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8. Robot-assisted partial knee replacement versus standard total knee replacement (RoboKnees): a protocol for a pilot randomized controlled trial.

Author

Madden, Kim, Flood, Breanne, Malek, Monica, Milantoni, Vincent, Astephen Wilson, Janie L., Tarride, Jean-Eric, Khanna, Vickas, Adili, Anthony, Bhandari, Mohit, Thabane, Lehana, Tushinski, Daniel, Wilson, Janie, Zalzal, Paul, Moro, Ashvin, Irish, Kim, Khan, Haider, Jagdeo, Vireshwar, Rajapaksege, Nathasha, and Yan, James

Subjects
TOTAL knee replacement, KNEE, SURGICAL robots, POSTOPERATIVE pain, KNEE surgery, REOPERATION
Abstract

Background: Total knee arthroplasty is a common surgery for end-stage knee osteoarthritis. Partial knee arthroplasty is also a treatment option for patients with arthritis present in only one or two knee compartments. Partial knee arthroplasty can preserve the natural knee biomechanics, but these replacements may not last as long as total knee replacements. Robotic-assisted orthopedic techniques can help facilitate partial knee replacements, increasing accuracy and precision. This trial will investigate the feasibility and assess clinical outcomes for a larger definitive trial. Methods: This is a protocol for an ongoing parallel randomized pilot trial of 64 patients with uni- or bicompartmental knee arthritis. Patients are randomized to either receive robot-assisted partial knee arthroplasty or manual total knee arthroplasty. The primary outcome of this pilot is investigating the feasibility of a larger trial. Secondary (clinical) outcomes include joint awareness, return to activities, knee function, patient global impression of change, persistent post-surgical pain, re-operations, resource utilization and cost-effectiveness, health-related quality of life, radiographic alignment, knee kinematics during walking gait, and complications up to 24 months post-surgery. Discussion: The RoboKnees pilot study is the first step in determining the outcome of robot-assisted partial knee replacements. Conclusions from this study will be used to design future large-scale trials. This study will inform surgeons about the potential benefits of robot-assisted partial knee replacements. Trial registration: This study was prospectively registered on clinicaltrials.gov (identifier: NCT04378049) on 4 May 2020, before the first patient was randomized. [ABSTRACT FROM AUTHOR]

Published
2024
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12. A biomechanical assessment of modular and monoblock revision hip implants using FE analysis and strain gage measurements

Author

Papini Marcello, Miric Milan, Shah Suraj, Zdero Rad, Bougherara Habiba, Zalzal Paul, and Schemitsch Emil H

Subjects
Orthopedic surgery, RD701-811, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background The bone loss associated with revision surgery or pathology has been the impetus for developing modular revision total hip prostheses. Few studies have assessed these modular implants quantitatively from a mechanical standpoint. Methods Three-dimensional finite element (FE) models were developed to mimic a hip implant alone (Construct A) and a hip implant-femur configuration (Construct B). Bonded contact was assumed for all interfaces to simulate long-term bony ongrowth and stability. The hip implants modeled were a Modular stem having two interlocking parts (Zimmer Modular Revision Hip System, Zimmer, Warsaw, IN, USA) and a Monoblock stem made from a single piece of material (Stryker Restoration HA Hip System, Stryker, Mahwah, NJ, USA). Axial loads of 700 and 2000 N were applied to Construct A and 2000 N to Construct B models. Stiffness, strain, and stress were computed. Mechanical tests using axial loads were used for Construct A to validate the FE model. Strain gages were placed along the medial and lateral side of the hip implants at 8 locations to measure axial strain distribution. Results There was approximately a 3% average difference between FE and experimental strains for Construct A at all locations for the Modular implant and in the proximal region for the Monoblock implant. FE results for Construct B showed that both implants carried the majority (Modular, 76%; Monoblock, 66%) of the 2000 N load relative to the femur. FE analysis and experiments demonstrated that the Modular implant was 3 to 4.5 times mechanically stiffer than the Monoblock due primarily to geometric differences. Conclusions This study provides mechanical characteristics of revision hip implants at sub-clinical axial loads as an initial predictor of potential failure.

Published
2010
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13. Characterization of titanium-containing bioactive glasses for coating metallic implants

Author

Papini Marcello, Wren Anthony, Curran Declan, Zalzal Paul, Rodriguez Omar, Schemitsch Emil, Placek Lana, and Towler Mark

Subjects
Histology, Materials science, Biomedical Engineering, chemistry.chemical_element, Bioengineering, engineering.material, Characterization (materials science), Metal, Coating, chemistry, Chemical engineering, visual_art, engineering, visual_art.visual_art_medium, Biotechnology, Titanium
Published
2016
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16. Fixation using alternative implants for the treatment of hip fractures (FAITH): design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures

Author

McCormack, Robert, Apostle, Kelly, Moon, Raely, Bielby, Shea A., Switzer, Julie A., Cole, Peter A., Anderson, Sarah A., Lafferty, Paul M., Li, Mengnai, Ly, Thuan V., Marston, Scott B., Foley, Amy L., Vang, Sandy, Oatt, Amber, Wright, David M., Marcantonio, Andrew J., Kain, Michael S. H., Iorio, Richard, Specht, Lawrence M., Tilzey, John F., Lobo, Margaret J., Garfi, John S., Vallier, Heather A., Dolenc, Andrea, Buckley, Richard E., Robinson, Chalitha, Prayson, Michael J., Laughlin, Richard, Rubino, L. Joseph, May, Jedediah, Rieser, Geoffrey Ryan, Dulaney-Cripe, Liz, Gayton, Chris, Shaer, James, Schrickel, Tyson, Duffy, Paul, Hileman, Barbara, Gorczyca, John T., Gross, Jonathan M., Humphrey, Catherine A., Kates, Stephen, Noble, Krista, McIntyre, Allison W., Pecorella, Kaili, Davis, Craig A., Weinerman, Stewart, Korley, Robert, Weingarten, Peter, Stull, Philip, Lindenbaum, Stephen, Hewitt, Michael, Schwappach, John, Baker, Janell K., Rutherford, Tori, Newman, Heike, Lieberman, Shane, Finn, Erin, Puloski, Shannon, Robbins, Kristin, Hurley, Meghan, Lyle, Lindsey, Mitchell, Khalis, Browner, Kieran, Whatley, Erica, Payton, Krystal, Reeves, Christina, Cannada, Lisa K., Karges, David, Johnston, Kelly, Hill, Leslie, Mehta, Samir, Esterhai, John, Ahn, Jaimo, Horan, Annamarie D., McGinnis, Kelly, Kaminski, Christine A., Kowalski, Brynn N., Keeve, Jonathan P., Anderson, Christopher G., Powell, James, McDonald, Michael D., Hoffman, Jodi M., Tarkin, Ivan, Siska, Peter, Gruen, Gary, Evans, Andrew, Farrell, Dana J., Irrgang, James, Luther, Arlene, Cross III., William W., Carcary, Kimberly, Cass, Joseph R., Sems, Stephen A., Torchia, Michael E., Scrabeck, Tyson, Jenkins, Mark, Dumais, Jules, Romero, Amanda W., Sagebien, Carlos A., Butler, Mark S., Monica, James T., Sanders, David, Seuffert, Patricia, Hsu, Joseph R., Ficke, James, Charlton, Michael, Napierala, Matthew, Fan, Mary, Tornetta III., Paul, Tannoury, Chadi, Carlisle, Hope, Silva, Heather, Boyer, Dory, Lawendy, Abdel, Archdeacon, Michael, Finnan, Ryan, Le, Toan, Wyrick, John, Hess, Shelley, Brennan, Michael L., Probe, Robert, Kile, Evelyn, Mills, Kelli, Clipper, Lydia, Tieszer, Christina, Yu, Michelle, Erwin, Katie, Horwitz, Daniel, Strohecker, Kent, Swenson, Teresa K., Aurang, Kamran, Zohman, Gary, Peterson, Brett, Huff, Roger B., Baele, Joseph, Stephen, David, Weber, Timothy, Edison, Matt, McBeth, Jessica, Shively, Karl, Ertl, Janos P., Mullis, Brian, Parr, J. Andrew, Worman, Ripley, Frizzell, Valda, Moore, Molly M., Kreder, Hans, Tobias, Erin, Thomas, Emily, DePaolo, Charles J., Alosky, Rachel, Shell, Leslie E., Hampton, Lynne, Shepard, Stephanie, Nanney, Tracy, Cuento, Claudine, Cantu, Robert V., Jenkinson, Richard, Henderson, Eric R., Eickhoff, Linda S., Hammerberg, E. Mark, Stahel, Philip, Hak, David, Mauffrey, Cyril, Gibula, Douglas, Gissel, Hannah, Henderson, Corey, Zamorano, David P., Nousiainen, Markku, Tynan, Martin C., Pourmand, Deeba, Lawson, Deanna, Della Rocca, Gregory J., Crist, Brett D., Murtha, Yvonne M., Anderson, Linda K., Linehan, Colleen, Pilling, Lindsey, Lewis, Courtland G., Axelrod, Terry, Caminiti, Stephanie, Sullivan, Raymond J., Roper, Elizabeth, Obremskey, William, Kregor, Philip, Richards, Justin E., Stringfellow, Kenya, Dohm, Michael P., Zellar, Abby, Segers, Michiel J. M., Murnaghan, John, Zijl, Jacco A. C., Verhoeven, Bart, Smits, Anke B., de Vries, Jean Paul P. M., Fioole, Bram, van der Hoeven, Henk, Theunissen, Evert B. M., de Vries Reilingh, Tammo S., Govaert, Lonneke, Wittich, Philippe, Nam, Diane, de Brauw, Maurits, Wille, Jan, Go, Peter M. N. Y. M., Ritchie, Ewan D., Wessel, Ronald N., Hammacher, Eric R., Heetveld, Martin J., Visser, Gijs A., Stockmann, Heyn, Silvis, Rob, Wadey, Veronica, Snellen, Jaap P., Rijbroek, Bram, Scheepers, Joris J. G., Vermeulen, Erik G. J., Siroen, Michiel P. C., Vuylsteke, Ronald, Brom, Hans L. F., Rijna, Herman, de Rijcke, Piet A. R., Koppert, Cees L., Moola, Farhad, Yee, Albert, Buijk, Steven E., Groenendijk, Richard P. R., Dawson, Imro, Tetteroo, Geert W. M., Bruijninckx, Milko M. M., Doornebosch, Pascal G., de Graaf, Eelco J. R., van der Elst, Maarten, van der Pol, Carmen C., van 't Riet, Martijne, Milner, Katrine, Karsten, Tom M., de Vries, Mark R., Stassen, Laurents P. S., Schep, Niels W. L., Schmidt, G. Ben, Hoffman, W. H., Poolman, Rudolf W., Simons, Maarten P., van der Heijden, Frank H. W. M., Willems, W. Jaap, Kunz, Monica, de Meulemeester, Frank R. A. J., van der Hart, Cor P., Turckan, Kahn, Festen, Sebastiaan, de Nies, Frank, Haverlag, Robert, Out, Nico J. M., Bosma, Jan, van Kampen, Albert, Biert, Jan, Schemitsch, Emil H., van Vugt, Arie B., Edwards, Michael J. R., Blokhuis, Taco J., Frolke, Jan Paul M., Geeraedts, Leo M. G., Gardeniers, Jean W. M., Tan, Edward T. C. H., Poelhekke, Lodewijk M. S. J., de Waal Malefijt, Maarten C., Schreurs, Bart, Ahn, Henry, Roukema, Gert R., Josaputra, Hong A., Keller, Paul, de Rooij, Peter D., Kuiken, Hans, Boxma, Han, Cleffken, Berry I., Liem, Ronald, Rhemrev, Steven J., Bosman, Coks H. R., Hall, Jeremy A., de Mol van Otterloo, Alexander, Hoogendoorn, Jochem, de Vries, Alexander C., Meylaerts, Sven A. G., Verhofstad, Michiel H. J., Meijer, Joost, van Egmond, Teun, van der Brand, Igor, Patka, Peter, McKee, Michael D., Eversdijk, Martin G., Peters, Rolf, Den Hartog, Dennis, Van Waes, Oscar J. F., Oprel, Pim, van der Vis, Harm M., Campo, Martin, Verhagen, Ronald, Albers, G. H. Robert, Zurcher, Arthur W., Whelan, Daniel B., Simmermacher, Rogier K. J., van Mulken, Jeroen, van Wessem, Karlijn, van Gaalen, Steven M., Leenen, Luke, Bronkhorst, Maarten W. G. A., Guicherit, Onno R., Goslings, J. Carel, Nauth, Aaron, Ponsen, Kees Jan, Bhatia, Mahesh, Arora, Vinod, Tyagi, Vivek, Liew, Susan, Bedi, Harvinder, Carr, Ashley, Curry, Hamish, Chia, Andrew, Csongvay, Steve, Vicente, Milena R., Donohue, Craig, Doig, Stephen, Edwards, Elton, Etherington, Greg, Esser, Max, Gong, Andrew, Jain, Arvind, Li, Doug, Miller, Russell, Moaveni, Ash, Perey, Bertrand, Wild, Lisa M., Russ, Matthias, Ton, Lu, Wang, Otis, Dowrick, Adam, Murdoch, Zoe, Sage, Claire, Frihagen, Frede, Clarke-Jenssen, John, Hjorthaug, Geir, Ianssen, Torben, Khan, Ryan M., Amundsen, Asgeir, Brattgjerd, Jan Egil, Borch, Tor, Boe, Berthe, Flatoy, Bernhard, Hasselund, Sondre, Haug, Knut Jorgen, Hemlock, Kim, Hoseth, Tor Magne, Jomaas, Geir, Hidy, Jennifer T., Kibsgard, Thomas, Lona, Tarjei, Moatshe, Gilbert, Muller, Oliver, Molund, Marius, Nicolaisen, Tor, Nilsen, Fredrik, Rydinge, Jonas, Smedsrud, Morten, Stodle, Are, Coles, Chad, Trommer, Axel, Ugland, Stein, Karlsten, Anders, Ekas, Guri, Vesterhus, Elise Berg, Brekke, Anne Christine, Gupta, Ajay, Jain, Neeraj, Khan, Farah, Sharma, Ateet, Leighton, Ross, Sanghavi, Amir, Trivedi, Mittal, Rai, Anil, Subash, Rai, Kamal, Yadav, Vineet, Singh, Sanjay, Tetsworth, Kevin, Donald, Geoff, Biddulph, Michael, Weinrauch, Patrick, Pincus, Paul, Yang, Steven, Halliday, Brett, Gervais, Trevor, Holt, Michael, Flynn, Annette, Prasad, Amal Shankar, Mishra, Vimlesh, Sundaresh, D. C., Johnston, David, Khanna, Angshuman, Cherian, Joe Joseph, Olakkengil, Davy J., Sharma, Gaurav, Pirpiris, Marinis, Love, David, Bucknill, Andrew, Farrugia, Richard J., Pape, Hans-Christoph, Knobe, Matthias, Glazebrook, Mark, Pfeifer, Roman, Hull, Peter, Lewis, Sophie, Evans, Simone, Nanda, Rajesh, Logishetty, Rajanikanth, Anand, Sanjeev, Bowler, Carol, Dadi, Akhil, Palla, Naveen, Alexander, David, Ganguly, Utsav, Rai, B. Sachidananda, Rajakumar, Janakiraman, Jennings, Andrew, Chuter, Graham, Rose, Glynis, Horner, Gillian, Clark, Callum, Eke, Kate, Reed, Mike, Coady, Cathy, Herriott, Chris, Dobb, Christine, Bhandari, Mohit, Swiontkowski, Marc, Devereaux, Pj, Jeray, Kyle, Thabane, Lehana, Stone, Trevor, Dunbar, Michael, Walter, Stephen, Sprague, Sheila, Scott, Taryn, Guyatt, Gordon, Amirault, David, Viveiros, Helena, McKay, Paula, Swinton, Marilyn, Gross, Michael, Truong, Victoria, Koo, Kaitlin, Heels-Ansdell, Diane, Zhou, Qi, Buckingham, Lisa, Duraikannan, Aravin, Maddock, Deborah, Simunovic, Nicole, Agel, Julie, Oxner, William, Van Lieshout, Esther M. M., Zielinski, Stephanie M., Rangan, Amar, Hanusch, Birgit C., Kottam, Lucksy, Clarkson, Rachel, Reardon, Gerald, Slobogean, Gerard, Katz, Jeffrey, Gillespie, Brenda, Greendale, Gail A., Guy, Pierre, Hartman, Curtis, Rubin, Craig, Waddell, James, FAITH Investigators, Richardson, Glen, Trenholm, Andrew, Wong, Ivan, Trask, Kelly, MacDonald, Shelley, Viskontas, Darius, Dobbin, Gwen, Bicknell, Ryan, Yach, Jeff, Bardana, Davide, Wood, Gavin, Harrison, Mark, Yen, David, Lambert, Sue, Howells, Fiona, Ward, Angela, Lemke, H. Michael, Zalzal, Paul, Brien, Heather, Naumetz, V., Weening, Brad, Wai, Eugene K., Papp, Steve, Gofton, Wade T., Liew, Allen, Kingwell, Stephen P., Zomar, Mauri, Johnson, Garth, O'Neil, Joseph, Roffey, Darren M., Borsella, Vivian, Avram, Victoria, Oliver, Todd M., Jones, Vicki, Jones, Clifford B., Ringler, James R., Endres, Terrence J., Moon, Karyn, Sietsema, Debra L., Jeray, Kyle J., Broderick, J. Scott, Goetz, David R., Pace, Thomas B., Schaller, Thomas M., Porter, Scott E., Tanner, Stephanie L., Snider, Rebecca G., Nastoff, Lauren A., Surgery, Emergency Medicine, Obstetrics and Gynaecology, Other Research, Other departments, Graduate School, and AMS - Amsterdam Movement Sciences

Subjects
Time Factors, Sports medicine, medicine.medical_treatment, Bone Screws, Dentistry, Femoral Neck Fractures, law.invention, Fracture Fixation, Internal, Study Protocol, Postoperative Complications, 0302 clinical medicine, Clinical Protocols, Randomized controlled trial, law, Fracture fixation, Orthopedics and Sports Medicine, 030212 general & internal medicine, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Likelihood Functions, 030222 orthopedics, Femoral neck fractures, 3. Good health, Europe, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Treatment Outcome, Research Design, Hip fractures, Sliding hip screw, Reoperation, medicine.medical_specialty, Asia, Prosthesis Design, 03 medical and health sciences, Fixation (surgical), Rheumatology, medicine, Humans, Internal fixation, Proportional Hazards Models, business.industry, Australia, Arthroplasty, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], North America, Orthopedic surgery, Quality of Life, Cancellous screws, business
Abstract

Hip fractures are a common type of fragility fracture that afflict 293,000 Americans (over 5,000 per week) and 35,000 Canadians (over 670 per week) annually. Despite the large population impact the optimal fixation technique for low energy femoral neck fractures remains controversial. The primary objective of the FAITH study is to assess the impact of cancellous screw fixation versus sliding hip screws on rates of revision surgery at 24 months in individuals with femoral neck fractures. The secondary objective is to determine the impact on health-related quality of life, functional outcomes, health state utilities, fracture healing, mortality and fracture-related adverse events. FAITH is a multi-centre, multi-national randomized controlled trial utilizing minimization to determine patient allocation. Surgeons in North America, Europe, Australia, and Asia will recruit a total of at least 1,000 patients with low-energy femoral neck fractures. Using central randomization, patients will be allocated to receive surgical treatment with cancellous screws or a sliding hip screw. Patient outcomes will be assessed at one week (baseline), 10 weeks, 6, 12, 18, and 24 months post initial fixation. We will independently adjudicate revision surgery and complications within 24 months of the initial fixation. Outcome analysis will be performed using a Cox proportional hazards model and likelihood ratio test. This study represents major international efforts to definitively resolve the treatment of low-energy femoral neck fractures. This trial will not only change current Orthopaedic practice, but will also set a benchmark for the conduct of future Orthopaedic trials. The FAITH trial is registered at ClinicalTrials.gov (Identifier NCT00761813 ).

Published
2014
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17. Regenerative Medicine and Restoration of Joint Function

Author

MOUNT SINAI HOSPITAL TORONTO (ONTARIO), Kandel, Rita, Zalzal, Paul, Pilliar, Robert, Toyserkani, Ehsan, Hurtig, Mark, Grynpas, Marc, McKee, Michael, Boitano, Marilyn, MOUNT SINAI HOSPITAL TORONTO (ONTARIO), Kandel, Rita, Zalzal, Paul, Pilliar, Robert, Toyserkani, Ehsan, Hurtig, Mark, Grynpas, Marc, McKee, Michael, and Boitano, Marilyn

Abstract

Currently amputation, arthrodesis (joint fusion), or joint replacement are used to treat a joint with an intra-articular fracture or destroyed by a combat injury. Generation of personalized, anatomically shaped biological implants formed using techniques of regenerative medicine in conjunction with biodegradable biomaterial structures to restore a damaged articular joint surface to normal tissue structure, form and function is one way to overcome the limitations associated with current treatment methods. The aims of this study are to: 1) identify the parameters that generate anatomically shaped bone substitutes of optimal composition and structure with an articulating profile. 2) to develop a source of human chondrocytes that can generate sufficient amounts of a cartilage layer to cover the bone substitute; and 3) to evaluate the structures formed in a preclinical model. The ongoing studies will further our understanding of the regulation of cell differentiation to chondrocytes and the bone substitute properties required to form a biological joint replacement., See also ADA573824.

Published
2012

18. Regenerative Medicine and Restoration of Joint Function

Author

MCMASTER UNIV HAMILTON (ONTARIO), Zalzal, Paul, Kandel, Rita, Pilliar, Robert, Toyserkani, Ehsan, Hurting, Mark, Grynpas, Marc, McKee, Michael, Boitano, Marilyn, MCMASTER UNIV HAMILTON (ONTARIO), Zalzal, Paul, Kandel, Rita, Pilliar, Robert, Toyserkani, Ehsan, Hurting, Mark, Grynpas, Marc, McKee, Michael, and Boitano, Marilyn

Abstract

Currently amputation, arthrodesis (joint fusion), or joint replacement are used to treat a joint with an intra-articular fracture or destroyed by a combat injury. Generation of personalized, anatomically shaped biological implants formed using techniques of regenerative medicine in conjunction with biodegradable biomaterial structures to restore a damaged articular joint surface to normal tissue structure, form and function is one way to overcome the limitations associated with current treatment methods. The aims of this study are to: 1) identify the parameters that generate anatomically shaped bone substitutes of optimal composition and structure with an articulating profile. 2) to develop a source of human chondrocytes that can generate sufficient amounts of a cartilage layer to cover the bone substitute; and 3) to evaluate the structures formed in a preclinical model. The ongoing studies will further our understanding of the regulation of cell differentiation to chondrocytes and the bone substitute properties required to form a biological joint replacement., See also ADA573823.

Published
2012

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