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
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
Crossfire
This trial aimed to determine whether surgical plate fixation improves pain, function, and cost-effectiveness compared to closed reduction with cast immobilisation in displaced distal radius fractures in adults aged 60 and older. Eligible participants must meet inclusion criteria, including age, fracture type, injury characteristics, medical fitness for surgery, independent living, and a willingness for a twelve-month follow-up. The injury must have occurred within one week of enrolment. The study compares these two techniques while also tracking non-randomised patients who consent to follow-up, providing a broader perspective on fracture presentation, treatment practices, and outcomes. Including non-randomised patients enhances the generalisation of results and offers valuable insights into standard care approaches. https://researchdata.edu.au/crossfire-combined-randomised-radius-elderly/662388
Cristal
This trial aimed 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 was nested within the Australian Orthopaedic Association National Joint Replacement Registry and recruited a total of 8,000 patients from 20 sites across Australia. https://pubmed.ncbi.nlm.nih.gov/34429127/