Medicine and Health Sciences Commons^™

The Role Of Scapular Morphology In Reverse Shoulder Arthroplasty, Ashish Gupta

Electronic Thesis and Dissertation Repository

Baseplate fixation in a reverse shoulder arthroplasty depends on adequate bone stock. In cases of severe glenoid bone loss and revision shoulder arthroplasty, deficiency of the glenoid vault compels the surgeon to attain screw fixation in the three columns of the scapula. The relationship of these columns demonstrated that the coracoid is closer to the lateral scapular pillar in females than in males. Significant gender dimorphism exists between the orientations of the three columns. The gender dimorphism is further evaluated by anthropometric measurements of the scapular body and the glenoid. The clinical significance lies in the ability to reconstruct the …

Physical Activity Levels In Total Hip Arthroplasty Comparing The Direct Anterior Approach To The Direct Lateral Approach: A Prospective Cohort Study, Abdulaziz N. Aljurayyan

Electronic Thesis and Dissertation Repository

Total hip arthroplasty (THA) is a cost-effective surgical procedure to treat patients with end-stage hip arthritis with high patient satisfaction. Different surgical approaches to the hip have been used to successfully perform THA. However, the role of these surgical approaches on physical activity and early functional recovery in THA patients remains controversial.

In this thesis, we prospectively evaluated physical activity levels in patients with end-stage hip OA whom are undergoing elective THA. The primary focus was to evaluate the impact of different surgical approaches on physical activity levels as a measure of functional recovery in the immediate postoperative period.

Due …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

Drop Vertical Jump Landing Mechanics Following Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis, Michal Daniluk

Electronic Thesis and Dissertation Repository

The use of combined anterior cruciate ligament (ACL) plus lateral extra-articular tenodesis (LET) reconstruction has shown promising results during clinical testing, however, no studies have examined its effectiveness during a dynamic functional task. We used the drop vertical jump (DVJ) to compare in vivo biomechanics of ACL reconstructed patients with and without LET.

Our primary outcome was peak knee abduction moment during stance phase. Secondary kinetic and kinematic outcomes included peak initial contact and stance values for knee abduction angle, knee flexion moment and angle, knee internal rotation moment and angle, and vertical ground reaction force. We also assessed fear …

A Randomized Controlled Trial To Establish Realistic Patient Expectations Following Total Knee Replacement Surgery, Sharon E. Culliton

Electronic Thesis and Dissertation Repository

Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients.

Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our …

Clinical And Cost-Effectiveness Of A Locking Versus Non-Locking Fixation Plate In Medial Opening Wedge High Tibial Osteotomy, Codie Primeau

Electronic Thesis and Dissertation Repository

We investigated the clinical and cost-effectiveness of using a locking versus non-locking fixation plate in medial opening wedge high tibial osteotomy (HTO) for patients with medial compartment knee osteoarthritis. Medical charts were retrospectively reviewed up to 12 months following HTO for 144 patients who received a locking plate and 105 patients who received a non-locking plate. Surgeon notes provided the time to return to full weight- bearing. Participants had completed the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively, six and 12 months postoperatively. Hospital and provincial administrative databases provided direct and indirect cost data. Improvements in KOOS scores were …

Evaluating The Effects Of Patellofemoral Offset Changes And Trochlear Design In Total Knee Arthroplasty: A Radiographic, Visual, And Topographical Analysis, Jacob Matz

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a common procedure for the treatment of advanced knee osteoarthritis. Complications involving the patellofemoral joint (PFJ) are common following TKA, and the etiology is controversial. The purpose of this thesis was to evaluate two potentially modifiable factors affecting the PFJ: (i) changes in patellofemoral offset (PFO) and (ii) trochlear design.

Through a retrospective radiographic review, we demonstrated that PFO changes occur frequently post-TKA, and that the PFJ can tolerate these changes without adverse clinical outcomes. Retrieval analysis provided additional evidence that PFO changes are not associated with femoral component surface damage or wear.

In order …

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 …

Platelet Rich Plasma In Musculoskeletal Pathologies, Nicole L. Kaniki

Electronic Thesis and Dissertation Repository

Purpose: To evaluate the effectiveness of platelet rich plasma (PRP) in musculoskeletal injuries.

Methods: We completed a review of the literature on the use of PRP in tendon, muscle, bone, and intra-articular injuries (Chapter 2). We completed a systematic review and meta-analysis on the effectiveness of PRP in ultrasound guided versus palpation guided injections of PRP in non-operative treatment of tendon and muscle injuries using an indirect analysis method (Chapter 3). We conducted a randomized controlled trial to determine the effectiveness of PRP versus corticosteroid (CS) injections in patients with plantar fasciitis (Chapter 4).

Results: Most studies …

Optimizing The Rehabilitation Of Elbow Lateral Collateral Ligament Injuries, Ranita Harpreet Kaur Manocha

Electronic Thesis and Dissertation Repository

Elbow lateral collateral ligament (LCL) injuries frequently arise following trauma, and can result in disabling instability. Typically such injuries are managed with immobilization followed by a graduated exercise regime; however there is minimal biomechanical evidence to support current treatment protocols. This investigation examines the in vitro effectiveness of several rehabilitation techniques using a custom elbow motion simulator. It was found that active range of motion is safest in the overhead position (n = 7). Early motion in this position may reduce the incidence of elbow stiffness without compromising ligament healing following LCL injury. Forearm pronation and active motion stabilize …

The Impact Of Surgical Technique On Coronal Plane Motion In Total Knee Arthroplasty, Kevin I. Perry

Electronic Thesis and Dissertation Repository

There are two predominant techniques used by most surgeons to perform total knee arthroplasty: gap balancing and measured resection. The purpose of the current study was to observe if surgical technique has an effect on post-operative coronal plane balance throughout range of motion and to observe if surgical technique has an effect on tibial and femoral component migration. This was a randomized, prospective controlled trial. Twenty-three patients (24 knees) were enrolled: twelve knees in each group. All knees showed migration of their components from the initial RSA to their RSA at 6 months. Migration was similar for both groups, but …