Update on Orthopaedic Research at BPH

InFocus Issue 21, January 2021

By Assoc Prof Peter Myers AM, MB, BS, FRACS, FAOrthA

More than 51 research projects are currently underway among Brisbane Private Hospital’s  Orthopaedic Group. Most of these projects are done at a surgeon’s own time and cost and are highly internationally regarded. Associate Professor Peter Myers provides In Focus with an update.

Clinical research is not easy. However, it is through such research that we can recommend one treatment over another based on scientific evidence. Research has varying degrees of complexity from simple audits through to randomized controlled trials. All involve a workload of study design, preparation, ethical approvals, statistical justification, patient recruiting, undertaking the actual study, recording of pre- and post-intervention scores, follow up over varying time lines, analysis of data and finally submission for presentation or publication.

Basic science or animal-based studies are even more difficult.

Conducting research is not profitable in itself; the reward is the satisfaction of having contributed in some small way to science. Ultimately this results in better outcomes of our interventions and treatments and to improved patient well-being.

The Orthopaedic craft group at BPH comprises some 27 surgeons who have their rooms at BPH and a further 8 who have regular operating lists along with another 7 who occasionally visit. This is a very strong group, highly respected among their peers both Nationally and Internationally. It includes past Presidents of the Australian Orthopaedic Association (AOA), the Australian Knee Society, the Australian Shoulder and Elbow Society, Sports Medicine Australia (Qld Branch – now a National body) along with examiners for the Royal Australasian College Surgeons and the supervisors of 6 AOA accredited speciality Fellowships along with other accolades. This is an elite group by any standards. 

The amount of clinical and basic science research being undertaken by the group is commendable since there is no remuneration for it and indeed research takes up time and costs money. The result is presentations at scientific meetings, publications in peer reviewed journals and sometimes inclusion in metanalyses on the subject. Many book chapters have also been based on this research. Even the simplest of audits allows a doctor to determine what aspects of care their patients prefer and thus a better treatment plan. 

There are currently more than 51 research projects underway among the Orthopaedic group at BPH that we know about and probably many more where the ethics approval has been granted from another institution.

The support of the hospital administration and staff with these projects has been greatly appreciated. There is little direct administrative involvement but the little things like the extra paperwork to be completed and that time involved, the extra sterilisation of equipment on occasions, allowing staff time to learn the details of new systems to be used in a study along with other concessions all go towards an harmonious and smooth uptake and running of a project.

Funding mostly comes from the surgeon doing the study. For larger projects institutional or company funding may be sought. There are some research grants available; these are competitive applications and tightly controlled. Research Foundation funding through the speciality Societies is available in limited amounts.

The fact that so many of the BPH Orthopaedic surgeons are doing research indicates a keen interest in the outcomes of their patients. Those patients who are recruited into such projects are almost always extremely happy to be involved and indeed interested in the process and the outcomes. We are grateful to the patients who have been involved in the many projects in past years and those who may be asked to be involved in the future. It is a requirement of the ethical approval process that no harm should come to a patient during the course of any study and patients included in a study are free to cease their involvement at any time.

Australian surgeons are respected Internationally and the quality of our research is integral to that. It is pleasing to see the Brisbane Private Hospital continue as a strong force in Orthopaedic Research in Australia.