Orthopaedics research at Subiaco

Our Orthopaedic Surgery Research Group is conducted to audit clinical outcomes, better understand disease and injury, and investigate new technologies which may lead to further improvements in patient treatment. We develop our research in partnership with universities and medical device companies.
Our diverse range of sub-specialist expertise covers all facets of orthopaedic surgery, including spinal and paediatric orthopaedics.

We cater to the complete orthopaedic needs of patients, including evaluation, surgery, after-surgery care and rehabilitation. St John of God Subiaco Hospital was the fi rst facility in Australia to use the Stryker Mako Orthopaedic Robot, which is used for patients undergoing partial or total knee replacement and total hip replacement.

Total knee and hip arthroplasty

Perth Hip and Knee Clinic consists of four experienced hip and knee joint replacement surgeons. Together, they provide 1,200 patients a year with joint replacement surgery.

Since opening in November 2015, Perth Hip and Knee's research database has been steadily growing, with over 2,500 patients enrolled. The registry is now reaching the point of maturity, with a large number of patients having over two years follow up. This will allow analysis and meets the requirements of international publications.

Perth Hip and Knee’s robotic total knee database has over 1,900 patients enrolled, capturing their preoperative, intraoperative and postoperative data and clinical outcomes. This represents one of the most comprehensive databases involving this emerging technology anywhere in the world.

Perth Hip and Knee is focused on ongoing collaboration with national and international likeminded surgical research groups to facilitate and drive orthopaedic research.

The current Data Acquisition Project has interest between America, Europe and Australia. This clinical research project aims to study the outcome of 800 total knee robotic arthroplasty patients to enhance the design of future prosthesis, improve surgical outcomes, and improve patient satisfaction and performance post total knee replacement.

The Global Paragon Stem study aims to analyse and identify post-surgical infection rates in patients undergoing total hip replacement by using an antimicrobial coating on the femoral stem. This hip replacement study is a multicentre project, with surgeons from Sydney and Melbourne in collaboration.

There is also national research collaboration on the RASKAL trial, which is seeking to explore robotic assisted surgery and joint alignment theory in patients undergoing total knee arthroplasty.

As a result of this surgical innovation and clinical research, surgeons at Perth Hip and Knee have been approved for the new limited release Mako THR software. This limited release software will enable surgeons to plan cup position using robotic planning and analysis in patients undergoing total hip arthroplasty and is currently being used at St John of God Subiaco Hospital.

Research interests for the 2021/22 annual year will continue to focus on the optimisation and individualised planning of total knee replacement. Our clinic has a leading role in developing and assessing the use of functional alignment in total knee arthroplasty. This alignment technique preferentially references a patient’s soft tissue rather than generic bony landmarks when aligning and inserting knee replacement surgery.

The ultimate aim of this continues to be improved outcomes for patients undergoing total knee arthroplasty.

Dr Gavin Clark
Dr Dermot Collopy

Armendariz, M., Tadros, B.J., Collopy, D., Clark, G. No evidence of mid-flexion instability after robotic-assisted total knee arthroplasty as assessed by intraoperative pressure sensors. Arthoplasty 6, Article number: 32 (2024) https://doi.org/10.1186/s42836-024-00253-3

Nixon, J., Tadros, B.J., Moreno-Suarez, I., Pretty, W., Collopy, D., Clark, G. Functionally aligned total knee arthroplasty: A lateral flexion laxity up to 6mm is safe! KSSTA Knee Surgery Sports Traumatology Arthoscopy Vol 32, Issue 5, May 2024, pages 1317-1323 https://doi.org/10.1002/ksa.12087

Clark, G., Esposito, C., Wood, D. Individualized Functional Knee Alignment in Total Knee Arthroplasty: A Robotic-assisted Technique. Techniques in Orthopaedics 37(3):p 185-191, September 2022. https://doi.org/10.1097/BTO.0000000000000567

Tran, T., McEwen, P., Peng, Y., Trivett, A., Steele, R., Donnelly, W., Clark G. Kinematic alignment in total knee arthroplasty: a five-year prospective, multicentre, survivorship study. Bone & Joint Volume 3 No. 8, 23 August 2022, pages 656-665 https://doi.org/10.1302/2633-1462.38.BJO-2021-0214.R1