or surgical procedures.Read moreRead less
ANALYSIS OF KNEE KINEMATICS- An MRI Study Of The Normal, Anterior Cruciate Injured, And Reconstructed Knee.
Funder
National Health and Medical Research Council
Funding Amount
$161,320.00
Summary
People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one norma ....People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one normal knee. The subjects will simulate a squat inside the MRI magnet against a weighted footplate. The images will be taken at fifteen degree intervals of knee movement. The contact points between the joint surfaces will be measured and compared to the normal knee. This imaging will be repeated after surgical repair, and then again two years later, to assess whether the normal movement pattern has been restored.Read moreRead less
The Design, Development And Clinical Assessment Of A New Metacarpophalangeal Joint Prosthesis
Funder
National Health and Medical Research Council
Funding Amount
$188,450.00
Summary
Rheumatoid arthritis is a crippling form of arthritis that affects many people in the community. It commonly involves the finger joints in the hands resulting in deformity, pain and subsequent loss of function. There have been implants designed for finger joint replacement, but unfortunately these implants have had only moderate benefits and can break and lead to further joint destruction resulting in the worsening of deformity and pain. A new implant for finger joint replacement has been develo ....Rheumatoid arthritis is a crippling form of arthritis that affects many people in the community. It commonly involves the finger joints in the hands resulting in deformity, pain and subsequent loss of function. There have been implants designed for finger joint replacement, but unfortunately these implants have had only moderate benefits and can break and lead to further joint destruction resulting in the worsening of deformity and pain. A new implant for finger joint replacement has been developed. This implant has several potential advantages. Firstly the unique design acts to prevent recurring deformity in the fingers with rheumatoid disease while allowing functional motion. Secondly, it is thought that patients will return to function earlier and avoid the need for further finger surgery as this implant design relies less on the tissues around it for stability. The purpose of this study is to investigate the biomechanical and clinical benefits of this new implant for finger joint replacement. The new design will undergo specific laboratory tests and be used in a clinical trial to quantify the therapeutic benefits it provides to patients with rheumatoid arthritis.Read moreRead less
Interrelationships Between The Disc And Bone Of Lumbar Spinal Segments
Funder
National Health and Medical Research Council
Funding Amount
$423,625.00
Summary
The cause of back pain due to osteoarthritis, osteoporotic vertebral crush fracture, and ageing is poorly understood. Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone structure are features associated with degeneration of the spine and with back pain. Degenerative disc disease is one of the major causes of back symptoms and is believed to be associated with degeneration of the spine. Spinal degeneration includes disc degeneration, facet joint osteoarthritis, ....The cause of back pain due to osteoarthritis, osteoporotic vertebral crush fracture, and ageing is poorly understood. Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone structure are features associated with degeneration of the spine and with back pain. Degenerative disc disease is one of the major causes of back symptoms and is believed to be associated with degeneration of the spine. Spinal degeneration includes disc degeneration, facet joint osteoarthritis, compromised vertebral body bone quality, muscle and ligament alterations. It is assumed that these changes result in increased or abnormal spine motion and modified load distribution across the spinal joint. It has been found that with age, there is increased disorganisation of the intervertebral disc and decreased quality of vertebral cancellous bone. However, bones with the same density within the range of normal subjects, can show selective loss of bone structure and reduced load-bearing capacities of these vertebrae. An important concept here is that even for a given bone mass, fracture risk increases with age, supporting the view that there is a component of bone fragility that is independent of mass. Increased bone fragility may be associated with compromised cancellous bone structure. While the relationship between disc degeneration and changes in vertebral bone is commonly invoked, the mechanisms of this relationship have largely been overlooked, with age changes given more attention. However, it may be that intervertebral disc disorganisation modulates age-related bone changes within the spine. Disc degeneration may influence trabecular bone responses before changes with age put the patient at risk of vertebral crush fracture. We propose that the mature disc cannot effectively regenerate after damage, and thus responses to disc damage will be more readily observed in vertebral bone architecture than in the disc.Read moreRead less
Vertebral Body Strength: Contribution Of Bone Mass, Bone Structure And Material Properties
Funder
National Health and Medical Research Council
Funding Amount
$434,498.00
Summary
This study will determine the contributions to vertebral body strength made by its structural and material properties. Using state-of-the-art computed-tomography scanners, digitised representations of vertebral bodies in three-dimensions will be produced, which enable measurement of bone structure. After strength testing of the vertebral bodies, the structural and material properties, which combine to predict vertebral body strength, will be identified in an aged population.
A Prospective Study To Identify The Mechanical Causes And Methods For Early Detection Of Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these ....Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these pathological gait patterns as they impose larger-than-normal forces on the knee's articular surfaces. We measure these knee forces with our new computer knee model coupled with data that we measure in a gait analysis laboratory. These forces may cause knee osteoarthritis in humans, but this is still unknown. Currently there is no simple medical test to detect the early onset of knee osteoarthritis. The bones in the knee are one of the first structures to show osteoarthritic changes. Using our new computerised analysis of high definition X-ray of the knee we can identify subtle differences in the knee due to osteoarthritis. This will be compared with changes to joint assessed using MRI. Osteoarthritis develops slowly in normal people, so to study progression of knee osteoarthritis we need a human population that has a higher risk of developing the disease. Partial meniscectomy in the knee is a common surgery performed to improve knee function in those who have suffered a knee meniscus injury. However, partial meniscectomy patients have a high risk of developing knee osteoarthritis. Therefore, using partial meniscectomy patients we are investigating if pathological gait patterns cause knee osteoarthritis, measuring the development of the disease with our new X-ray methods. With the gait analysis methods we can also identify the movements that characterise these pathological gait patterns so we can formulate rehabilitation programmes to help prevent knee osteoarthritis.Read moreRead less
In Vivo Patellofemoral Joint Measurement Using Kinematic Radiostereometric Analysis (RSA)
Funder
National Health and Medical Research Council
Funding Amount
$141,000.00
Summary
Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between peo ....Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between people with TKA in which the patellar surface is replaced (patellar resurfacing) or retained, but have been unable to accurately account for differences in patellar movement in those people with post-surgery complications. To date, studies of patellar motion after total knee replacement have been limited to two-dimensional analyses. This study addresses the technological limitations of previous trials by utilising accurate techniques for directly measuring skeletal motion using kinematic radiostereometric analysis (RSA). These data will measure patellar kinematics in three-dimensions for the first time. This information will allow optimisation of the design of TKA and the surgical techniques required for their implantation. Furthermore, the results will assist in the identification of surgical indications for patellar resurfacing, and the kinematic factors associated with anterior knee pain following total knee replacement surgery.Read moreRead less