TOWARD AN EVIDENCE-BASED APPROACH FOR TREATING END-STAGE KNEE ARTHRITIS
Grant number: 1122526 | Funding period: 2017 - 2021
World-wide more than one million total knee replacements (TKR) will be performed for end-stage knee osteoarthritis in 2016 alone. With an ageing population, demand for this procedure will increase dramatically, placing burden on a constrained health system. Up to 25% of TKR recipients experience on going pain after surgery and are dissatisfied with TKR. My research seeks to improve efficiencies and equitability of this important surgical procedure and in doing so optimise patient outcomes
Related publications (56)
A blinded, three-arm randomised trial assessing joint function and measuring three-dimensional knee joint kinematics in individuals six months after a total knee joint replacement; comparing a medially stabilised design, to standard fixed bearing conventional designs – posterior stabilising and cruciate retaining
Michelle M Dowsey, Marcus Pandy, Tony J Young, Hans Gray, Shangyuanye Guan, Peter F Choong
<jats:p><p class="abstract"><strong>Background:</strong> No randomised trial exists to assess the relative prost..
Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action
Penny O'Brien, Samantha Bunzli, Ivan Lin, Dawn Bessarab, Juli Coffin, Michelle M Dowsey, Peter FM Choong
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Litt..
Cohort profile: the St Vincent's Melbourne Arthroplasty Outcomes (SMART) Registry, a pragmatic prospective database defining outcomes in total hip and knee replacement patients
Daniel Gould, Sharmala Thuraisingam, Cade Shadbolt, Josh Knight, Jesse Young, Chris Schilling, Peter F Choong, Michelle M Dowsey
PURPOSE: The St Vincent's Melbourne Arthroplasty Outcomes (SMART) Registry is an institutional clinical registry housed at a terti..
The effect of animated consent material on participants' willingness to enrol in a placebo-controlled surgical trial: a protocol for a randomised feasibility study
Elizabeth Nelson, Cade Shadbolt, Samantha Bunzli, Angela Cochrane, Peter Choong, Michelle Dowsey
BACKGROUND: Placebo-controlled surgical trials are recognised as the gold standard way to test the efficacy of a surgical procedur..
Placebo Surgery Controlled Trials: Do They Achieve What They Set Out to do? A Systematic Review.
Samantha Bunzli, Emma Choong, Cade Shadbolt, Laura Wall, Elizabeth Nelson, Chris Schilling, Helen Wilding, Stefan Lohmander, Zsolt Balogh, Francesco Paolucci, Philip Clarke, Peter Choong, Michelle Dowsey
OBJECTIVE: To explore whether placebo surgery controlled trials achieve what they set out to do by investigating discrepancy betwe..
Developing prediction models for total knee replacement surgery in patients with osteoarthritis: Statistical analysis plan
Sharmala Thuraisingam, Michelle Dowsey, Jo-Anne Manski-Nankervis, Tim Spelman, Peter Choong, Jane Gunn, Patty Chondros
Background Approximately 12–20% of those with osteoarthritis (OA) in Australia who undergo total knee replacement (TKR) surgery do..
Risk Factors for Chronic Opioid Use Following Hip and Knee Arthroplasty: Evidence from New Zealand Population Data
Yana Pryymachenko, Ross A Wilson, J Haxby Abbott, Michelle M Dowsey, Peter FM Choong
BACKGROUND: Patients awaiting total joint arthroplasty (TJA) have high rates of opioid use, and many continue to use opioid medica..
Embedding consumer and community involvement within an established research centre: moving from general recommendations to an actionable framework
T Gunatillake, C Shadbolt, D Gould, M Lam, MG Hearst, C Vleeskens, P Choong, M Dowsey
Background: The value of involving consumers and community members in every stage of the research process is gaining recognition a..
Sex-based differences in the outcomes of total hip and knee arthroplasty: a narrative review
Annabelle LC Choong, Cade Shadbolt, Michelle M Dowsey, Peter FM Choong
Total joint arthroplasty (TJA) is an effective treatment for end-stage osteoarthritis, which aims to alleviate pain and improve fu..
National osteoarthritis strategy brief report Advanced care
Xia Wang, David J Hunter, Michelle Dowsey, Ian Harris, Peter O'Sullivan, Bill Donnelly, Thomas Buttel, Anita Wluka, Philip Clark, Raj Anand, Yuen Leow, Jane M Gunn, Yingyu Feng, Peter Choong
BACKGROUND: Osteoarthritis (OA) is one of the most common chronic joint diseases and a leading cause of pain and disability in Aus..
Tackling the Burden of Osteoarthritis as a Health Care Opportunity in Indigenous Communities-A Call to Action
Penny O'Brien, Samantha Bunzli, Ivan Lin, Tilini Gunatillake, Dawn Bessarab, Juli Coffin, Gail Garvey, Michelle Dowsey, Peter Choong
Osteoarthritis is a highly prevalent and disabling disease, causing a significant individual and socioeconomic burden worldwide. U..
What Influences Patient Satisfaction after TKA? A Qualitative Investigation
Nardia-Rose Klem, Anne Smith, Peter O'Sullivan, Michelle M Dowsey, Robert Schutze, Peter Kent, Peter F Choong, Samantha Bunzli
BACKGROUND: Patient satisfaction is a common measure of the success of an orthopaedic intervention. However, there is poor underst..
Population growth, ageing and obesity do not sufficiently explain the increased utilization of total knee replacement in Australia
Jason Trieu, Michelle M Dowsey, Chris Schilling, Tim Spelman, Peter F Choong
BACKGROUND: The utilization of total knee replacement (TKR) has increased significantly. The objective of this study was to assess..
Patient-reported outcome measures (PROMs): can they be used to guide patient-centered care and optimize outcomes in total knee replacement?
Michelle Tew, Kim Dalziel, Philip Clarke, Anne Smith, Peter F Choong, Michelle Dowsey
PURPOSE: As patient-reported outcome measures (PROMs) are increasingly integrated into clinical practice, there is a need to trans..
A Randomized Controlled Trial Comparing a Medial Stabilised Total Knee Prosthesis to a Cruciate Retaining and Posterior Stabilised Design - A Report of the Clinical and Functional Outcomes Following Total Knee Replacement
Michelle M Dowsey, Daniel Gould, Tim Spelman, Marcus G Pandy, Peter F Choong
Background The purpose of this randomized controlled trial was to compare the performance of 3 total knee joint replacement (TKJR)..
Misconceived expectations: Patient reflections on the total knee replacement journey
Samantha Bunzli, Penny O'Brien, Nardia Klem, Ian Incoll, Jasvinder Singh, Myles Davaris, Peter Choong, Michelle Dowsey
INTRODUCTION: Fifty per cent of patients consent for total knee replacement (TKR) with unrealistic expectations about what it invo..
Exploring the Impact of Quality of Life on Survival: A Case Study in Total Knee Replacement Surgery
Michelle Tew, Kim Dalziel, Michelle Dowsey, Peter F Choong, Philip Clarke
Background. There is growing evidence that quality of life (QoL) has a strong association with mortality. However, incorporation o..
In pursuit of enhanced recovery after total joint replacement: a narrative review of drivers of length of stay
Siddharth Rele, Michelle M Dowsey, Peter FM Choong
A continual increase in the prevalence of osteoarthritis drives growing demand for total joint arthroplasty. So far, a decrease in..
Attitudes of patients and surgeons towards sham surgery trials: a protocol for a scoping review of attributes to inform a discrete choice experiment
Laura Wall, Madeleine Hinwood, Danielle Lang, Angela Smith, Samantha Bunzli, Philip Clarke, Peter FM Choong, Michelle M Dowsey, Francesco Paolucci
INTRODUCTION: In order to properly evaluate the efficacy of orthopaedic procedures, rigorous, randomised controlled sham surgery t..
Satisfaction after total knee replacement for osteoarthritis is usually high, but what are we measuring? A systematic review
Nardia-Rose Klem, Peter Kent, Anne Smith, Michelle Dowsey, Robyn Fary, Rob Schütze, Peter O'Sullivan, Peter Choong, Samantha Bunzli
Objective: Patient satisfaction is considered an important outcome measure after total knee replacement, but the construct is comp..
The influence of sex and pre-operative obesity on biomechanics two years after total knee arthroplasty: A longitudinal cohort study
KL Paterson, L Sosdian, KL Bennell, BR Metcalf, T Wrigley, J Kasza, MM Dowsey, PF Choong, RS Hinman
BACKGROUND: Sex and obesity may influence knee biomechanics associated with poor outcomes following primary total knee arthroplast..
Patient-related risk factors for unplanned 30-day readmission following total knee arthroplasty: a narrative literature review
Daniel Gould, Michelle Dowsey, Imkyeong Jo, Peter Choong
Osteoarthritis is a debilitating condition as well as a growing global health problem, and total knee arthroplasty (TKA) is an eff..
Co-Morbidities and Sex Differences in Long-Term Quality-of-Life Outcomes among Patients with and without Diabetes after Total Knee Replacement: Five-Year Data from Registry Study
Michelle Tew, Michelle M Dowsey, Annabelle Choong, Peter F Choong, Philip Clarke
Improved understanding of quality-of-life (QoL) outcomes can provide valuable information on intervention effectiveness and guide ..
The Surgeon's Role in the Opioid Crisis: A Narrative Review and Call to Action
Cade Shadbolt, J Haxby Abbott, Ximena Camacho, Philip Clarke, L Stefan Lohmander, Tim Spelman, Eric C Sun, Jonas B Thorlund, Yuting Zhang, Michelle M Dowsey, Peter FM Choong
Over the past two decades, there has been a sharp rise in the use of prescription opioids. In several countries, most notably the ..
Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14 354 Medicare patients
Max Catchpool, Josh Knight, Jesse T Young, Philip Clarke, Michael J Barrington, Peter FM Choong, Michelle M Dowsey
BACKGROUND: Persistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre-..
Chlorhexidine-alcohol versus iodineealcohol for surgical site skin preparation in an elective arthroplasty (ACAISA) study: a cluster randomized controlled trial
TN Peel, MM Dowsey, KL Buising, AC Cheng, PFM Choong
OBJECTIVES: Surgical site skin preparation is an effective method to prevent wound complications. The optimal agent has not been e..
The effect of mindfulness training prior to total joint arthroplasty on postoperative pain and physical function: A randomised controlled trial
Michelle Dowsey, David Castle, Simon Knowles, Kaveh Monshat, Michael Salzberg, Elizabeth Nelson, Anthony Dunin, Jo Dunin, Tim Spelman, Peter Choong
Misconceptions and the Acceptance of Evidence-based Nonsurgical Interventions for Knee Osteoarthritis. A Qualitative Study
Samantha Bunzli, Penny O'Brien, Darshini Ayton, Michelle Dowsey, Jane Gunn, Peter Choong, Jo-Anne Manski-Nankervis
BACKGROUND: In contrast to best practice guidelines for knee osteoarthritis (OA), findings from several different healthcare setti..
What are the patient factors that impact on decisions to progress to total knee replacement? A qualitative study involving patients with knee osteoarthritis
Penny O'Brien, Samantha Bunzli, Darshini Ayton, Michelle M Dowsey, Jane Gunn, Jo-Anne Manski-Nankervis
OBJECTIVES: General practitioners (GPs) are often the first health professionals to assess patients with osteoarthritis (OA). Desp..
How do surgeons' trade-off between patient outcomes and risk of complications in total knee arthroplasty? a discrete choice experiment in Australia
Sandie Szawlowski, Peter FM Choong, Jinhu Li, Elizabeth Nelson, Mandana Nikpour, Anthony Scott, Vijaya Sundararajan, Michelle M Dowsey
OBJECTIVE: To measure the trade-off between risk of complications versus patient improvement in pain and function in orthopaedic s..
Knee Arthroplasty Component Malrotation Does Not Affect Function or Quality of Life in the Short to Medium Term
Sina Babazadeh, Michelle M Dowsey, Michael G Vasimalla, James D Stoney, Peter FM Choong
BACKGROUND: Component rotation in total knee arthroplasty is thought to affect patella tracking, flexion gap, and balancing and he..
Achieving Consensus on Total Joint Replacement Trial Outcome Reporting Using the OMERACT Filter: Endorsement of the Final Core Domain Set for Total Hip and Total Knee Replacement Trials for Endstage Arthritis
Jasvinder A Singh, Michelle M Dowsey, Michael Dohm, Susan M Goodman, Amye L Leong, Marieke MJH Scholte Voshaar, Peter F Choong
Barriers and facilitators to orthopaedic surgeons’ uptake of decision aids for total knee arthroplasty: a qualitative study
A Scott, S Bunzli, S French, P Choong, M Dowsey
Objectives: The demand for total knee arthroplasty (TKA) is increasing. Differentiating who will derive a clinically meaningful im..