Tagged / Orthopaedic Research Institute

Lifelong health and wellbeing: improving orthopaedic practice and patient care

ORI-3

It’s British Science Week 2017 and to celebrate we’re sharing some of our science research stories, to highlight some of the fantastic research taking place here at BU. Today we’re looking at the Orthopeadic Research Institute (ORI).

Living well in older age is increasingly becoming a concern for our society. A key priority for our health services is to enable people to stay healthy and independent for as long as possible. BU’s newly established Orthopaedic Research Institute (ORI) is addressing this need by carrying out research to improve orthopaedic practices and patient care, thus supporting people to improve their activity levels and mobility as they age. Orthopaedics will become a critical issue as our population ages, as longer and more active lives will increase the risk that joints will wear out and replacements or treatments will be needed.

Deputy Head of ORI Associate Professor Tom Wainwright explains: “Knee and hip problems are going to become more prevalent, so we’re going to need better solutions to manage that; whether it’s better surgical procedures or better nonsurgical interventions. We have some very effective treatments in orthopaedics, but they’re not 100% effective, so part of our role is to work out how to make them better – improve them, through developing better surgical techniques, testing new medical techonology or developing better rehabilitation processes.”

Between them, Associate Professor Wainwright and Head of ORI Professor Rob Middleton have a wealth of clinical and research expertise. Professor Rob Middleton is a practising orthopaedic surgeon, specialising in hip replacement, while Associate Professor Wainwright is a physiotherapist and clinical researcher. They carried out research alongside their clinical practice before joining BU and have a national and international reputation for their work to date.

One of their biggest successes so far is speeding up the recovery process after hip and knee surgery, which has led to their work being cited in best practice health guidelines around the world. This approach, called Enhanced Recovery after Surgery, seeks to minimise the impact of surgery and accelerate recovery by employing strategies throughout the patient pathway, to improve outcomes and reduce the need for medical interventions. Their research into this area was a first in the UK for orthopaedics and demonstrated its value to patient care, as well as showing an improvement in patient and staff satisfaction and leading to significant cost savings to hospitals.

A more recent example of their work is a programme developed with local partners in Dorset called CHAIN – Cycling Against Hip Pain – which is designed to help people to live well with conditions such as osteoarthritis and to improve their mobility. The programme provides a combination of education and static cycling sessions,designed to improve mobility and increase people’s confidence in managing their conditions. The results have been excellent, with patients reporting improvements in walking, finding daily living tasks easier and most importantly, decreases in pain. Even the least likely candidates have seen improvements, demonstrating the value of education and exercise in improving patient care and in helping to reduce or delay the need for further medical interventions.

“As well as developing interventions to help patients recover from surgery and manage their conditions. We also work with a number of global orthopaedic companies to test and run clinical trials
on the latest orthopaedic technology,” says Associate Professor Wainwright. “We work with companies such as ZimmerBiomet, Lima Corporate, and Firstkind Ltd to ensure that their technology is delivering the best possible outcomes for patients.”

One example of their work with ZimmerBiomet was to explore ways to improve the technology used in hip replacements. The hip joint is a ball and socket joint and one of the risks of hip replacement is dislocation; where the new ball comes out of the socket. ORI’s research has shown that a larger ball reduces the risk of dislocation, and does not adversely affect the rate of wear.

“We currently have five trials underway within local hospitals and more to come,” explains Associate Professor Wainwright. “These trials are looking at different ways that we can improve the medical technology used in orthopaedics and means that not only are we contributing to improving future care, but we’re also bringing the latest technology to Dorset and improving care in the local area. As Dorset has a very high proportion of orthopaedic surgeries, there is potentially a very large group of people we can benefit.”

“We take a very interdisciplinary approach to our research. Establishing ourselves within BU is a real advantage for us, because we can draw on the expertise of colleagues in other areas of research, including other health professionals, psychologists, technologists and engineers,” explains Associate Professor Wainwright, “Ultimately, our driving force is that we wantto ensure that everyone gets the best possible treatment for their condition – it’s just the right thing to do.”

Wainwright, T.W., Immins, T. and Middleton, R.G., (2015) A cycling and education programme to promote self-management and to increase functional ability in patients with osteoarthritis of the hip. Osteoarthritis and Cartilage, 23 (2), 372.

Howie, D.W., Holubowycz, O.T., Middleton,R. and Grp, L.A.S., (2012) Large Femoral Heads Decrease the Incidence of Dislocation After Total Hip Arthroplasty A Randomized Controlled Trial. Journal of Bone and Joint Surgery – American Volume, 94A (12), 1095- 1102.

Wainwright, T. and Middleton, R., (2010) An orthopaedic enhanced recovery pathway. Current Anaesthesia and Critical Care, 21 (3), 114-120.

ORI was established at BU thanks to generous funding from the Dorset Local Enterprise Partnership (LEP).

This article appeared in the 2016 Bournemouth Research Chronicle. Download a copy of the magazine, or view the articles online.

Congratulations to FHSS orthopaedics academics

j-nurs-ortho-2016Congratulations to James Gavin, Tikki Immins and  Thomas Wainwright on the publication of their systematic review: ‘Stair negotiation as a rehabilitation intervention for enhancing recovery following total hip and knee replacement surgery‘.

Reference:

Gavin, J., Immins, T., Wainwright, T. (2016). Stair negotiation as a rehabilitation intervention for enhancing recovery following total hip and knee replacement surgery. Int J Orthop Trauma Nurs. Available online October 2016

 

ORI presentation at RCN Society of Orthopaedic and Trauma Nursing International Conference and Exhibition

RCN Society of Orthopaedic and Trauma Nursing International Conference and Exhibition, 8-9th  September 2016, Cardiff

Nice poster, but can't say the same thing for the poster board...

Nice poster, but can’t say the same thing for the poster board…

The theme for this conference was ‘Valuing the past, embracing the future‘ and it was great to be able to represent BU’s Orthopaedic Research Institute (ORI) whose work is firmly on the ’embracing the future’ side of the theme. I was there to deliver a poster presentation entitled:

A review of the literature related to the role of nutritional supplementation for an enhanced recovery pathway for hip and knee replacement’

This was produced through work with Associate Professor Tom Wainwright (Deputy Head) and Professor Rob Middleton (Head) of ORI, and Dr Simon Dyall of the Faculty of Health and Social Sciences. There was good interest in the poster from orthopaedic nurses and fellow academics, and I had a great chat about nutrition with the one medical doctor in attendance – the first time I’ve heard of an orthogeriatrician!

Headline? At present, the evidence base does not support the use of nutritional supplementation in enhanced recovery after surgery pathways for hip/knee replacement. However, that’s not to say that nutrition does not play a role. More high quality research is required particularly to explore the role of zinc, vitamin D and omega fatty acids, and possibly other nutrients that have been overlooked too. If you’d like to find out more you can get a full size version of the poster here. Any comments on this most welcome.

For those interested in orthopaedics in general, the opening presentation included learning about Norman, aged 90, who can apparently lay claim to having had the longest lasting hip replacement. He had his first replacement in 1948 and it only needed revising this year! (if I remember correctly)! Far, far longer than most hip replacements last.

Norman, 90 years young, had first hip replacement in 1948!

Norman, 90 years young, had first hip replacement in 1948!

 Other presentations included work on fracture prevention (increasingly important for our aging and increasingly frail population), developing post-graduate education in orthopaedic nursing, recognition of delirium, and the latest on the timely identification of compartment syndrome (a life-threatening complication).

Having a couple of hours to spare before returning to Bournemouth I took a look at some of the beautiful architecture in Cardiff. It had the feeling of a city that values its past:

The clock tower of Cardiff Castle

The clock tower of Cardiff Castle

but is also embracing the future…

Wales Millenium Centre

Wales Millenium Centre

Many thanks to the Faculty of Health and Social Sciences for supporting my attendance.

 

Research and Impact in Active Ageing Symposia (University of Cumbria) – A URA Experience

Louise Burgess, Undergraduate Research Assistant (URA)

When first applying to become an URA, I was unsure about what to expect. Initially, I thought my summer would be spent holding a clipboard and collecting endless lists of data for someone else to analyse. In reality, the role has been much more exciting than I could have imagined, even prompting me to investigate future careers within research. The research I am assisting with aims to examine the most effective acute recovery routine for individuals who have undergone hip arthroplasty, a reconstructive procedure which involves the replacement of the femoral head and acetabulum with an artificial prosthesis. I felt immediately welcomed by James Gavin (Lead Researcher) and the Orthopaedic Research Institute (ORI) team: Tom Wainwright, (Deputy Head), Tikki Immins (Research Fellow) Shay Bahadori (Medical Device Engineer), in my URA role.

Since starting 2 weeks ago, I have been involved in:

  • Designing and implementing a testing protocolRecruitment media
  • Recruitment through designing posters and contacting volunteers
  • Advancing skills technical: electromyography (EMG), isometric strength testing, clinical recovery exercises
  • Developing my subject knowledge and understanding
  • Training on the PrimusRS Multimodal Dynamometer
  • Developing data collection spreadsheets
  • Data collection: anthropometric, handgrip strength, walk speed, muscle activity and isometric strength.
  • Data analysis (using Biometrics Datalog EMG software)
  • Conference presentation:Research and Impact in Active Ageing Symposia (University of Cumbria)

Attending the Research and Impact in Active Ageing Symposia (University of Cumbria) proved to be a valuable experience for me as both a student, and as a researcher. The morning began with a talk from Prof Tim Donovan, who covered the role of vision and eye movement in motor control. This was followed by Prof Giuseppe de Vito (University College Dublin), focussing on how old muscle responds to training and nutritional interventions. Finally, Prof Andrea Macaluso (University of Rome Foro Italico) discussed his work on physical activity levels and physiological factors underlying mobility in ageing.

The morning was followed by a poster presentation session, where I presented the findings of my dissertation project. My dissertation entitled, ‘The Incidence of Injuries and the Epidemiology of Osteoarthritis in Retired, Amateur, Rugby Union Males’ was a project I thoroughly enjoyed and despite being incredibly nervous, I really liked sharing it with others. I presented my work to other students, academics, researchers, and members of the NHS. The feedback I received during the question and answer session after my presentation was positive, with ideas how the research could be expanded in the future. Having the opportunity to take part within the symposia increased my confidence within my own research, improved my presentation skills and developed my knowledge of research in active ageing. I even won the prize for best poster presentation, a £100 Human Kinetics book voucher!

I’m not even half way through my time as a URA, but I would still highly recommend other students to apply for similar positions at Bournemouth University.

For more information on ORI please visit:

  • bournemouth.ac.uk/ori2
  • Twitter: @BU_Orthopaedic

Or to get involved with the current research please email me on:

  • Lburgess@bournemouth.ac.uk