Collaborative Orthopaedic Research (CORe)

SURGE Projects

Current projects:

  • Biceps Tenodesis vs Labrum Debridement in combined Rotator Cuff (RC) Tears and Superior Labral Anterior to Posterior (SLAP) Lesions: A Randomized Trial (2017-Present)
    This follow-up trial is comparing the effectiveness of biceps tenodesis versus labrum debridement in patients undergoing an arthroscopic rotator cuff repair with the following characteristics: combined rotator cuff (RC) tear, degenerative labrum (SLAP tear) and a normal biceps tendon. Subjects will be followed up to one year after surgery to determine the impact of each intervention on shoulder pain, ROM, strength and quality of life of the patients.

  • Early Mobilization following Rotator Cuff Repair: a Meta-analysis of the Current Evidence (2017-Present) 
    The primary objective of our systematic review is to consolidate the existing evidence on the early postoperative management of patients undergoing mini-open or arthroscopic RC repairs to determine the impact of early mobilization versus immobilization within the first 4-6 weeks postoperatively on 1) time to return to work, both modified and full duties; 2) healing rates of the repaired tendons; 3) shoulder power and 4) health-related quality of life (HRQL). This study received funding from the WCB-AB.

  • Early Functional Return to Work Following Distal Biceps Repair (2016-Present) 
    This follow-up trial is examining the impact of early mobilization versus sling immobilization in the first six weeks following Distal Biceps repair. Subjects will be followed up to one year after surgery to determine the impact of each intervention on distal biceps ROM, the quality of life of the patient and the integrity of the tissue repair. This study received funding from the WCB-AB and Edmonton Civic Employees Research Awards.

  • Appropriate and Efficient Management of Shoulder Injuries: Who Needs Surgery? (2015 –Present)
    This cohort study is examining how often orthopedic surgery consult is needed for patients with shoulder pain that is not related to fractures or severe arthritis. The group is also evaluating the outcome of appropriate non-operative management. This study is funded by Workers Compensation Board of Alberta (WCB-AB).

  • Operative versus Non-Operative Management of Distal Radius Fractures in the Late Middle Aged: A Randomized Trial of Feasibility (2015- Present)
    This study is evaluating the feasibility of undertaking a full-scale randomized trial of distal radius fracture management in individuals who are 55-70 years of age. SURGE is also undertaking a concurrent scoping review of the literature to develop a standardized rehabilitation protocol for these injuries. This study is supported by the Sturgeon Community Hospital Foundation.

  • Early Mobilization Following Arthroscopic Rotator Cuff Repair: A Single-Blind, Randomized Control Trial (2010-2017).
    This follow-up trial is examining the impact of early mobilization versus sling immobilization in the first six weeks following Arthroscopic rotator cuff repair. Subjects will be followed up to two years after surgury to determine the impact of each intervention on shoulder ROM, the quality of life of the patient and the integrity of the tissue repair. This study received funding from the Arthroscopic Association of North America, Medical Services Incorporated Foundation of Alberta and WCB-AB.

 

Projects completed in the past five years:

  • Morphology of the Sublabral Foramen and Sub-Supraspinatus Recess (2015).
    This study identified the normal morphology of the superior labrum by measuring the depths of the sublabral foramen and sub-supraspinatus recess in patients that underwent surgery for repair of a labral tear not involving the superior labrum. In addition, the study qualitatively determined the normal motion that occurs at the superior labrum with arm motion through various planes. This work has been submitted for publication in the Shoulder & Elbow Journal.

  • Early Mobilization following Mini-Open Rotator Cuff Repair: A Randomized Clinical Trial (2015).
    This trial compared early mobilization versus sling immobilization in the first six weeks following mini-open rotator cuff repair on the subjects’ shoulder ROM, strength and patient quality of life over the first two postoperative years. This study was supported by Covenant Health and the Edmonton Civic Employees (ECE) Charitable Foundation. This study was selected as a "Top 10" abstract at the 2014 Canadian Orthopaedic Association Annual Meeting and for the "Game Changers" Session at the American Academy of Orthopaedic Surgeons 2015 Annual Meeting. This work is published in the Bone and Joint Journal.

  • Evaluation of the Instability Severity Index Score (ISIS) and the Western Ontario Shoulder Instability Index (WOSI) as Predictors of Failure after Arthroscopic Bankart Repair (2014).
    This cohort study examined the ability of the ISIS and WOSI score to identify preoperatively those patients who would experience either clinical (unable to return to pre-injury activity) or surgical (recurrent dislocation) failure. We found that the ISIS was not able to determine those who would experience surgical or clinical failure, while the WOSI could not determine who would experience surgical failure, but could detect who would be more likely to experience clinical failure. This work has been published in the Bone and Joint Journal.

  • Imaging for Quantifying Glenoid and Hill-Sachs Bone Loss in Traumatic Instability of the Shoulder: A Cadaveric Study and Scoping Review (2014).
    The first part of this two-part study examined the ability of plain radiography to detect the loss of the sclerotic contour of the glenoid in a cadaveric study. We found that >20% loss of the contour was needed before it was reliably detected. In the second phase of the study, we undertook a scoping review to determine if there were imaging techniques available that reliably and consistently identified bony defects in traumatic instability. The first phase was published in Knee Surgery, Sports, Traumatology and Arthroscopy while the phase two results were published in BMC Musculoskeletal Disorders.
     
  • Creating Rehabilitation Guidelines for Management of Rotator Cuff Repairs:  Perceived Need and Application (2013).
    We performed two surveys of registered physical therapists (PTs) in Alberta. The first survey was prior to implementation of evidence and consensus-based treatment guidelines created by SURGE. The survey explored current practice patterns and whether guidelines would be useful for physical therapists. The second survey occurred one year after implementation of the guidelines and examined PTs utility and opinions of the guidelines and the web-based resources. This work was presented as a symposium at the 2014 Canadian Physiotherapy Association Annual Meeting.

  • Augmented Fixation Methods for Unstable Proximal Humerus Fractures Treated with Locking Plate Fixation: Cadaveric Evaluations (2012).
    We examined two different augmented fixation methods to improved fracture fixation in unstable proximal humerus fractures using a cadaveric model and both cyclic and static loading methods. In the first method, a fibular allogrant was used to replace the lost medial column infrastructre and demonstrated superior loading characteristics under both cyclic and static loads. In the second method, the medial column was restored through a medial offset of the humeral shaft. Again, the loading characteristics under both cyclic and static loading were superior when the medial column was restored. These results have been published in the Journal of Shoulder and Elbow Surgery, and Clinical Biomechanics.

  • Reconstruction of the Ulnar Coronoid Process (2012). 
    This modeling study determined that the contralateral ulnar coronoid process can be used to determine morphology and alignment to assist with surgical planning in the event of an elbow fracture. This work was supported by the ECE Charitable Foundation.