Current Research

Shoulder instability injuries (i.e. dislocations and subluxations) are a common problem experienced by contact sport athletes. Various surgical stabilisation procedures are commonly used to restore shoulder function and correct stability following these injuries. This research is examining how different surgical stabilisation procedures impact on shoulder joint function and movement in contact sport athletes following instability injury.

Advanced computational models of the shoulder and musculoskeletal system are developed from medical imaging (i.e. CT or MRI) to investigate movement, muscle control and the joint loads experienced during activities of daily living and sporting tasks involving the shoulder – with these being compared across athletes who undergo different stabilisation procedures. The knowledge gained from this work will be used to guide surgical planning and rehabilitation practices for contact sport athletes following instability injury.

Patient-centred care (PCC) is an essential component of high-quality healthcare and shared decision making is its cornerstone. Yet, integrating the principles of PCC into healthcare practice is not always straightforward and shared decision making can be complicated and ethically demanding.

In this work, we use Emmanuel et al.’s deliberative model to provide a practical framework for considering ethical aspects of PCC and shared decision-making. The model encourages us to appreciate PCC through a broader lens and consider patient autonomy alongside other moral obligations such as justice and the equitable distribution of finite resources.

Adhesive capsulitis (AC) is a disabling and poorly understood pathological condition of the shoulder joint.

The research aims to increase our understanding of the pathogenesis, diagnosis and clinical outcomes of people with AC by investigating: 1) transcriptome-wide alterations in gene expression of the glenohumeral joint capsule in people with AC compared to people with non-inflammatory shoulder instability (controls); 2) serum and urine biomarkers to better understand diagnosis and staging of AC; and 3) clinical outcomes in people with AC compared to controls 12-months following arthroscopic capsular release or labral repair respectively.

Methods: The study is a prospective multi-centre longitudinal study investigating people undergoing arthroscopic capsulotomy for AC compared to people undergoing arthroscopic stabilization for shoulder instability. Tissue samples collected from the anterior glenohumeral joint capsule during surgery will undergo RNA-seq to determine differences in gene expression between the study groups. Gene Set Enrichment Analysis will be used to further understand the pathogenesis of AC as well as guide serum and urine biomarker analysis. Clinical outcomes regarding pain, function and quality of life will be assessed using the Oxford Shoulder Score, Oxford Shoulder Instability Score, Quick DASH, American Shoulder and Elbow Society Score, EQ-5D-5 L and active shoulder range of movement. Clinical outcomes will be collected pre-operatively and 12-months post-operatively and study groups will be compared for statistically significant differences using linear regression, adjusting for baseline demographic variables.

Joint Replacement surgery is recognized as one of the most successful of all surgical interventions currently undertaken.

In Australia, there are over 70,000 procedures done each year 1, however the ability to track patient outcomes and prosthesis utilization is an important tool in raising standards and minimizing risk and poor outcomes.

The Barwon Orthopaedic Research Unit (BORU) has been collecting standardized data using validated outcome tools since 1998, making it one of the biggest regional registries in the country. This enables improved audit, hospital comparative data and research data for sub-group analysis and allows a more detailed understanding of outcomes. The current gold standard clinical practice entails periodic lifelong prosthesis and patient monitoring both clinically and radiologically.

All patients at Barwon Health who are scheduled for joint replacement surgery are involved in this project. Their details are entered into a database specifically designed to record relevant data about the operation itself and the patient responses to questionnaires. The questionnaires relate to the patient’s general health and problems with the joint.

Modern polybraid sutures form the foundation for of repair of tendon, ligament and muscle tissue in musculoskeletal/orthopaedic surgery.

Suture abrasion has been identified as a factor in breakage of contemporary suture materials, which may lead to failure of tissue healing. In previous published investigations supervised by the research team, bending and abrasion fatigue was assessed over a simulated suture anchor eyelet and focused on different suture material’s abrasion resistance. The hypothesis of this current project is that material differences exist in the abrasion resistance between a standard contemporary polybraid suture and anchor eyelets of differing materials in current surgical use. This is also altered by angular rotation of the suture eyelet as seen in surgery, which in turn affects the abrasion resistance of the tissue repair construct. The findings of this study have the potential to influence current surgical practice in conditions such as rotator cuff repair surgery.

The overall objective is to investigate wellbeing, work participation, and health service utilisation among younger people with shoulder pain presenting to orthopaedic outpatient clinics.

The specific aims of the study are to:

• compare the Health-Related Quality of Life (HRQoL) of people aged between 20-55 years who have shoulder pain with age- and sex-matched Australian population norms;
• evaluate shoulder pain, shoulder-related function, psychological distress, employment status, work limitations and shoulder-related parenting disability in this patient group; and
• explore health service utilisation and medication use for shoulder pain, and associated costs.

The aim of this project is to investigate the short and long-term outcomes of the Integra PyroTITAN HRA Shoulder Implant.

This project is important because there is very little information about the outcomes and safety of these implants.  The Integra PyroTITAN Humeral Resurfacing Arthoplasty (HRA) shoulder joint implant study investigates the short and long term outcomes of the implant.