Ten-year risk of complication and mortality after total hip arthroplasty in morbidly obese patients: a population study.

Background: The relationship between morbid obesity and long-term patient outcomes after primary total hip arthroplasty (THA) has been understudied. The purpose of this study was to determine the association between morbid obesity and 10-year complications (revision surgery, reoperation, dislocation) and mortality in patients undergoing primary THA.

Methods: We conducted a population-based cohort study of patients aged 45–74 years who underwent primary THA for osteoarthritis between 2002 and 2007 using Ontario administrative health care databases.

Estimating the density of femoral head trabecular bone from hip fracture patients using computed tomography scan data.

The purpose of this study was to compare computed tomography density (ρ ) obtained using typical clinical computed tomography scan parameters to ash density (ρ ), for the prediction of densities of femoral head trabecular bone from hip fracture patients. An experimental study was conducted to investigate the relationships between ρ and ρ and between each of these densities and ρ and ρ . Seven human femoral heads from hip fracture patients were computed tomography-scanned ex vivo, and 76 cylindrical trabecular bone specimens were collected.

Implementation of a novel night float call system: resident satisfaction and quality of life.

Background: Compliance with Professional Association of Internes and Residents of Ontario duty hour guidelines has been problematic at our institution. To facilitate orthopedic residents' ability to go home postcall without significant disruption of ongoing clinical activities, a novel call system was adopted at our tertiary care centre. We sought to evaluate the satisfaction and quality of life of orthopaedic residents with that system.

Role of the advanced practice physiotherapist in decreasing surgical wait times.

The role of the advanced practice physiotherapist (APP) in outpatient orthopedic clinics has been present in Ontario for over five years. These professionals have additional duties beyond those of a regular physiotherapist in order to screen patients pre- and post-operatively, triage patients for surgery, prescribe conservative management and monitor patients on an ongoing basis. The purpose of this role is to improve patient access to timely surgical care by reducing wait times for hip and knee replacement surgeries.

Determining patient concerns before joint arthroplasty.

Despite the prevalence of studies relating to hip and knee arthroplasties, no Canadian studies exist in the literature regarding patients' perceptions and concerns prior to undergoing these procedures. A 32-question, 5-point Likert scale questionnaire was developed and administered to a Canadian cohort. One hundred fifty-six knee and 85 hip arthroplasty patients returned the survey.

Easing the burden for joint replacement wait times: the role of the expanded practice physiotherapist.

There is a critical shortage of orthopedic surgeons in Canada today due to a decreasing number of surgeons practising here and the increased demand for their services from a population with record-high rates of osteoarthritis and obesity. A method of managing the increased demand for total joint replacement was implemented and evaluated. A physiotherapist and orthopedic surgeons performed assessments on patients referred for surgery and found that 34% did not require surgery and that all patients required appropriate conservative management.

Reducing hip and knee replacement wait times: an expanded role for physiotherapists in orthopedic surgical clinics.

This paper describes a research project that examined an expanded role for physiotherapists to provide pre- and post-operative consultation to patients with hip and knee complaints with the overall goal to save the surgeon's time and improve patient throughput, thereby reducing wait times.

Repeatability of a novel technique for in vivo measurement of three-dimensional patellar tracking using magnetic resonance imaging.

Purpose: To determine the repeatability of a novel noninvasive MRI-based technique for measuring patellofemoral kinematics in vivo.

Materials And Methods: The patellar kinematics measurement method relies on registering bone models (with associated coordinate systems) developed from a high resolution MRI scan to loaded bone positions derived from fast, low resolution MRI scans. The intrasubject variability, high resolution to low resolution registration error, and interexperimenter repeatability were quantified in experiments on three healthy subjects.

A comparison of plate versus staple-and-cast fixation in maintaining femoral tibial alignment after valgus tibial osteotomy.

Purpose: To compare 2 methods of fixation for maintenance of alignment during healing of valgus tibial osteotomies.

Methods: We performed a retrospective chart and radiographic review of valgus tibial osteotomy cases of staple fixation supplemented by a postoperative cast and of blade plate fixation for maintenance of femoral-tibial alignment during healing of the osteotomy.

Results: Both groups (staple-and-cast, n = 16; plate, n = 28) were similar in terms of age, preoperative alignment, extent of osteoarthritis and degree of intra-operative correction.

Influence of obesity on outcome after knee arthroscopy.

Purpose: To compare the clinical outcomes in overweight women with those of a group of normal-weight women 4 to 11 years after arthroscopic debridement of the knee.

Methods: A questionnaire containing the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the short form health survey SF-36, and a survey regarding satisfaction with surgery was mailed to 121 patients. Questionnaire data were supplemented by chart review.

Incidence of undiagnosed sleep apnea in patients scheduled for elective total joint arthroplasty.

We investigated the frequency of undiagnosed sleep apnea in patients scheduled for elective total joint arthroplasty. Two hundred fifty-four patients were assessed between September 1999 and May 2001. At intake, patients were given a standard systems review with the addition of targeted questions about sleep apnea.