Orthopaedic Innovation Lives at Concordia

Concordia Arthroplasty Research Chair Adopts National Strategy for Ambitious Research Projects

Concordia’s Arthroplasty Research Chair partners with the Orthopaedic Innovation Centre (OIC) for our clinical research.

A 2.5-year bilateral knee study to develop guidelines on whether to operate on one or two knees at the same time.

Another study aims to assess the benefits of CT scans when used to monitor the slightest microscopic movement in a joint implant.

Still another far-reaching project is being planned to create a first-in-Canada orthopaedic analytic hub (national database on why joints fail) at the research centre located at Concordia.

These are just some of the exciting projects underway or being planned at the Orthopaedic Innovation Centre (OIC) that promise continuous improvements that may well contribute to the invaluable gift of movement for well over 2,000 hip and knee patients at the Concordia Hospital alone – in addition to others in operating rooms across Canada and beyond once data is ultimately collated and shared.

We have two distinct categories of research at Concordia.  Clinical Research and Biomedical Engineering Research.  Both work together to improve the lives of people

Research at the centre, which opened in 2009, is guided by Dr. Thomas Turgeon, arthroplasty research chair, Concordia Foundation, and also include participation by doctors David Hedden, Eric Bohm, Colin Burnell, Bryan Flynn and Jhase Sniderman, (partners in the  Concordia Joint Replacement Group); research staff including engineers; administrators and other key health care professionals.

Together, they conduct a variety of projects in two distinct categories: clinical research, like those mentioned above, and projects conducted by engineers that do research for medical device companies that want to improve their joint implants, among other engineering investigations.

Trevor Gascoyne, president and CEO of the Orthopaedic Innovation Centre, an engineer himself, notes that the strong focus on continuous improvement and patient safety has resulted in new medical knees that now last up to 25 years, more than double those of past years.

Bilateral knee study led by Dr. Eric Bohm

Trevor explains that Dr. Bohm’s study is centred on the question of:  “What do I tell patients who ask me should I get one knee done or should I get both done at the same time? If both knees require surgery, he was unsure how to respond because there was no data to explain if function was better if they were done at the same time.”

Other considerations are whether a patient has family support and what efficiencies could be realized for use of facilities and for the patients themselves with bilateral operations.

Patient safety is always foremost, and by getting both knees done at the same time, patients won’t struggle with the decision whether to go ahead with the second knee.

“When you stage the operations, you may choose not to do a second surgery,” adds Dr. Christian Righolt, director of clinical research. “We have a lot of interest because patients world-wide have the same concerns.”

Implant migration study – benefits of CT scan

This is to assess the benefits of CT scans when used to monitor the critical questions of if and how much a joint has moved.

Dr. Righolt points out that, “One way to ensure patient safety is to make sure the implants don’t move less than the width of a hair in the first few years after surgery.” As incredible as the statement may sound, both the CEO and clinical director agree that most implants function efficiently for years without movement. However, there could be undocumented benefits to using a CT scan.

“Currently, we study this using a dual stereo x-ray system (radiostereometric analysis), and we have a dedicated set-up to do this,” he adds. However, “a CT may give us a better 3-D view of the joint, and there would not be a specialized surgical set-up needed.”

Use of CT scans could result in cost savings in equipment, time efficiencies, and potentially spark related studies and permit the OIC to help other medical centres.

“Other centres can perform the CT imaging for the surgeries, but the specialty is going to be in how they analyze the results,” adds  Trevor. “Building that knowledge and capacity here means we can help Toronto with their analysis; we can help Vancouver, because they are now able to send us the scans, and we can do the analysis and provide the data for them.”

First in Canada national data base – a future project

The researchers refer to the data base they are in the process of setting up as a “national orthopaedic analytic hub”.

“The centre will analyze data across Canada on failed joints, (the OIC now does this only on a local basis). But it will provide analysis that could lead to other beneficial outcomes,” says Dr. Righolt.

“It’s not unlike our clinical data,” adds Trevor. “But we could ask far greater questions – all leading possibly to beneficial surgical techniques. The difference is the order of magnitude.”

The ambitious project could also eventually help surgeons and researchers across the country understand the design details of the implant, the manufacturer, and importantly, patient satisfaction with the medical implant.

With vision and resolve, the promising projects will put Concordia proudly at the forefront of patient-centered care, and Manitobans stand to be among the first to benefit.

Stay in touch with the newly formed Arthroplasty Research Chair website.  www.arthroplastyresearchchair.com   

Trevor Gascoyne is a world-renowned arthroplasty engineer (P.Eng.), and, as the Canadian Chair of the International Standards Organization (ISO) leads the committee on all bone and joint replacement standards. He is the GM of the Canadian RSA Network. He leads embedded research within OIC through direct operating room trials.

“Christiaan Righolt is an engineer, data scientist, epidemiologist, and assistant professor in the Department of Surgery at the U of Manitoba. He previously introduced new microscopy techniques into Manitoba cancer research and led various infectious disease studies, among many other career highs, and aims to leverage his multidisciplinary background into Canadian arthroplasty research.”