Biomechanical Analysis Of Ligament Modelling Techniques And Femoral Component Malrotation Following Tka, Liam A. Montgomery

Electronic Thesis and Dissertation Repository

Previous studies have demonstrated that satisfaction and revision rates following total knee arthroplasty (TKA) are lower than those of comparable surgeries such as total hip replacements. A leading cause for these revisions is joint instability which may be due to improper ligament balancing or poorly aligned surgical implants. One of the methods used to investigate biomechanical forces and kinematics is computational modelling of the post-operative TKA knee.

A unique knee model was used to investigate the biomechanical and kinematic effects of ligament model complexity, as well as the effects of simulating ligament wrapping versus ignoring ligament wrapping. We then used …

Validation Of Arterial Spin Labeling For Longitudinal Monitoring And Differential Diagnosis Of Frontotemporal Dementia, Tracy Ssali

Electronic Thesis and Dissertation Repository

Frontotemporal dementia (FTD) is a devastating neurodegenerative disease characterized by a rapid decline in behavioural, language, and motor abilities. Advances in the understanding of FTD genetics and pathophysiology, and the subsequent development of novel disease modifying treatments have highlighted the need for tools to assess their efficacy. While structural magnetic resonance imaging (MRI) and functional imaging with ¹⁸F-flurodeoxyglucose (FDG) positron emission tomography (PET) are used for clinical diagnosis, structural changes are subtle at the early stages and PET imaging is expensive and access limited. Given the coupling of cerebral blood flow (CBF) to energy metabolism, an attractive alternative is …

The Effect Of Obesity On Revision Total Knee Arthroplasty: Functional Outcome, Ninety-Day Costs, Reoperations, Readmissions And Cost-Effectiveness, Mohamad Nasser Eddine

Electronic Thesis and Dissertation Repository

The demand for revision total knee arthroplasty (RTKA) is increasing due to obesity and an aging population. The purpose of this study is to evaluate the effect of different body mass index (BMI) categories on RTKA using a retrospective cohort analysis. The first part was to assess patients’ functionality post-RTKA. The second part was to determine the survival of RTKA and re-revision rate. The third part was to explore the complication and readmission rates, and to estimate the 90-day costs of RTKA. We found the most common indication for RTKA in super obese patients is infection, unlike other BMI categories, …

Using Hyperspectral Near-Infrared Spectroscopy And Diffuse Correlation Spectroscopy To Monitor The Effects Of Phenylephrine In The Microcirculation, Laura Mawdsley

Electronic Thesis and Dissertation Repository

The microcirculation is the site of oxygen exchange in the body, and little work has been done to determine if different microvascular beds respond similarly to a simultaneous vascular challenge. A hybrid microvascular monitoring device was developed that uses hyperspectral near-infrared spectroscopy and diffuse correlation spectroscopy to simultaneously monitor the brain and skeletal muscle. Experiments were conducted on Sprague Dawley rats (n=6, 156g±6.4g) to discern the effect that phenylephrine (0.1 mL bolus, 10 mg/kg) has on the mean arterial pressure (MAP), hemoglobin concentration, and blood flow in each microvasculature. Hemoglobin concentration increased by 2.1±0.2 mmol in the brain, and decreased …

The Cost-Effectiveness Of A Midvastus Versus Standard Medial Parapatellar Surgical Approach For Total Knee Arthroplasty, Ishita Joshi

Electronic Thesis and Dissertation Repository

The minimally invasive midvastus (MMV) surgical approach for total knee arthroplasty (TKA) is a less invasive technique that has been proposed to accelerate recovery over standard TKA, however, advantages are not yet definitively established. We investigated the cost-effectiveness of MMV TKA versus the standard medial parapatellar (MPP) approach for TKA alongside a randomized controlled trial in patients with knee osteoarthritis. Patients reported resource use as well as indirect costs, and health outcomes were measured using the EQ-5D-5L and the Western Ontario and McMaster Universities Osteoarthritis Index over the 12-month study period. The results of our net benefit regression analysis suggest …

Rapid Recovery Of Cerebral Blood Content And Oxygenation In Adults From Time-Resolved Near-Infrared Spectroscopy, David J. F. Cohen

Electronic Thesis and Dissertation Repository

Patient neurological outcomes following cardiac surgery are improved when near-infrared spectroscopy (NIRS) is used to optimize intraoperative cerebral oxygen delivery. However, current NIRS analysis methods have difficulties monitoring adult brains due to contamination from the extracerebral layer (ECL).

The objective of this thesis is to develop a time-resolved (TR) NIRS data analysis method for monitoring adult cerebral oxygen saturation (ScO2) and total hemoglobin (HbT) by assuming the head is composed of two layers – the ECL and the brain. We tested the validity of this assumption using in silico data from an adult human head using two approaches; a few-wavelength, …

Novel Imaging Tools Reveal The Dynamics Of The Myocardial Growth Hormone Secretagogue Receptor In Heart Disease And Heart Failure, Rebecca Sullivan

Electronic Thesis and Dissertation Repository

Heart disease (HD) is the leading cause of mortality worldwide. Currently, diagnosis is based on clinical features, imaging, and circulating cardiac biomarkers. Cardiac imaging technologies, such as echocardiography and cardiac magnetic resonance imaging (cMRI), enable the non-invasive detection of changes in heart function. Although these modalities can detect changes in structure and anatomy, it is usually at later stages, where prevention may not be possible. In conjunction with imaging, circulating biomarkers of heart failure (HF), notably B-type natriuretic peptide (BNP) and cardiac troponin I and T, can be detected with increased levels in the blood. These biomarkers are associated with …

Predicting Dissatisfaction With Total Knee Arthroplasty, Joseph S. Munn

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a common and effective treatment for end-stage osteoarthritis. However, approximately 20% of patients are consistently found to be dissatisfied or unsure of their satisfaction with their TKA at 1-year post-surgery. Two strategies for reducing dissatisfaction have appeared in the literature. The first aims to reduce the number of dissatisfied patients who will undergo surgery by identifying patients likely to be dissatisfied pre-surgery. The second aims to implement interventions that improve patient satisfaction by generating realistic expectations for outcomes and by association improving met expectations scores. It may be possible to improve the performance of these …