Cutting-Edge Orthopaedic Research
Our Mission Statement
Our research projects in arthroplasty and traumatology focus on improving patient outcomes and reducing complications in total hip and knee arthroplasty as well as in the treatment of complex lower-limb fractures. We believe that outcomes are the true measures of quality in the health care system and we promote the principles of value-based healthcare in order to achieve the best outcomes for patients while minimizing costs.
METAL-ON-METAL (MoM) BEARING SURFACES
Polyethylene wear-related osteolysis has been the limiting factor on the long-term survival of total hip arthroplasty. MoM bearings were introduced to reduce the wear of the articulation. Although the early results of MoM bearings seemed promising, registry-studies showed an increased early revision rate due to soft-tissue reactions caused by the metal debris. Our research aims to delineate possible risk factors for adverse soft-tissue reactions, improve the diagnostic modalities used in imaging of MoM hips, and to define evidence-based revision thresholds for specific implants.
OUTCOMES OF HIP AND KNEE REVISION ARTHROPLASTY
A decade ago, the prognosis of revision for a failed total hip or knee was guarded. With the introduction of ultra porous metals and joint-specific revision instrumentations, the previously non-salvageble cases could be managed with relatively straightforward techniques. However, little is known about the long-term outcome of revision surgery using contemporary implants. We aim to understand the variables that affect the outcomes of revision hip and knee arthroplasty. Our research also aims to determine the best surgical techniques for the unique scenarios encountered during revision surgery.
IMPROVING EARLY RECOVERY AFTER PRIMARY HIP AND KNEE REPLACEMENT
As the indications for hip and knee arthroplasty have expanded to younger patients groups, the expectations for rapid recovery from these procedures have been emphasized. The hospitalization period has already decreased significantly, but there is still a need for more patient-specific measures to support the recovery from surgery. We aim to provide means to facilitate the early functional recovery using novel technological applications.
Fractures of the acetabulum occur primarily in young adults as a result of high-energy trauma. Interestingly, elderly patients are an emerging patients group. The surgical treatment is often complicated by poor bone quality and possible concomitant degenerative changes of the hip prior to injury. We aim to define the prognostic factors for poor outcome after open reduction and internal fixation (ORIF) of acetabular fractures and to identify the subgroup of patients benefiting most from primary arthroplasty rather than ORIF.
PROXIMAL TIBIAL FRACTURES
Tibial plateau fractures compose approximately 1% of all fractures with lateral plateau fractures being the most common type. Post-traumatic osteoarthritis can develop in patients following a tibial plateau fracture. This may be caused by initial trauma to the tibial plateau cartilage. Furthermore, an altered axial loading pattern to the tibial plateau caused by articular incongruence can also influence the development of osteoarthritis. Our research focuses on understanding the risk factors for osteoarthritis following these injuries. We also aim to determine the optimal diagnostic and operative treatment strategies for fractures of the proximal tibia. A special focus is on understanding how to minimize deep postoperative infection following surgical treatment of these fractures.
Ankle fractures are among the most frequent surgically treated fractures. The operative treatment of these fractures can be associated with several complications such as malreduction and infection. As the population continues to age, the number of elderly patients with comorbidities sustaining ankle fractures will increase and therefore an increase in complications related to ankle fracture surgery is also expected. Our research projects focus on understanding the risk factors for deep infection and postoperative malreduction. We are also studying the treatment and outcomes of complex open ankle fractures with special emphasis on flap reconstruction for management of soft-tissue defects.