Medicine and Health Sciences Commons^™

A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch

Electronic Thesis and Dissertation Repository

One hundred and ninety-six patients at the Fowler Kennedy Sport Medicine Clinic (FKSMC) undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomized as part of the multi-center STABILITY study to receive either an isolated ACLR or ACLR with a lateral extra-articular tenodesis (LET). The STABILITY study followed these patients up to two years postoperative, and a long-term follow-up protocol was initiated afterwards. Eighty-two patients from this center were seen at three, five and seven years postoperative as part of a long-term follow-up. Our primary outcome was a composite outcome of instability and graft failure. Secondary outcomes included patient-reported outcome measures …

Total Hip Arthroplasty In Young Patients, Aaron G. Chen

Electronic Thesis and Dissertation Repository

Total hip arthroplasty (THA) is the gold standard in treatment of hip arthritis yet is often avoided in young patients due to concerns of inferior survivorship. We aim to explore the role of THA in young patients and assess whether these historical concerns are valid in contemporary THA by presenting the results of: (1) a systematic review and meta-analysis of the current literature, (2) a retrospective database review, and (3) a retrospective population-based study. We found excellent long-term survivorship with modern THA in young patients, demonstrating greater than 90% revision-free survival up to 15 years. Factors that may increase risk …

Investigation Of Exercise, Nutrition, And High Tibial Osteotomy Interventions For Patients With Medial Dominant Knee Osteoarthritis, Codie Primeau

Electronic Thesis and Dissertation Repository

Purpose: To evaluate the effectiveness of two distinct interventions in improving outcomes for patients with knee osteoarthritis (OA) and varus alignment: 1) a 12-week minimally supervised therapeutic exercise program with nutrition recommendations, 2) and high tibial osteotomy (HTO).

Methods: This dissertation involved four studies. Participants were recruited as part of two separate ongoing prospective cohort studies evaluating clinical, biomechanical, and physiological outcomes following a) a 12-week exercise and nutrition program (studies 1-2) or b) HTO (studies 3-4) for knee OA. For studies 1 & 2, we evaluated change in physiological measures (body composition, muscle strength, gait biomechanics), patient-reported …

The Impact Of Quality-Based Procedures On Radical Prostatectomy Outcomes In Ontario, Nickan Motamedi

Electronic Thesis and Dissertation Repository

Ontario’s new health funding model, Quality-Based Procedures (QBP), designated certain performance outcomes that would determine future cancer care funding. We examined pre-specified outcomes for radical prostatectomy, one of the procedures integrated into QBP funding in 2015. We conducted two retrospective studies using provincial administratively-linked databases, including patients who underwent radical prostatectomy between April 2010 and March 2019. Our first study evaluated the 30-day complication rate and the trend in surgical approach. Our second study compared QBP outcomes before and after implementation of the funding model. The first study demonstrated that complication rate improved over the study period, possibly due to …

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how …

Comparing Mid Lumbar Interbody Fusion (Midlf) With Traditional Posterior Lumbar Interbody Fusion (Plif), Joel T. Phillips

Electronic Thesis and Dissertation Repository

Mid-lumbar interbody fusion (MIDLF) uses a novel cortical bone trajectory (CBT) screw that provides robust fixation that is less dependent on cancellous bone quality than a traditional pedicle screw. MIDLF also allows for decompression and instrumentation through a smaller central surgical window. The aim of this study is to compare MIDLF with posterior lumbar interbody fusion (PLIF) with regards to perioperative complications, operative time, blood loss, length in hospital, radiographic outcomes and post-operative patient functional scores. A retrospective review of our institutional database was performed of patients undergoing MIDLF. Matched PLIF controls were then selected from the same database for …

Inpatient Versus Outpatient Total Hip Arthroplasty, Michael Pollock

Electronic Thesis and Dissertation Repository

We conducted a randomized controlled trial to evaluate patients undergoing a total hip arthroplasty (THA) who were discharged from the hospital either on the day of surgery (outpatient) or were admitted overnight following surgery (inpatient). Our primary outcome was the rate of serious adverse events during the first three months postoperatively. Secondary outcome measures included cost, patient satisfaction, functional outcomes, quality of life and pain. We found no statistically significant difference between the two groups in serious adverse events. We found that outpatient THA was less expensive from the perspectives of the hospital and ministry of health; but the difference …

Predictors Of Appropriate Referral To Total Knee Arthroplasty: A Validation Study, Samuel J. Malian

Electronic Thesis and Dissertation Repository

Approximately 45% of referrals from primary care physicians to arthroplasty surgeons are inappropriate. Currently, Canadians are waiting over three months for consultation with an arthroplasty surgeon. Reducing the proportion of inappropriate referrals will reduce the wait time to first consultation with an arthroplasty surgeon. This study’s objective was to validate a model that identified patient-reported predictors of appropriate referrals to arthroplasty. We screened 258 patients attending their first consultation with an arthroplasty surgeon. Participants completed the questionnaires prior to their appointment and the surgeon detailed each consultation outcome on a standardized form. We constructed our validation model using the same …

Volume 36, Issue 1, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 34, Issue 6, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 24, Index, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 24, Issue 6, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 23, Index, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 23, Issue 4, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 23, Issue 2, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 21, Issue 6, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 19, Issue 3, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 17, Issue 3, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 15, Issue 3, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 15, Issue 2, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 15, Issue 1, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 14, Issue 5, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 13, Issue 1, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 12, Index, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 07, Issue 1, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.

Volume 05, Issue 3, Canadian Medical Association

Canadian Journal of Surgery

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.

Visit the journal website at http://canjsurg.ca/ for more.