ACOA Invests $2million in Orthpaedic Innovation

Andy Fillmore, Member of Parliament for Halifax, on behalf of the Atlantic Canada Opportunities Agency (ACOA) announced a $2 million investment for a NSHA orthopaedic project on Wednesday April 17th. 

Left to right: Dr. Travis McDonough (CEO & Founder Kinduct), Barbara Campbell (CEO OrthoMX), MP Andy Fillmore (MP for Halifax), Dr. Alex Fuentes (Chief Scientific & Technology Officer, Emovi), Dr. Michael Dunbar (Principal Investigator & Orthopaedic Surgeon), Dr. Gail Tomblin Murphy (VP Research & Innovation, NSHA)

Dr. Michael Dunbar and the orthopaedic research team, in conjunction with partners Kinduct, Emovi and OrthoMX, are seeking to advance the standard of care, increase treatment options and improve orthopaedic wait times.

NSHA puts a priority on translating research into clinical practice and this project will provide medical staff with enhanced information such that they can make more timely and precise decisions.

“Once again, we are drawing a straight line from research and innovation to improved patient outcomes. Nova Scotia Health Authority places a high priority on research and this particular project will advance the standard for patients who need orthopaedic care. We are very pleased to collaborate with industry partners to improve care for Nova Scotians.”
      - Janet Knox, President and CEO, Nova Scotia Health Authority

The technology involved is a three part partnership between Kinduct, Emovi and OrthoMX. Kinduct developed a platform for remote patient monitoring where patients can access information about their care and interact with their healthcare team. Emovi's KneeKG system is a wearable knee assessment device that assesses knee joint functions dynamically. OrthoMX uses the InStride app to track walking patterns. These three parts together will shape the new Mobility Assessment Clinic at the QEII Health Sciences Centre. 

“Today we see that meaningful collaboration fosters innovation. With the support of ACOA, our NSHA collaborative research partnership with Kinduct, Emovi and OrthoMX is bringing transformative innovations to patients across Nova Scotia.”
    - Dr. Michael Dunbar, Orthopaedic Surgeon, Endowed Chair of Arthroplasty Outcomes, Queen Elizabeth II Health Sciences Centre
 
Congratulations to Dr. Dunbar and the orthopaedic team!

Local Researchers Changing the Game Post Hip & Knee Replacement

Dr. David Anderson (Photo: Bruce Bottomley, courtesy Dalhousie)

Nova Scotia Health Authority (NSHA) and Dalhousie University researchers are changing the way we prevent venous thromboembolism (blood clots) after hip and knee replacement surgery. The EPCAT II Study (Extended Venous Thromboembolism Prophylaxis Comparing Rivaroxaban to Aspirin Following Total Hip and Knee Arthroplasty II) found that there was no significant differences between widely available, inexpensive Aspirin and current standard of care Rivaroxaban after total hip or total knee arthroplasty. The team was recently published in New England Journal of Medicine (NEJM).

"This large, randomized, double-blind trial is likely to be practice-changing, because the point estimates for the relative safety and efficacy of the two treatments are precise and the included patients represent a typical population undergoing joint-replacement surgery." says Dr. David Garcia who commented on the results in an NEJM Editorial.

Lead author Dr. David Anderson (Dalhousie University Dean of Medicine), Dr. Michael Dunbar (NSHA Orthopedic Surgeon, Researcher and QEII Foundation Endowed Chair in Arthroplasty Outcomes) and their research teams at NSHA completed an interdisciplinary study between orthopaedics and hematology. The study was a joint effort conducted at 14 other institutions across several provinces (NS, ON, QC, NB, MB) and many participating sites commended NSHA Hematology Research Manager Susan Pleasance and her team on their excellent study management. NSHA's Research Methods Unit (RMU) contributed with sample size calculation, analytic design and analysis of all results. They also contributed to data management activities of the study, including database consulting and design, data reporting, data cleaning and preparation for analysis.

This was an exceptional example of a large, interdisciplinary, inter provincial and multi-site cooperative research study.

The EPCAT II trial recruited patients from January 2013 through April 2016 and followed 3424 patients post knee and hip replacement in a multicentre, double blind, randomized control trial funded by CIHR.All enrolled patients had an initial 5 day course of Rivaroxaban, then randomized to continue on Rivaroxaban or switch to Aspirin for additional 9 days (knee-1620 patients) or 30 days (hip-1804 patients) and followed for 90 days post surgery. 

The primary effectiveness outcome was the rate of symptomatic venous thromboembolism. Results show that the rates were similar between the two drugs. The primary safety outcome was a major or clinically important bleeding event both of which were also similar between the two drugs.


The EPCAT II trial builds on the EPCAT I trial which suggested that extended prophylaxis with Aspirin after total hip replacement was as safe and effective as heparin to prevent venous thromboembolism after an initial 10-day postoperative course of heparin.

"Going forward, the very low rates of bleeding and thrombosis seen with the relatively inexpensive and user-friendly aspirin-based strategy probably mean that the EPCAT II trial has established a prophylaxis regimen against which all strategies to prevent venous thromboembolism after joint replacement will be compared." (Dr. David Garcia)


Additional Media:

• QEII Foundation- CTV House Calls: video from 2016
• NEJM video summarizing the research findings

Congratulations Dr. Michael Dunbar!

Dr. Michael Dunbar

We extend our warm congratulations to Dr. Michael Dunbar, orthopaedic surgeon at NSHA, QEII Foundation Endowed Chair in Arthroplasty Outcomes and professor of surgery at Dalhousie University, who was inducted as a fellow into the Canadian Academy of Health Sciences on September 13th.  Membership is considered one of the highest honours for members of the Canadian health sciences community.

Dr. Dunbar holds leadership positions with Canadian Joint Replacement Registry; Canadian Arthroplasty Society and the Knee Society. He authored over 120 scientific papers and has delivered over 300 presentations world-wide. As principal or co-investigator his grant capture is over $25 Million. He received the J. Èdouard Samson Award for outstanding orthopaedic research in Canada over a five-year period and was named one of the top 22 knee surgeons in North America by his peers.

Please extend your best wishes to Dr. Dunbar on this great achievement.