Research

Musculoskeletal disorders and diseases account for more than one-half of all chronic conditions in people over 50 years of age in developed countries.

In Australia, more than 6.3 million Australians (31%) are affected by a musculoskeletal condition. Arthritis affects nearly 17% of the population and back disorders affect approximately 15%. This compares to 5% for cardiovascular disease and 4% for diabetes. Furthermore, one in two women and one in four men will be diagnosed with osteoporosis in their lifetime, with its high risk of fracture.

Through our research, COTR aims to improve the management of musculoskeletal conditions by a better understanding of the causes and biology, develop improved surgical and medical approaches to management and thereby prevent hospital admissions, get patients out of hospital quicker to reduce health care costs and to rapidly return patients to normal activities of daily living and well-being.

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  • Joint replacement and reconstruction research unit

    Royal Adelaide Hospital campus

    The Joint Replacement and Reconstruction Research Unit of COTR conducts research into a broad range of areas related to primary and complex revision hip and knee replacement as well as joint reconstruction for congenital joint disorders. The research opportunities include epidemiology using a 25 year prospective joint replacement database, implant wear studies, clinical studies and randomised controlled trials, basic bone biology and pathology, diagnostics, anatomy and surgical techniques, gait analysis and mechanical testing.

    Research projects

    • Risk factors for complications after joint replacement surgery - a retrospective database review
    • Longitudinal patterns of general health and musculoskeletal health status of persons undergoing hip and knee replacement
    • Optimising surgical approach for joint replacement and reconstruction
    • Wear, osteolysis and loosening of hip and knee replacement
    • Implant wear and failure – a laboratory investigation comparing current to earlier generation implants
    • Bone grafting at revision joint replacement

    Lead researchers

    Associate Professor Bogdan Solomon, Associate Professor Gerald Atkins, Mr Stuart Callary, Dr Oksana Holubowycz, Ms Kerry Costi, Ms Marg McGee, Professor David Findlay, Professor Donald Howie

    Contact

    Associate Professor Bogdan Solomon
    Email: bogdan.solomon@sa.gov.au

    Mr Stuart Callary
    Phone: +61 8 7074 2227
    Email: stuart.callary@sa.gov.au

  • Lower limb trauma research unit

    Royal Adelaide Hospital campus

    Musculoskeletal injuries comprise the majority of the more than 425,000 hospital admissions per year for trauma. In the younger adult, sporting injuries, road accidents and occupational injuries contribute to most physical trauma. In the elderly, fragility fractures arising from low impact falls are the primary causes of injury, with a rate of 175 hip fractures per 100,000 persons in Australians aged 40 years or older. Through orthopaedic trauma research, we aim for optimal management of musculoskeletal injury. We have a multifaceted research program, covering bone biology, advanced imaging, biomechanics, anatomy, pathology and clinical trials and opportunities exist for higher degree research in lower limb trauma covering one or more of these areas.

    Research projects

    • Developing innovative surgical procedures that enable faster healing and get individuals with fractures back on their feet faster.
    • Redefining weight-bearing regimes after pelvic and lower limb fractures to reduce complications and increase acute care efficiencies.
    • Improving the management of trochanteric hip fractures and return to community ambulation following fragility hip fracture.
    • Hip abductor function following intramedullary versus extramedullary fixation of hip fracture.

    Lead researchers

    Mr Stuart Callary, Associate Professor Bogdan Solomon, Associate Professor Mellick Chehade, Associate Professor Tony Pohl

    Contact

    Associate Professor Bogdan Solomon
    Email: bogdan.solomon@sa.gov.au

    Mr Stuart Callary 
    Phone: +61 8 7074 2227
    Email: stuart.callary@sa.gov.au

  • Bone cell biology group

    Royal Adelaide Hospital campus

    We are an internationally recognised research group running an integrated program of research into the cell biology of the major bone cell types, osteoclasts, osteoblasts and osteocytes. Our work is funded by competitive grants from the NH&MRC. The group consists of 4 post-docs, 2 Research Assistants and 5 current HDR students.

    Research projects

    Projects are available in all of our major research areas including:

    • The role of the osteocyte-derived protein Sclerostin in bone remodelling.
    • Human osteocyte differentiation.
    • Osteocytic osteolysis.
    • FGF23 production in osteocytes.
    • MicroRNA control of bone remodelling.
    • The effect of orthopaedic wear particles on osteocyte activity.
    • Vitamin D metabolism in osteoclasts, osteoblasts and osteocytes.

    Lead researchers

    Associate Professor Gerald Atkins (Head), Professor David Findlay

    Contact

    Associate Professor Gerald Atkins
    Phone: +61 8 8313 7214
    Email: gerald.atkins@adelaide.edu.au

  • Musculoskeletal biomechanics research program

    Modbury and Royal Adelaide Hospital campuses

    There are a range of projects available in the area of upper limb, lower limb, pelvis, injury, pathology, surgery and medical device development and evaluation using state of the art biomechanical testing facilities. The Centre's biomechanics laboratory houses an Instron 8874 bi-axial materials testing machine, and custom testing apparatus, and accesses a variety of other equipment via the Adelaide Centre for Spinal Research. Please also refer to Adelaide Spinal Research Group and Lower Limb Trauma Research Group for further projects.

    Research projects

    • Evaluating the effect of intrauterine growth restriction (IUGR) and catch-up growth on the mechanical behaviour of bone.
    • Biomechanical evaluation of novel rotator cuff repair techniques and anchors.
    • Upper limb fracture mechanisms.

    Lead researchers

    Dr Claire Jones, Professor Greg Bain

    Contact

    Dr Claire Jones
    Phone: +61 8 8313 2850
    Email: claire.jones@adelaide.edu.au

  • Adelaide spinal research group / SA spinal cord injury service

    Royal Adelaide Hospital campus

    Sitting within COTR is the Adelaide Centre for Spinal Research (ACSR), which hosts a group of Clinicians, Engineers and Basic Scientists located within the Royal Adelaide Hospital and SA Pathology. Professor Brian Freeman is the Research Director at the ACSR.

    Spinal disorders and pain present a large socioeconomic burden in Australia. Back complaints are the 6th most common reason to visit a GP, and 80% of Australians will experience low back pain in their life. Because the primary function of the spine is to transmit loads and enable motion during every day activities, it is important to study how spinal structures respond to loads and motion, and how this response changes with age, disease and injury. The group also study spinal cord injury and ways to improve outcomes from this potentially devastating event. Another important research area is paediatric orthopaedics, in particular addressing abnormalities of the spine in children. The ACSR brings together clinicians and scientists in a multidisciplinary program spanning bone structure and cell biology, intervertebral disc biology, biomechanics, pre-clinical studies and clinical research.

    The ACSR biomechanics laboratory has an array of specialised equipment including an Instron 6-axis spine simulator and materials testing machine, two AMTI 6-axis load cells, an Optotrak Certus motion capture system, National Instruments high speed data acquisition system, two Olympus high speed cameras, intervertebral disc pressure transducers, Wacom tablet monitor, and a specimen preparation laboratory.

    The ACSR welcomes enquiries from students with Mechanical Engineering, Biomedical Science, and Medicine/Surgery backgrounds, wishing to undertake Honours, Masters and PhD research projects. We also assist a number of orthopaedic residents and fellows to carry out biomechanics projects in our laboratory.

    Hampstead campus

    Our group's main interest is in human spinal cord injury, a complex neurological disorder for which there is a lack of defined preventative treatments. Our research is focused on the broad processes of bone healing and the degradation and repair of bone, including both anabolic and catabolic processes, as well as determining the cellular contributions and molecular signalling. Specific health consequences and disease processes to which the bone endocrine system may contribute also are a focus. Our group has expertise in medical, behavioural and basic sciences that gives an ability to examine questions that are both mechanistically informative and clinically relevant.

    Research projects

    • Timing of spinal cord decompression following traumatic spinal cord injury.
    • Bone quality of the human facet joint: the effects of age and gender.
    • Innervation of the bony compartments of the human spine: investigating the relationship between innervation and pain tolerance.
    • Establishing the human age-equivalence of the immature sheep spine with respect to tissue maturation and biomechanics.
    • Investigating the mechanical causes of pars interarticularis fractures.
    • Investigating the relationship between abdominal muscles and degenerative spondylolisthesis.
    • Modelling cervical intervertebral disc degeneration using a sheep model.
    • Biomechanical evaluation of spinal surgery techniques and implants.
    • Injury mechanisms for acute spinal column and cord trauma.
    • Bending and lifting techniques to minimise lumbar spine loading and twisting.
    • Characterising the microstructure and biomechanical properties of spinal tissues.

    Projects investigate in spinal cord injured patients (both traumatic and those with non traumatic lesions) the anti-anabolic and catabolic processes responsible for the accelerated bone resorption with a focus on relationships between muscle-bone interaction and both bone homeostasis and mechanotransduction. Closely related projects utilise ex vivo and in vitro tools to begin to examine how Wnt pathway modulators might diverge in their skeletal actions in disease states to affect human health. We are also beginning to explore links between the renal-bone endocrine system and the health outcomes of spinal cord injured patients. These projects will help to provide translation insight as to the requirement, or benefits of therapeutic approaches for individuals with spinal cord injury.

    • Role of Muscle–bone Interaction in Spinal Cord Injury Bone Loss.
    • Effects of Wnt Pathway Modulators on Lipid Metabolism.
    • Vitamin D Status and Susceptibility for Anxiety and Depressive Disorders in Spinal Cord Injured Inpatients.

    Lead researchers

    Professor Brian Freeman, Dr Julia Kuliwaba, Dr Claire Jones, Dr Ruth Marshall, Dr Jillian Clark

    Contact

    Dr Claire Jones
    Phone: +61 8 8313 2850
    Email: claire.jones@adelaide.edu.au

    Dr Ruth Marshall
    Phone: +61 8 8222 1630
    Email: ruth.marshall@sa.gov.au

    Dr Jillian Clark
    Phone: +61 8 8222 1651
    Email: jillian.clark@sa.gov.au

  • WCH paediatric orthopaedic research

    The Research Team at the Department of Orthopaedic Surgery, Women's and Children's Hospital comprises orthopaedic surgeons, doctors-in-training, medical and research/higher degree students. It is supported by a Clinical Research Manager, Research Scientist and Research Assistant. The Department has a long track record of internationally recognised research activity and publications including basic science and clinical research investigating a range of paediatric musculoskeletal conditions.

    Current areas of interest for the Research Team at the WCH campus include mechanisms of bone growth and repair, paediatric musculoskeletal infections, the management of congenital and developmental musculoskeletal deformities such as scoliosis and lower limb deformity and paediatric trauma.

    Research projects

    There are a number of planned and ongoing research projects that would be suitable for PhD or Honours students including the following:    

    • Long-term population-based study of paediatric patients undergoing of scoliosis correction utilising the South Australian Cancer Register, Birth Defects Register and Pregnancy Outcome Data.
    • Management of clubfoot in South Australia: epidemiology and outcomes.
    • Developmental dysplasia of the hip: risk factors, management and outcomes.

    Publications and projects

    Lead researcher

    Associate Professor Peter Cundy

    Contact

    Dr Nicole Williams
    Phone: +61 8 8161 7059
    Email: nicole.williams01@adelaide.edu.au

    Ms Georgia Antoniou
    Phone: +61 8 8161 7059
    Email: georgia.antoniou@sa.gov.au