Medicine and Health Sciences Commons^™

Biomechanics Analysis Of Anterior Cortical Perforation In Antegrade Femoral Nailing, Michael Ching

Electronic Thesis and Dissertation Repository

Hip and femur fractures are a common problem in an aging population. The number of hip and femur fractures are on the rise in Canada. Cephalomedullary fixation is a common method of treating hip and femur fractures, with a known complication of anterior cortical perforation of the distal femur. The literature describes risk factors, such as the influence of the start point at the greater trochanter, but there is no consensus on management. Some cases are treated with restricted weightbearing and other cases with revision surgery. Restricted weightbearing increases perioperative complications including mortality and decreases functional outcomes.

We analyze the …

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 …

The Feasibility Of Gathering Patient-Reported Outcome Measures On Individuals With Acute Ankle Sprains In A Busy Clinic Environment, Ryan Reeson

Electronic Thesis and Dissertation Repository

Ankle sprains are the most common sports injury and can lead to long-term deficits. Patient-reported outcome measures (PROMs) may assist clinicians in evaluating the recovery trajectory of patients with ankle sprains. However, before a large-scale study can be performed, it is necessary to determine whether it is feasible to collect PROMs in a busy clinic environment. This study had a narrow recruitment window but the consent rate was 100%. Ten patients at Fowler Kennedy Sport Medicine Clinic were followed for up to six visits. Three PROMs that characterized lower extremity function were measured. The measurement completion rate decreased from 100% …

Assessing The Impact Of Surgical Technique On Implant Migration, Tibiofemoral Contact Kinematics, And Functional Recovery Following Uncemented Total Knee Arthroplasty, Harley A. Williams

Electronic Thesis and Dissertation Repository

The standard of care treatment for end-stage osteoarthritis of the knee joint is a total knee arthroplasty (TKA). As we move towards a younger TKA patient cohort, implant longevity is of increasing concern. Porous hydroxyapatite coated uncemented implants provide a promising alternative to cemented fixation methods. Currently, a lack of consensus exists regarding which surgical technique is best suited to the uncemented TKA procedure. This thesis sought to examine the impact of surgical technique on tibial and femoral component migration. Additionally, we investigated the impact of technique on post-operative kinematics and functional recovery. The results of this thesis indicate no …

Assessing The Impact Of Collared Versus Collarless Stems On Implant Migration, Patient Activity And Patient Function Following Total Hip Arthroplasty: A Randomized Clinical Trial, Maxwell E. Perelgut

Electronic Thesis and Dissertation Repository

Total hip arthroplasty (THA) is a common procedure used to treat end-stage hip osteoarthritis (OA). Various designs of implants are currently used to successfully perform these procedures. However, the role of these design variations on early implant migration and patient recovery is still being studied. In this study patients were prospectively randomized to receive either a collared or collarless femoral stem. Differences were compared between groups assessing implant migration, patient activity and patient functional differences. Compared to the collarless femoral stem, it is believed that a collared femoral stem provides improved axial stability early in the post-operative timeline. This study …

Radial Head Stability In Anterior Monteggia Injuries: An In Vitro Biomechanical Study, Armin Badre

Electronic Thesis and Dissertation Repository

Anterior Monteggia fracture-dislocations are frequently complicated by persistent radial head instability leading to suboptimal outcomes. In this biomechanical investigation using a cadaveric elbow motion simulator, we examined the effects of ulnar extension angulation, soft tissue disruption, biceps loading and elbow motion on radial head translation. Our results showed significant anterior radial head translation with progressive ulnar extension angulation, with greater soft tissue injuries and increased biceps loading (P=.000). There was no significant difference in radial head translation between simulated active and passive elbow flexion (P=.251). These findings support the importance of an anatomic reduction of the ulnar fracture. However, in …

The Development And Evaluation Of Resources To Improve The Quality Of Care For Patients With Knee Osteoarthritis, Laura K. Churchill

Electronic Thesis and Dissertation Repository

Purpose: The non-operative management of patients with knee osteoarthritis (OA) is often considered suboptimal. Sub-optimal management includes inadequate use of non-surgical treatments, misuse of diagnostic imaging, and non-operative referrals to surgeons in consideration of total knee replacement (TKR). These inefficiencies result from an interplay of factors involving primary care physicians, patients, and the systems in which they function. The overall purpose of this thesis is to develop a means to optimize the management of patients with knee OA, and the timing and quality of referrals to TKR.

Methods: This thesis includes three studies. In study 1, we identified and cross-validated …