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Orthopaedic Surgery Research

The Department of Orthopaedic Surgery at Royal Prince Alfred Hospital is founded on the idea of academic and surgical excellence in musculoskeletal injuries and conditions. Our surgeons have a diverse range of interests and specialise in multiple areas including joint reconstruction/replacement (arthroplasty), trauma and oncology. Committed to an evidence-based approach to patient education and appropriate care, the department strives to further the field through high quality research.

Our Research Team

Dr Jeffrey Petchell Head of Department, 
Orthopaedic Surgeon,
Research Lead (Upper limb surgery)
Professor Ian Harris Orthopaedic Surgeon, 
Research Lead and Expert Advisor 
Associate Professor Mark Horsley Orthopaedic Surgeon,
Research Lead (Foot and ankle surgery)
Dr Richard Boyle Orthopaedic Surgeon, 
Research Lead (Bone and soft tissue tumours)
Dr Brett Fritsch Orthopaedic Surgeon,
Research Lead (Robotic surgery)
Dr Sanjeev Gupta Orthopaedic Surgeon,
Education Lead, 
Research Lead (Lower limb arthroplasty)
Dr Christopher Smithers Orthopaedic Surgeon, 
Research Lead (Upper limb surgery)
Dr Maurice Guzman Orthopaedic Surgeon,
Research Lead (Robotic surgery, Bone and soft tissue tumours and lower limb arthroplasty)
Dr Daniel Franks Orthopaedic Surgeon,
Research Lead (Bone and soft tissue tumours and lower limb arthroplasty)
Dr Verinder Sidhu Orthopaedic Surgeon,
Research Lead (Trauma, foot & ankle surgery)
Kate Alexander Research Manager 
Philip Hay Orthopaedic Research Officer
Helena Lamberth Orthopaedic Research Officer
Cherie Fischer Bone and Soft Tissue Sarcoma Database Manager
Darya Shapilsky Bone and Soft Tissue Sarcoma Data Officer
Dr John Farey PhD student. The Role of Dual Mobility Total Hip Replacement in the Management of Femoral Neck Fractures in Older Patients: Reducing the Risk of Prosthetic Dislocation.  Supervisors: Professor Christine Lin, Professor Ian Harris.
Sascha Karunaratne PhD student. Decision Making in TKA. Supervisors: Professor Michael Solomon, Professor Ian Harris, Professor Lyndal Trevena, Associate Professor Mark Horsley.
Dr Verinder Sidhu PhD student. CRISTAL: A cluster randomised, crossover non-inferiority trail of aspirin compared to low molecular weight heparin for venous thromboembolism prophylaxis and safety in hip or knee arthroplasty, a registry nested study. Supervisor: Professor Ian Harris.

Selected Grants

Amount awarded Grant and project details
$4,744,165 NHMRC, 2023-2027
ROADMAP: RandOmisedArthroplasty infection worlDwide Multidomain Adaptive Platform trial
RPA Investigator: Harris I
$2,645,721 Medical Research Future Fund (MRFF), 2023-2026
Next-gen clinical registries: common data models, AI & cloud computing
RPA Investigator: Harris I
$1,491,743 Medical Research Future Fund (MRFF), 2023-2026
Restructuring musculoskeletal health services to ensure equitable access to effective, affordable allied health care
RPA Investigator: Harris I
$1,166,592 NHMRC, 2023-2027
Strengthening Healthcare Systems with Patient Reported Outcome Measures (PROMs) 
RPA Investigator: Harris I
$258,246 HCF Research Foundation, 2019-2023
Assisting patients with knee osteoarthritis to make informed choices about total knee arthroplasty and non-operative management
RPA Investigator: Harris I
$20,000 Arthritis Australia, 2023
REduced oPioids After joInt Replacement Surgery (REPAIRS): a pilot trial
RPA Investigator: Harris I
$19,956 ANZMUSC, 2023
REduced oPioids After joInt Replacement Surgery (REPAIRS): a pilot trial
RPA Investigator: Harris I
$4955 AOA Research Foundation, 2023
Calculating the smallest worthwhile effect for shoulder surgery
RPA Investigator: Harris I
$4000 Wiser Healthcare, 2023
REduced oPioids After joInt Replacement Surgery (REPAIRS): a pilot trial
RPA Investigator: Harris I

Our Publications

2023

CRISTAL Study Group; Sidhu VS, Kelly TL, Pratt N, Graves SE, Buchbinder R, Adie S, Cashman K, Ackerman IN, Bastiras D, Brighton R, Burns AWR, Chong BH, Clavisi O, Cripps M, Dekkers M, de Steiger R, Dixon M, Ellis A, Griffith EC, Hale D, Hansen A, Harris A, Hau R, Horsley M, James D, Khorshid O, Kuo L, Lewis PL, Lieu D, Lorimer M, MacDessi SJ, McCombe P, McDougall C, Mulford J, Naylor JM, Page RS, Radovanovic J, Solomon M, Sorial R, Summersell P, Tran P, Walter WL, Webb S, Wilson C, Wysocki D, Harris IA. Effect of Aspirin vs Enoxaparin on 90-Day Mortality in Patients Undergoing Hip or Knee Arthroplasty: A Secondary Analysis of the CRISTAL Cluster Randomized Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2317838. doi: 10.1001/jamanetworkopen.2023.17838.
Devitt BM, Neri T, Fritsch BA. Combined anterolateral complex and anterior cruciate ligament injury: Anatomy, biomechanics, and management-State-of-the-art. J ISAKOS. 2023 Feb;8(1):37-46. doi: 10.1016/j.jisako.2022.10.004. Epub 2022 Nov 9.
Duong JKH, Bolton C, Murphy GT, Fritsch BA. Anterior cruciate ligament repair versus reconstruction: A clinical, MRI and patient-reported outcome comparison. Knee. 2023 Dec;45:100-109. doi: 10.1016/j.knee.2023.09.008. Epub 2023 Nov 3.
Figueroa F, Figueroa D, Guiloff R, Putnis S, Fritsch B, Itriago M. Navigation in anterior cruciate ligament reconstruction: State of the art. J ISAKOS. 2023 Feb;8(1):47-53. doi: 10.1016/j.jisako.2022.09.001. Epub 2022 Sep 27.
Gupta S, Smith GH, Wakelin EA, Van Der Veen T, Plaskos C, Pierrepont JW. Automated landmark detection in functional lateral radiographs using deep learning. InOrthopaedic Proceedings 2023 Feb 23 (Vol. 105, No. SUPP_3, pp. 70-70). Bone & Joint.
Harris IA, Sidhu VS, Buchbinder R. Low Molecular Weight Heparin is Superior to Aspirin in the Prevention of Thromboembolic Disease, or is it? Response to an Editorial. J Arthroplasty. 2023 Apr;38(4):e7-e8. doi: 10.1016/j.arth.2023.01.002.
Karunaratne S, Harris IA, Horsley M, Trevena L, Solomon M. Establishing a hierarchy of total knee arthroplasty patients' goals and its congruity to health professionals' perceptions: a cohort study. ANZ J Surg. 2024 Feb;94(1-2):234-240. doi: 10.1111/ans.18817. Epub 2023 Dec 10.
Kim R, Wakelin EA, Plaskos C, Gupta S, Putman S. Variation in knee balance as a function of hip-knee-ankle angle and joint line obliquity in robotic assisted total knee arthroplasty. Int Orthop. 2023 Feb;47(2):479-484. doi: 10.1007/s00264-022-05636-2. Epub 2022 Nov 22.
Kim RG, An VVG, Lee SLK, Khadra SM, Petchell JF. Overlapping surgery in arthroplasty - a systematic review and meta-analysis. Orthop Traumatol Surg Res. 2023 Jun;109(4):103299. doi: 10.1016/j.otsr.2022.103299. Epub 2022 Apr 25.
Kim RG, Maher AW, Karunaratne S, Stalley PD, Boyle RA. Tenosynovial giant cell tumours: experience at an Australian tertiary referral centre for musculoskeletal tumours with minimum two-year follow-up. Bone Jt Open. 2023 Nov 8;4(11):846-852. doi: 10.1302/2633-1462.411.BJO-2023-0116.R1.
Murphy GT, Shatrov J, Duong J, Fritsch BA. How does the use of quantified gap-balancing affect component positioning and limb alignment in robotic total knee arthroplasty using functional alignment philosophy? A comparison of two robotic platforms. Int Orthop. 2023 May;47(5):1221-1232. doi: 10.1007/s00264-022-05681-x. Epub 2023 Feb 6.
Narulla R, Song M, Karunaratne S, Smithers C, Petchell J. Trends in shoulder surgery patient-reported outcome measures. JSES Int. 2023 Apr 8;7(4):653-661. doi: 10.1016/j.jseint.2023.03.010.
Sidhu V, Badge H, Churches T, Maree Naylor J, Adie S, A Harris I. Comparative effectiveness of aspirin for symptomatic venous thromboembolism prophylaxis in patients undergoing total joint arthroplasty, a cohort study. BMC Musculoskelet Disord. 2023 Aug 3;24(1):629. doi: 10.1186/s12891-023-06750-x.
Sidhu V, Naylor JM, Adie S, Bastiras D, Buchbinder R, Ackerman I, Harris IA. Post-discharge patient-reported non-adherence to aspirin compared to enoxaparin for venous thromboembolism prophylaxis after hip or knee arthroplasty. ANZ J Surg. 2023 Apr;93(4):989-994. doi: 10.1111/ans.18284. Epub 2023 Jan 20.
Sidhu VS, Harris IA. Aspirin vs Enoxaparin and Symptomatic Venous Thromboembolism in Hip or Knee Arthroplasty-Reply. JAMA. 2023 Jan 10;329(2):177-178. doi: 10.1001/jama.2022.20754.
Sidhu VS, Naylor JM, Adie S, Lieu D, Walker R, Horsley M, Kim RG, Harris IA. Is Enoxaparin Associated With a Higher Risk of Persistent Wound Drainage Than Aspirin? A Secondary Analysis of Data From the CRISTAL Randomized Trial. Clin Orthop Relat Res. 2023 Jul 1;481(7):1351-1359. doi: 10.1097/CORR.0000000000002544. Epub 2023 Jan 17.
Twiggs J, Miles B, Parker D, Liu D, Shimmin A, Fritsch B, Roe J, Baré J, Solomon M, Dickison D, McMahon S, Boyle R, Walter L. Patient-reported impairment following TKA is reduced when a computationally simulated predicted ideal alignment is achieved. Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):1098-1105. doi: 10.1007/s00167-022-07225-7. Epub 2022 Nov 29.

Our Presentations

2023

Alexander K, Boyle R, Guzman M, Franks D, Stalley P, Steffens D. Embedding Research in Clinical Practice: RPA Bone and Soft Tissue Sarcoma Unit. ANZSA Annual Scientific Meeting. 10 November 2023. Melbourne, Australia.
Boyle R. No more surgery for PVNS, Custom 3D implants in revision surgery, Conversion of ECI pelvic reconstructions to 3D custom implants, Case study - proximal femoral reconstruction with vascularised fibula grafting. Orthopaedics Downunder. February 2023. Melbourne, Australia.
Boyle R. PVNS in the hip, Use of custom 3D implants in revision surgery. Australian Arthroplasty Society. May 2023. Bowral, Australia.
Boyle R. Tumour session for metastatic disease and Use of Custom 3D Implants in Revision Arthroplasty. Australian Orthopaedic Association Annual Scientific Meeting. 12-16 November 2023. Melbourne, Australia.
Duong J, Bolton C, Murphy GT, Fritsch BA. ACL Repair Versus Reconstruction- A Clinical, MRI and Patient-Reported Outcome Comparison. ISAKOS Congress. 21 June 2023. Boston, USA.
Fritsch BA. Coronal plane HTO: Tips and tricks. AAOS 2023. March 7-11 2023. Las Vegas, USA.
Fritsch BA. Instructional Course Lecture: Managing the Posterolateral Corner. ISAKOS Congress. 19 June 2023. Boston, USA.
Fritsch BA. Instructional Course Lecture: Meniscal Injuries: When to Leave, Resect or Repair? ISAKOS Congress. 18 June 2023. Boston, USA.
Fritsch BA. Live Surgery: ACL reconstruction and bucket handle medial meniscus repair, lateral meniscus root repair, and lateral tenodesis. Pune Knee Course. April 2023. Pune, India.
Fritsch BA. MCL primary repair and augmentation. Pune Knee Course. April 2023. Pune, India.
Fritsch BA. My approach to the dilocated knee. Pune Knee Course. April 2023. Pune, India.
Fritsch BA. Objectively measured knee laxity using two independent arthrometers does not predict outcomes following ACLR in a large cohort of patients. Australian Knee Society Annual Scientific Meeting 2023. 18 November 2023. Cape Schank, Australia.
Fritsch BA. Patient specific alignment - no 2 knees are the same. Pune Knee Course. April 2023. Pune, India.
Fritsch BA. PLC - clinical evaluation and imaging. Pune Knee Course. April 2023. Pune, India.
Fritsch BA. Presentation: Whoever holds the data on the future: AI, data ownership and the future of surgical decision making. ISAKOS Congress. 19 June 2023. Boston, USA.
Fritsch BA. Surgical Demonstration: ACL with IB + LET. ISAKOS Congress. 18 June 2023. Boston, USA.
Gupta S. Automated Landmark Detection in Functional Lateral Radiographs Using Deep Learning. Australian Orthopaedic Association Annual Scientific Meeting. 12-16 November 2023. Melbourne, Australia.
Gupta S. Cost Analysis of Robotic Assisted Total Knee Arthroplasty in the Public Health System. Australian Arthroplasty Society. May 2023. Bowral, Australia.
Harris IA. CRISTAL as an example of an efficient crossover cluster design. ACTA International Clinical Trials Symposium. 27-28 November 2023. Melbourne, Australia.
Harris IA. Guidelines, benchmarks and registries: improving the care of people with hip fractures, Cemented vs cementless arthroplasty for hip fractures: benefits and risks.Royal College of Orthopaedic Surgeons of Thailand Annual Meeting. 20-22 October 2023. Pattaya, Thailand.
Harris IA. Hippocrasy, overtreatement and overdiagnosis. St Vincent's Hospital Melbourne Grand Rounds. 24 April 2023. Melbourne, Australia.
Harris IA. How effective is musculoskeletal surgery? Swedish Society of Hand Surgeons Annual Meeting. 31 August 2023.
Harris IA. Surgical effectiveness, Hippocrasy. ANZ Hepato-pancreatico-biliary society (AANZHPBA) Annual Meeting. 05 October 2023. Sydney, Australia.
Harris IA. Surgical effectiveness, Hippocrasy. Ballarat Urology Group. 12 August 2023. Ballarat, Australia.
Harris IA. Surgical effectiveness: perception versus reality,Hip fracture registry: guidelines, standards and outcomes. 40th Anniversary Dept of Orthopaedics and Traumatology of the Chinese University Hong Kong. 10-11 November 2023. New Territories, Hong Kong.
Harris IA. Surgical effectiveness: perception versus reality. Australian Society of Surgical Students. 7 May 2023.
Harris IA. Surgical effectiveness: perception versus reality. NZ Occupational Medicine Society annual meeting. 8 Sep 2023.
Harris IA. The effectiveness of surgery for musculoskeletal pain. Australian Pain Society ASM. 3-5 April 2023. Canberra, Australia.
Harris IA. Value in MSK funding. Parliamentary Friends of Arthritis. 21 March 2023. Canberra, Australia.
Harris IA. Where to from here for surgery, medication and management of pain in Workers' compensation schemes. Pain Points Webinar. 26 October 2023. [Internet]
Kim RG, An VVG, Petchell JF. Hip fracture surgery performed out-of-hours - a systematic review and meta-analysis. ACT AOA Branch Meeting. 1 December 2023. Canberra, Australia.
Murphy GT, Shatrov J, Duong J, Parker DA, Fritsch BA. How Does The Use of a Gap Balancing vs Measured Resection Technique Affect Component Positioning and Limb Alignment In Robotic Total Knee Arthroplasty? A Comparison of the Mako and Omnibot Systems ISAKOS Congress. 19 June 2023. Boston, USA.