Dr Turgeon is associate professor at the University of Manitoba’s Max Rady College of Medicine, Department of Surgery, in the section of orthopaedic surgery
Dr Turgeon’s research is aimed at improving the lives of people who have undergone hip and knee replacements. He uses innovative research methods, such as radiostereometric analysis, to gain a deeper understanding of how implant design, stability, and biomaterials affect clinical outcomes. Dr Turgeon is particularly interested in developing new methods to prevent implant failure and improve the longevity of the replacement.
He is Associate Professor at the University of Manitoba’s Max Rady College of Medicine, Department of Surgery, in the Section of Orthopaedic Surgery. He is a surgeon-scientist with the Orthopaedic Innovation Centre, where he collaborates with other experts in the field, and is a member of the Canadian RSA Network and the Concordia Joint Replacement Group. His specialties include implant design and stability, clinical outcome studies, implant failure, and additive manufacturing in orthopaedics. His research has been recognised by several awards and honours and his findings have been published in numerous high-impact journals.
OPN: What drove you to choose a career in orthopaedics and medical devices?
TT: Orthopaedics, and specifically hip and knee replacement surgery, are amongst the most impactful medical procedures ever developed. The dramatic improvement in pain and quality of life that we can achieve with hip and knee replacement is tremendously rewarding on a personal level. That said, not all patients have positive or optimal outcomes and I believe that improvements in implant design and surgical technique with continue to provide addition benefits to patients.
OPN: You recently published results from a new study regarding the emerging reverse hip replacement system technology, could you tell us more about what the research involved and what outcomes you discovered?
TT: We conducted a study of the novel Reverse Hip Replacement System (Reverse HRS). This innovative reverse total hip has been developed with a femoral cup and acetabular ball, creating enhanced mechanical stability. Our study was designed to assess the implant fixation using radiostereometric analysis (RSA), and the clinical safety and efficacy of this novel design.
This study enrolled 22 patients (11 male/11 female; median age 70.6 years) and evaluated implant fixation using radiostereometric analysis (RSA). RSA is a well validated technique used to predict long-term implant stability by studying the implants early behaviour. RSA markers were viewed via radiologic imaging at six weeks (baseline) and 6, 12, and 24 months. Mean acetabular subsidence from baseline to 24 months was 0.087 mm (SD 0.152), below the critical threshold of 0.2 mm (p = 0.005). Mean femoral subsidence from baseline to 24 months was -0.002 mm (SD 0.194), below the published reference of 0.5 mm (p < 0.001).
The study outcomes with the Reverse HRS demonstrate excellent fixation with a predicted low risk of revision at ten years, mean migration below the level of radiostereometric analysis (RSA) detection for both the femoral and acetabular components, and high rates of patient satisfaction including no patients reporting symptoms consistent with soft-tissue impingement within the articulation and no symptoms consistent with adverse reaction to metal debris.
OPN: What could your findings mean to the orthopaedic industry and the patient experience?
TT: These data demonstrate that this Reverse Hip Replacement System delivers excellent fixation with a predicted low risk of revision for loosening at ten years post-surgery.
OPN: Could you tell us more about the Reverse Hip Replacement System?
TT: The Reverse HRS is a Metal-on-Polyethylene reverse geometry hip prosthesis designed to improve stability at extended ranges of motion and reduce the risk of dislocation. Like most conventional systems, the Reverse HRS consists of a femoral stem, an acetabular cup and a cobalt-chrome ball that articulates within a polyethylene liner.
Unlike existing total hip replacement systems, the ball is placed on a trunnion within the acetabular cup instead of the femoral stem, and the polyethylene liner is attached to a femoral cup, which then attaches to the femoral stem, as opposed to the polyethylene liner being attached to the acetabular cup. This technological difference does not change the center of rotation of the Reverse HRS and it remains similar to a normal physiological hip, or a well-positioned traditional Total Hip Arthroplasty. The advanced Reverse HRS implant is designed to provide greater range of motion in all planes, enhanced hip stability, and to reduce the risk of dislocation.
Importantly, the Reverse HRS also provides variability of component placement including higher abduction angles and anteversion of the acetabular cup. The femoral cup articulates around the acetabular ball and overlaps with the acetabular cup as the hip undergoes flexion-extension, abduction-adduction and internal-external rot