Orthopaedic Surgery
Surgery is a relatively under-researched area of medical practice, as many current surgical treatments have not been tested against placebo or non-surgical treatments in randomised trials. The Surgery theme aims to address the lack of high-quality evidence in surgery as studies of this nature – including placebo surgical trials – will have the highest impact on clinical practice.
Theme Leader
Current research projects & trials
CRISTAL - Cluster randomised trial of aspirin versus low molecular weight heparin for venous thromboembolism prophylaxis in hip and knee replacement: a registry nested study
The trial hopes to produce robust evidence to replace the costly, inconvenient and risky method of using injections for VTE prophylaxis, with aspirin: cheap, easy to take and safe. This trial aims to compare the safety and effectiveness of aspirin and low molecular weight heparin – two commonly used methods of preventing deep venous thrombosis and pulmonary embolus – in joint replacement surgery. The trial will be nested within the Australian Orthopaedic Association National Joint Replacement Registry and will recruit a total of 8,000 patients from 20 sites across Australia. You may be able to participate in this study if you are a patient undergoing elective hip and knee replacement at participating centres. Principal Investigator: Professor Ian Harris This trial is run by the Whitlam Orthopaedic Research Centre (part of the Ingham Institute for Applied Medical Research) with the Australian Orthopaedic Association National Joint Replacement Registry study. The trial has been funded by the Medical Research Futures Fund. For more information, please contact: Professor Ian Harris e: ian.harris@sydney.edu.au
CROSSFIRE - Evaluation of surgical fixation versus conservative management for distal radius fractures in the elderly
The trial will test if surgical fixation is more effective than closed reduction and cast immobilisation in displaced distal radius fractures. The aim of this study is to determine whether plate fixation leads to better pain and function and if it is more cost-effective compared to closed reduction with cast immobilisation in displaced distal radius fractures in adults aged 60 years and older. You may participate in this study if you pass the following inclusion criteria; 60 years or older, have a displaced distal radius fracture, have an isolated and low energy injury, medically fit for surgery, living independently, and available for follow up for twelve months. The injury must have occurred within one week of enrolment into the study. The trial will compare the two techniques, but will also separately follow patients that are unwilling to be randomised into one of the techniques, but who have consented to follow up. The inclusion of non-randomised patients provides a more complete picture of fracture presentation, practice and outcome insights about standard care, and improves the generalisation of the results. This study is currently recruiting. You may be eligible to participate if you are 60 years or older, have a displaced distal radius fracture, have an isolated and low energy injury, medically fit for surgery, living independently, and available for follow up for twelve months. The injury must have occurred within one week of enrolment into the study. Principal Investigator: Professor Ian Harris This study has received ethics approval from the Hunter New England Research Ethics & Governance Office and funding from the NHMRC. For more information about this Whitlam Orthopaedic Research Centre project, please contact: Andrew Lawson e: aalawson@tpg.com.au Trial registered on ANZCTR: ACTRN12616000969460
SUcceSS - Surgery for Spinal Stenosis: A randomised, placebo-controlled trial
The intention of the trial is to rigorously test, using a high level of scientific scrutiny, the use of decompressive surgery for central spinal canal stenosis. The SUcceSS trial aims to randomly allocate participants with chronic, symptomatic lumbar spinal stenosis to either decompressive surgery or placebo surgery to measure the efficacy of decompressive surgery on patients with central spinal canal stenosis. Decompressive spinal surgery via laminectomy for symptomatic spinal stenosis is justified primarily upon clinical experience, expert consensus and pathophysiological considerations. The efficacy of surgical decompression, the most popular procedure for spinal stenosis, has not yet been proven. There is an urgent requirement to test decompressive surgery for spinal stenosis as the intervention is expensive and potentially harmful and is increasingly used due to our ageing population. This study is currently recruiting. You may be eligible to participate if you are aged 50 years or older and have experienced pain, numbness and/or fatigue below the gluteal line with or without back pain (if back pain present, leg pain is greater than back pain) that is precipitated by walking and alleviated by sitting or lumbar flexion. Principal Investigator: Associate Professor Manuela Ferreira Institute for Musculoskeletal Health Investigators: Professor Ian Harris, Professor Jane Latimer, Professor Chris Maher This trial has been granted ethics approval by the South Eastern Sydney Local Health District Ethics, and funding from the NHMRC. For further information about this Institute for Bone and Joint Research trial, please contact: Associate Professor Manuela Ferreira e: manuela.ferreira@sydney.edu.au Trial registered on ANZCTR: ACTRN12617000884303p