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Research and innovation

Our clinical achievements are at the heart of what we do and one of our key strengths as a department.  We are also rightly proud of our training record and our expertise in the area of clinical research.

We have over 20 surgeons and consultants in the department working across the whole spectrum of orthopaedic conditions. We are proud to employ experts in the field working across all areas of joint surgery and musculoskeletal rehabilitation, keyhole surgery, day case hip replacement, arthroscopic knee surgery and specialist hand and wrist procedures.  

We routinely treat common joint and musculoskeletal conditions and have recently started to offer same day surgery for many conditions including hip replacement surgery to eligible patients.  Our care opinion feedback is second to none as you can read in our testimonals section.   We do this from state-of-the-art facilities such as our National Treatment Centre for Orthopaedics in the grounds of the Victoria Hospital Kirkcaldy and in our dedicated Day Surgery Unit at Queen Margaret Hospital in Dunfermline.

Research

Our team is committed to providing quality orthopaedic care and advancing treatments through innovative research and clinical trials.

Orthopaedic research is a ‘joint’ effort within NHS Fife between staff in the orthopaedic and trauma clinical service and the research innovation and knowledge (RIK) orthopaedic clinical research team.

One of the most long-established research departments in Scotland, we pride ourselves in our robust research methods and the breadth of our study areas. For over 20 years we’ve run an interdisciplinary research team working with a variety of commercial and non-commercial sponsors and funders, investigators, and researchers across a wide range of interests and experience, members of the public and service users and colleagues from across Scotland, the UK and further afield. As part of your treatment journey, you may be invited to take part in Research studies. There is no obligation to take part and will not impact the quality of care that you will receive.

Background

The Orthopaedic Clinical Research Team started in 2020 with one dedicated research nurse who along with two consultants who managed three studies.  Since August 2024, the team has expanded to a team of five research staff who support commercial and non-commercial studies which span both elective (planned) surgery and trauma (emergency) research. The team benefits from having a close working relationship with staff in the National Treatment Centre at the Victoria Hospital  with the support of orthopaedic consultants.

A recent achievement for the team was reaching their recruitment target for PANACHE on their last recruiting day for the study. 

Recent studies which NHS Fife has supported*

*not including commercial studies

AFTER: Ankle Fracture Treatment: Enhancing Rehabilitation trial
CRAFFT; Children’s Radius Acute Fracture Fixation Trial
COREKids; Development of a core outcome set for childhood lower limb fractures 
FAME: The Fractured Ankle Management Evaluation Trial
MOTION: What is the clinical-effectiveness and cost-effectiveness of surgery with medial opening wedge high tibial osteotomy (HTO) compared with non-surgical treatment in the management of osteoarthritis (OA) of the knee in patients younger than 50 years?
PANACHE: Absorbable versus Non-Absorbable sutures for Carpal Tunnel Hand surgery
PROFHER-2 Trial: PROximal Fracture of the Humerus: Evaluation by Randomisation Trial no.2 
SCIENCE: Surgery or Cast for Injuries of the EpicoNdyle in Children’s Elbows
WORKWELL: Testing work advice for people with arthritis

 

 

The AFTER trial – The Ankle Fracture Treatment: Enhancing Rehabilitation

AFTER: Ankle Fracture Treatment: Enhancing Rehabilitation trial

The AFTER trial – The Ankle Fracture Treatment: Enhancing Rehabilitation trial is trying to find out if attending physiotherapy after an ankle fracture really does help improve recovery.  There is currently no scientific evidence

showing that seeing a physiotherapist after an ankle fracture improves recovery. The trial will be facilitated by PI, Mr Adeel Akhtar and co-investigator Mr Phil Walmsley and supported by the Orthopaedic research

team.  NHS Fife will be the first hospital in Scotland to open the AFTER study.  For more information click on the link below.

AFTER Study website

CRAFFT: Children’s Radius Acute Fracture Fixation Trial

CRAFFT – The Children's Radius Acute Fracture Fixation Trial is trying to find out the best way to treat children who have broken their arm at the wrist, and the bones have moved out of place. The study is comparing the two most common treatments used throughout the UK. The first treatment is to put the arm in a plaster cast for four to six weeks, allowing the broken bones to heal, and grow back to the right position naturally.  The second treatment is to put the bones back into the right position which requires a procedure or operation. The study is facilitated by PI, Mr Muhammad Adeel Akhtar and CI, Mr Phil Walmsley and supported by the Orthopaedic research

FAME: The Fractured Ankle Management Evaluation Trial

FAME - Fractured Ankle Management Evaluation is facilitated by Principal Investigator (PI), Mr Phil Walmsley and supported by Co-Investigator (CI), Mr Muhammad Adeel Akhtar. The study is investigating two different types of treatment  for broken ankles. Treatment often involves an operation involving plates and screws which are fitted against the bone fragments to
keep them in place. An alternative non-surgical treatment involves applying a snug  plaster cast called a close contact cast, carefully shaped to the ankle, to hold the bones correctly while they heal. This study will investigate whether the non-surgical treatment option will provide patients with comparable ankle function and quality of life to those treated with surgery.

Congratulations to the Orthopaedic team who have smashed their original recruitment target of 15 and successfully recruited 18 patients to date. Well done!

A link to the FAME study publication is found here: ‘understanding the
experience of recovery from ankle fracture at 6 months in people aged 50 years and over’

COREKids: Development of a core outcome set for childhood lower limb fractures

Development of a core outcome set for childhood lower limb fractures was a study facilitated by PI, Dr Melvin Carew, Emergency Department Consultant.  The study closed to recruitment early after the UK target of 300 was successfully reached. NHS Fife’s R&D Department helped recruit 95 of the overall UK target - an amazing achievement!

COREKids: Development of a core outcome set for childhood lower limb fractures

Publications and presentations

Follow the research team

Research Innovation and Knowledge - NHS Fife: Posts | LinkedIn

NHS Fife Research & Development (@NHSFifeResearch) / X

Get in touch with the Orthopaedic Research Team

Orthopaedic Clinical Research Team: fife.orthopaedicresearch@nhs.scot


 

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