Orthopaedic Articles - Articles for Orthopaedic Practice

Orthopaedic articles on current trends, tips & tricks and best evidence from top orthopaedic specialists.

Knee Osteoarthritis: Early Detection, Progression and Arthroplasty Outcome using Biomechanics of Human Motion

Janie Astephen Wilson


Knee Osteoarthritis: Early Detection, Progression and Arthroplasty Outcome using Biomechanics of Human Motion

Janie L. Astephen Wilson, Ph.D.
Associate Professor
School of Biomedical Engineering
Dalhousie University
Halifax, NS

Knee OA is a complex disease process with many interacting risk factors that contribute to disease initiation and progression. The pathomechanic pathways of knee OA are poorly defined, hindering our ability to develop early, effective treatment strategies. Early management for knee OA is heavily reliant on pharmaceutical relief of symptoms, which often do not address the underlying disease process and can exacerbate the structural deterioration of the joint. Primary treatment of knee OA therefore remains surgical, and is typically total knee arthroplasty (TKA) when the disease process has advanced to a point of debilitating pain and/or functional limitations. While arthroplasty is an effective procedure in removing the pain and some of the functional limitations of knee OA, it is a joint salvage surgery that does not offer effective early relief of symptoms, nor a viable lifelong solution for the increasingly younger individuals presenting with advanced stages of knee OA.





Longer Lasting Artificial Joint Designs with Higher Patient Satisfaction

Eric Bohm


Longer Lasting Artificial Joint Designs with Higher Patient Satisfaction

Urs P. Wyss, Ph.D., P.Eng
.Professor, Mechanical Engineering
University of Manitoba, Orthopaedic Innovation Centre
Winnipeg, MB

Eric R. Bohm, BEng, M.D., MSc, FRCSC
Director for Arthroplasty Research, Concordia Joint Replacement Group
Associate Professor, Faculty of Medicine University of Manitoba
Winnipeg, MB

Jan M. Brandt, Ph.D.
Professor, Mechanical Engineering
University of Manitoba, Orthopaedic Innovation Centre
Winnipeg, MB

The quality and performance of artificial joints have improved sufficiently enough over the last years that they are more often used today in younger patients with joint degeneration. Younger patients, however, are generally more active and also have higher expectations of artificial joints, such as being able to do sports. After many apparent improvements, these newer joints have a survival rate of over 80% after 15 years, and this has not improved much over time. Therefore, younger patients still require one or more revisions in their lifetime. It is also a well-known fact that patients with artificial knee joints have a lower satisfaction score than patients with artificial hip joints. This can be partially explained by unmatched patient expectations, but also by the fact that knee joints are not as simple as hip joints, which are a ball and socket type of joint. There are also new demands on artificial joints from emerging markets in Asia, the Middle East and Africa that require different ranges of motion and sizes, due to different priorities in activities of daily living, and differences in overall body type, size and weight. Squatting, kneeling and cross-legged sitting is much more common in some of those countries than in so-called Western countries, requiring designs that are more tailored for such activities. The performance of ankle, elbow, shoulder, finger and toe joints also leaves room for improvement, as the survival rate of these joints is not as good as those of hip and knee joints.














The Role of In Vitro Testing and Retrieval Analysis in Improving Clinical Outcomes

COA Bulletin


The Role of In Vitro Testing and Retrieval Analysis in Improving Clinical Outcomes

Jan-M. Brandt, Dipl.-Ing., PhD
Director of Tribology, Concordia Joint Replacement Group
Assistant Professor, Faculty of Medicine, University of Manitoba
Winnipeg, MB

Eric R. Bohm, BEng, M.D., MSc, FRCSC
Director for Arthroplasty Research, Concordia Joint Replacement Group
Associate Professor, Faculty of Medicine University of Manitoba
Winnipeg, MB

Urs P. Wyss, PhD, PEng
Professor, Department of Mechanical & Manufacturing Engineering
University of Manitoba
Winnipeg, MB

Over the past decade, the number of patients requiring total joint arthroplasty has been rapidly increasing, especially in the group of younger, more active patients. This change in patient demographics increasingly exposes total joint replacements to increased mechanical wear and tear. Feedback obtained from retrieved components has been shown to provide valuable information to the surgeon and engineer on how the total joint replacements performed clinically. Retrieval analyses have been shown to help to improve current in vitro test conditions with the goal of increasing the durability of total joint replacements.










Imaging Osteoarthritis

COA Bulletin


Imaging Osteoarthritis

James (J.D.) Johnston, PhD, PEng
Assistant Professor
Department of Mechanical Engineering
University of Saskatchewan
Saskatoon, SK

Osteoarthritis (OA) is a painful, debilitating disease characterized by degenerated cartilage and altered subchondral bone. The exact etiology of OA is unknown. Currently, most of our understanding of cartilage and subchondral bone changes with OA are from animal models, which may not be applicable to humans, and cadaveric studies, where longitudinal assessments are not possible and changes cannot be related to clinical symptoms. Medical imaging offers unique potential for examining and tracking OA pathogenesis in vivo.





Osteoarthritis (OA) - Past, Present and Future

Cyril B. Frank


Osteoarthritis (OA) - Past, Present and Future

Cy Frank, M.D., FRCSC
2013 Macnab Lecturer, COA/CORS Annual Meeting

David Hart, PhD
Calgary, AB

The Past - What do we know about OA?
As described by many clinicians and researchers over the last several decades, Osteoarthritis (OA) is, by far, the most common type of arthritis. Whether described by the word 'Osteoarthrosis' that is preferred by some since the condition does not always involve inflammation, OA of literally every diarthrodial joint has been identified, including its most common locations in the knee, hip and spine. It can be unilateral or bilateral and many anatomic combinations of joint involvement have been seen. A recent review conducted by the COA's partners in the Arthritis Alliance of Canada (AAC), Canadian cohort data strongly suggests that the prevalence of OA will more than double in the decades ahead, and its future economic burden in Canada is predicted to grow exponentially1.




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Articles about career planning for orthopaedic surgery residents and orthopaedic surgeons.

Articles about education.
Articles on foot and ankle topics from members of the Orthogate Community.
Articles on hand and wrist topics from members of the Orthogate Community.
Articles on hip and knee topics from members of the Orthogate Community.
Articles about medical informatics.
Articles about orthopedic informatics.
Articles on pediatric orthopaedic topics from members of the Orthogate Community.
Articles on shoulder and elbow topics from members of the Orthogate Community.
Articles on spine topics from members of the Orthogate Community.
Articles on sports medicine topics from members of the Orthogate Community.
Articles on trauma topics from members of the Orthogate Community.
Articles on musculoskeletal tumor topics from members of the Orthogate Community.

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