Medicine and Health Sciences Commons^™

Assessing Inflammation In The Pathology Of Knee Osteoarthritis, Zachary J. Koudys

Electronic Thesis and Dissertation Repository

Osteoarthritis (OA) is a joint disease that causes pain, stiffness, and loss of function. Inflammation of the synovium plays a role in the pathology of OA. Macrophages are the dominant immune cells in synovial tissue. Activated macrophages over-express the translocator protein (TSPO). [¹⁸F]FEPPA is a 2^nd generation positron emission tomography (PET) tracer that can target TSPO with high specificity. Hybrid [¹⁸F]FEPPA PET/MRI may enable accurate quantification of macrophage activity in vivo. In this work, [¹⁸F]FEPPA tracer uptake in knee synovial tissue was measured ex vivo using autoradiography and was validated to correlate to …

Reducing Length Of Stay After Total Hip And Knee Arthroplasty: Assessing Cost-Effectiveness, Caregiver Involvement And Surgical Approach, Bryn O. Zomar

Electronic Thesis and Dissertation Repository

Purpose

The overall purpose of this dissertation was to evaluate factors related to reducing length of stay after total hip and knee arthroplasty (THA and TKA).

Methods

Study 1 was a randomized controlled trial (RCT) to investigate the cost-effectiveness of outpatient THA compared to standard overnight stay. Study 2 was a prospective cohort study to assess patient- and caregiver-related factors and how they may relate to caregiver strain and level of assistance when caring for patients undergoing THA and TKA. Finally, Study 3 was a 2x2 factorial RCT to compare the trajectory of early functional recovery between the medial parapatellar …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

Wearable Sensors And Total Knee Arthroplasty: Assessing Quantitative Function To Improve The Patient Experience, Megan Fennema

Electronic Thesis and Dissertation Repository

Osteoarthritis (OA) is a chronic degenerative disease for which the only long-term solution is total knee arthroplasty (TKA), though many patients are not satisfied with their TKA. Satisfaction in TKA patients is not well understood. Subjective questionnaires and objective functional tests have been previously used to assess TKA outcomes, but both have disadvantages. Wearable sensors have facilitated affordable biomechanical measurement in OA and TKA populations. The objective of this work was to use wearable sensors alongside functional tests with TKA patients to identify quantitative function that related to subjective function and satisfaction. A wearable sensor-setup was validated before implementation in …

The Association Between Soft Tissue Releases And Bony Resections Performed During Total Knee Arthroplasty And Patients' Pain And Satisfaction Postoperatively, Matt Carter

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a surgical treatment of degenerative knee conditions such as osteoarthritis to reduce pain and increase function. Intraoperative soft tissue releases (STRs) and bony resections (BRs) are necessary for a balanced and aligned TKA. It is possible that the degree of STRs and BRs is related to final outcome following TKA and thus there may be implications for patient rehabilitation, patient expectations, pain medications, and timelines for recovery. Thus, our primary objective was to examine the association between the number of STRs and BRs performed intraoperatively and patients’ satisfaction and pain at three months. We performed …

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 …

A Model To Reduce The Proportion Of Inappropriate Referrals To Surgery For Patients With Osteoarthritis: A Pilot Study, Laura K. Churchill

Electronic Thesis and Dissertation Repository

A significant proportion of patients referred for total knee arthroplasty are inappropriate candidates for surgery, which warrants remediation of the referral process to reduce wait times for the initial consult. We conducted a prospective feasibility investigation involving 166 patients referred from their general practitioner for a consultation with an orthopaedic surgeon at a joint replacement clinic. The aim of this study was to improve the validity of data collection forms and to improve the feasibility of collecting data in a clinical setting. We also wanted to strengthen our estimate of the sample size to inform the timeline. We were able …