NJR Research Fellows
The NJR runs a rolling Research Fellowship programme delivered in partnership with the Royal College of Surgeons of England.
Chairman of the NJR Research Sub-committee, Professor Mark Wilkinson said: "We look forward to welcoming new fellows who can help to maximise the value of the data in the NJR and use it in new ways to help drive improvement and quality in orthopaedics."
In May 2016, the NJR's Fellowship programme recruited for a fifth time, supported in partnership with the Royal College of Surgeons of England. As the NJR/RCS Clinical Research Fellow from August 2017, Mr Jonathan T Evans will be exploring benchmarking data in orthopaedics. His work will be showcased here when complete.
About Jonathan T Evans – Joint NJR/RCSEng Research Fellow
“I am currently an ST5 Specialty Registrar in the South West (Peninsula) Deanery and am honoured to be awarded the Joint NJR/RCSEng fellowship for 2017. I will be taking two years out of clinical training to complete an MD at the Musculoskeletal Research Unit at the University of Bristol. I come from a Military background, serving as a Medical Officer in the Royal Navy and the Royal Air Force, before taking up a civilian Higher Specialty Training number in 2015.
“I intend to spend two years completing my research project titled 'Extended benchmarking in hip prostheses'. Benchmarking data is vital in orthopaedics to give information on prosthesis survivorship. Patients and surgeons need to be aware of what they can expect from their implants and be aware of the risk of revision surgery with its associated morbidity and mortality. Currently, benchmarking data is available up to 10 years and this has helped guide the NICE recommendation of using prostheses with lower than a 5% revision risk at 10 years.
“As patients live longer we can expect that prostheses will need to survive way beyond 10 years. We aim to use NJR data in conjunction with single centre series to create and validate a predictive algorithm offering benchmarking points at 12, 15, 18 and 20 years postoperatively. In addition we will investigate the validity of creating benchmarks for common cup/stem constructs, rather than looking at them individually. Once implanted, the cup and stem are inextricably linked and revision of either component has significant risks for the patient and cost for the NHS. We aim to investigate whether the survivorship of a construct is indeed related to survivorship of individual elements, as well as create construct benchmarks for common cup/stem combinations.”
In May 2016, the NJR's Fellowship programme recruited for a fourth time, supported in partnership with the Royal College of Surgeons of England. Mr Richard Craig is the first NJR/RCS Clinical Research Fellow appointment who will look at one of the NJR upper limb datasets. His work will be showcased here when complete.
About Richard Craig – Joint NJR/RCSEng Research Fellow
"I am a Specialty Registrar in Trauma and Orthopaedic Surgery on the Oxford rotation. The award of the Joint NJR/RCSEng fellowship has enabled me to take time out of clinical training to study towards a DPhil at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.
"My project title is “Improving Outcomes of Shoulder Joint Replacement Surgery”. This is the first time that an NJR fellow has been appointed to look at one of the upper limb datasets. In recent years, there has been a rapid expansion in the overall number of shoulder replacements performed in the UK together with an unregulated expansion in the different shoulder implants available. This has occurred against a background of limited supporting high-quality evidence.
"Choice of procedure and patient selection for shoulder arthritis surgery have been identified amongst the top ten research priorities in shoulder surgery by a 2015 James Lind Alliance Priority Setting Partnership. I will be performing a detailed assessment of current UK practice and performing an outcomes analysis focussed heavily on Patient Reported Outcome Measures (PROMs). Poor PROMs may be an early marker for failure following shoulder arthroplasty surgery and PROMs, together with other factors, will be built into revision risk prediction models based on current UK data. Using this data, I aim to inform surgeons better regarding which patients will do well with shoulder replacement surgery and to inform future NJR strategy."
In Spring 2015, the NJR's Fellowship programme recruited for a third time, supported in partnership with the Royal College of Surgeons of England. Mr Tanvir Khan was appointed in August 2015 as NJR/RCS Clinical Research Fellow and his work will be showcased here when complete.
About Tanvir Khan – Joint NJR/RCSEng Research Fellow
I am a Specialty Registrar in Trauma & Orthopaedic Surgery based in Nottingham. Having completed a NIHR Academic Clinical Fellowship, I have taken time out from my clinical training program to undertake a PhD within the Department of Academic Orthopaedic & Trauma Surgery at The University of Nottingham.
I am delighted to have been awarded the 2-year joint NJR/Royal College of Surgeons of England Fellowship which will enable me to perform a national epidemiological analysis of revision surgery for periprosthetic fractures. As the number of hip and knee replacements performed is rising annually, fractures around prosthetic joints are a growing problem. Fractures are one of the most common reasons for undertaking revision surgery. They can lead to significant morbidity and poor function. Treatment is challenging and surgical decision-making is critical in preventing catastrophic outcomes. This project will identify which patients are at higher risk of fracture and investigate results of treatment. Thus, the ultimate aim is to reduce the prevalence of fractures and determine the best approaches to treatment for better patient outcome.
In August 2014, the NJR's Research Sub-committee offered Adrian Sayers the honourary position of 'NJR Research Fellow' for the duration of his Medical Research Council (MRC) Fellowship. The honourary position recognises that Mr Sayer's research uses substantial NJR data and his objectives are aligned to the ongoing research priorities of the registry.
About Adrian Sayers - Honourary NJR Research Fellow
"I have worked in health related research since 2004 following a MSc in Nutrition, Physical Activity & Public Health at the University of Bristol. I received a scholarship in 2006 to undertake a MSc in medical statistics at the London School of Hygiene and Tropical Medicine and since 2007, have worked in musculoskeletal research at the University of Bristol. I have recently been awarded a three-year MRC Population Health Science Fellowship as well as the honorary position of NJR Research Fellow."
"My MRC fellowship title is Factors affecting mortality, morbidity and patient outcomes after joint replacement surgery (femoral). The NJR is an early warning system which highlights issues relating to patient safety and strives to improve patient outcomes. However, it is currently unclear what the optimal statistical methods are for achieving those aims. Using data from the NJR of England, Wales, and Northern Ireland I hope to apply novel statistical procedures which will provide new and unique insights into patient safety and hopefully improve patient outcomes."
In 2012, the Fellowship programme recruited for a second time and Mr Jeya Palan was appointed in February 2013 and his work will be showcased here when complete.
About Jeya Palan - NJR Research Fellow
"I am a trauma and orthopaedic specialty registrar, based in Leicester and am currently undertaking a PhD based at the University of Leicester. As part of this, I have been looking into why a small minority of patients continue to be dissatisfied with the results of their hip or knee replacement. This clinical study will provide information to help identify these patients before surgery, so that more focused work can be done to improve their satisfaction rate after surgery. I became interested in the NJR Fellowship because I believe the work undertaken by the NJR is vital in helping to monitor the results of joint replacement surgery, in order to improve patient outcomes after surgery."
"My NJR Fellowship research will cover two main projects. The first is the reasons why unicompartmental or ‘partial’ knee replacements have a wide range of revision rates. I will be undertaking a radiographic analysis of the Oxford brand of partial knee implants in order to try and answer this question. I hope that by assessing the radiographs of patients who have had partial replacements, the reasons for revision after the initial operation can be identified."
"The second is concentrating on analysing revision hip and knee replacements and how well revision implants do. The number of hip and knee replacements being performed is increasing all the time and patients are also having hip and knee replacements at a younger age. This means that in the future, there will be an increasing number of revision hip and knee replacements and the performance of revision implants will need to be reviewed. I am also interested in looking at the potential risks to the patient of having revision surgery, which for patients and surgeons, is a significant undertaking."
Working with the NJR’s Research Sub-committee, the first two Fellows - Mr Paul Baker and Mr Simon Jameson - completed a period of 12 and 16 months respectively. They have both made significant contributions to the NJR research strategy and outputs in terms of published papers and poster presentations including:
- More than twenty published papers in journals including the Journal of Bone and Joint Surgery (Britain, America), Clinical Orthopaedics and Related Research (CORR), Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) and The Knee
- Open the portfolio of published papers from Simon Jameson (pdf) >
- More than 30 poster and podium presentations at national and international orthopaedic meetings including the American Association of Orthopaedic Surgeons, British Association for Surgery of the Knee, British Hip Society, International Society of Arthroplasty Registers, European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and the British Orthopaedic Association
- Please see below for a link to Simon Jameson’s doctoral thesis: Jameson, Simon (2015) Rationalisation of primary hip replacement using evidence from linked national databases. Doctoral thesis, Durham University