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Featured researches published by Jeffrey Gollish.


Physical Therapy | 2008

Assessing Recovery and Establishing Prognosis Following Total Knee Arthroplasty

Deborah M. Kennedy; Paul W Stratford; Daniel L. Riddle; Steven Hanna; Jeffrey Gollish

Background and Purpose: Information about expected rate of change after arthroplasty is critical for making prognostic decisions related to rehabilitation. The goals of this study were: (1) to describe the pattern of change in lower-extremity functional status of patients over a 1-year period after total knee arthroplasty (TKA) and (2) to describe the effect of preoperative functional status on change over time. Subjects: Eighty-four patients (44 female, 40 male) with osteoarthritis, mean age of 66 years (SD=9), participated. Methods: Repeated measurements for the Lower Extremity Functional Scale (LEFS) and the Six-Minute Walk Test (6MWT) were taken over a 1-year period. Data were plotted to examine the pattern of change over time. Different models of recovery were explored using nonlinear mixed-effects modeling that accounted for preoperative status and gender. Results: Growth curves were generated that depict the rate and amount of change in LEFS scores and 6MWT distances up to 1 year following TKA. The curves account for preoperative status and gender differences across participants. Discussion and Conclusion: The greatest improvement occurred in the first 12 weeks after TKA. Slower improvement continued to occur from 12 weeks to 26 weeks after TKA, and little improvement occurred beyond 26 weeks after TKA. The findings can be used by physical therapists to make prognostic judgments related to the expected rate of improvement following TKA and the total amount of improvement that may be expected.


Acta Anaesthesiologica Scandinavica | 2009

Adding Gabapentin to a multimodal regimen does not reduce acute pain, opioid consumption or chronic pain after total hip arthroplasty

Hance Clarke; S. Pereira; D. Kennedy; J. Andrion; Nicholas Mitsakakis; Jeffrey Gollish; Joel Katz; Joseph Kay

Background: Gabapentin (GPN) is effective in reducing post‐operative pain and opioid consumption, but its effects with regional anesthesia for total hip arthroplasty (THA) are not known. We designed this study to determine whether (1) gabapentin administration reduces pain and opioid use after THA using a multimodal analgesic regimen including spinal anesthesia; (2) pre‐operative administration of gabapentin is more effective than post‐operative administration.


BJA: British Journal of Anaesthesia | 2014

Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block

Hance Clarke; Joel Katz; Colin J. L. McCartney; Paul W. Stratford; D. Kennedy; M.G. Pagé; Imad T. Awad; Jeffrey Gollish; J. Kay

BACKGROUNDnThis study was designed to determine whether a 4 day perioperative regimen of gabapentin added to celecoxib improves in-hospital rehabilitation and physical function on postoperative day 4 and 6 weeks and 3 months after total knee arthroplasty (TKA).nnnMETHODSnAfter Research Ethics Board approval and informed consent, 212 patients were enrolled in a randomized, double-blinded, placebo-controlled study. Two hours before surgery, patients received celecoxib 400 mg p.o. and were randomly assigned to receive either gabapentin 600 mg or placebo p.o. Two hours later, patients received femoral, sciatic nerve blocks, and spinal anaesthesia. After operation, patients received gabapentin 200 mg or placebo three times per day (TID) for 4 days. All patients also received celecoxib 200 mg q12 h for 72 h and i.v. patient-controlled analgesia for 24 h. Pain and function were assessed at baseline, during hospitalization, on postoperative day 4 (POD4), and 6 weeks and 3 months after surgery.nnnRESULTSnThe gabapentin group used less morphine in the first 24 h after surgery [G=38.3 (29.5 mg), P=48.2 (29.4 mg)] (P<0.0125) and had increased knee range of motion compared with the placebo group in-hospital (P<0.05). There were no differences between groups in favour of the gabapentin group for pain or physical function on POD 4 [95% confidence interval (CI): pain: -1.4, 0.5; function: -6.3, 2.0], 6 weeks (95% CI: pain: 0.1, 1.9; function: -0.2, 6.5) or 3 months (95% CI: pain: -0.2, 1.7; function: -2.2, 4.3) after TKA.nnnCONCLUSIONSnIn the context of celecoxib, spinal anaesthesia, femoral and sciatic nerve blocks, a dose of gabapentin 600 mg before operation followed by 4 days of gabapentin 200 mg TID decreased postoperative analgesic requirements and improved knee range of motion after TKA. Gabapentin provided no improvement in pain or physical function on POD4 and 6 weeks or 3 months after surgery.


BJA: British Journal of Anaesthesia | 2015

Pregabalin reduces postoperative opioid consumption and pain for 1 week after hospital discharge, but does not affect function at 6 weeks or 3 months after total hip arthroplasty

H. Clarke; G.M. Pagé; Colin J. L. McCartney; A. Huang; Paul W. Stratford; J. Andrion; D. Kennedy; Imad T. Awad; Jeffrey Gollish; J. Kay; Joel Katz

BACKGROUNDnThis study examined whether a perioperative regimen of pregabalin added to celecoxib improved pain scores and functional outcomes postdischarge up to 3 months after total hip arthroplasty (primary outcome) and acute postoperative pain and adverse effects (secondary outcomes).nnnMETHODSnOne hundred and eighty-four patients were enrolled in a randomized, double-blind, placebo-controlled study. Two hours before receiving a spinal anaesthetic and undergoing surgery, patients received celecoxib 400 mg p.o. and were randomly assigned to receive either pregabalin 150 mg p.o. or placebo p.o. After surgery, patients received pregabalin 75 mg or placebo twice daily in hospital and for 7 days after discharge. Patients also received celecoxib 200 mg every 12 h for 72 h and morphine i.v. patient-controlled analgesia for 24 h. Pain and function were assessed at baseline, 6 weeks, and 3 months after surgery.nnnRESULTSnThere was no difference between groups in physical function or incidence and intensity of chronic pain 3 months after total hip arthroplasty. The pregabalin group used less morphine [mean (sd): 39.85 (28.1) mg] than the placebo group [54.01 (31.2) mg] in the first 24 h after surgery (P<0.01). Pain scores were significantly lower in the pregabalin group vs the placebo group on days 1-7 after hospital discharge, and the pregabalin group required less adjunctive opioid medication (Percocet) 1 week after hospital discharge (P<0.05).nnnCONCLUSIONSnPerioperative administration of pregabalin did not improve pain or physical function at 6 weeks or 3 months after total hip arthroplasty. Perioperative administration of pregabalin decreased opioid consumption in hospital and reduced daily pain scores and adjunct opioid consumption for 1 week after discharge.


Pain Medicine | 2010

Gabapentin Does Not Reduce Preoperative Anxiety When Given Prior to Total Hip Arthroplasty

Hance Clarke; Joseph Kay; Beverley A. Orser; Jeffrey Gollish; Nicholas Mitsakakis; Joel Katz

INTRODUCTIONnGabapentin is an anti-epileptic drug which is also used for the treatment of postoperative pain and a variety of psychiatric diseases including chronic anxiety disorders. We tested the hypothesis that compared with a placebo control, gabapentin would reduce preoperative anxiety in patients undergoing total hip arthroplasty.nnnMETHODSnFollowing ethics approval, patients participating in a larger double blind, randomized, trial of multimodal analgesia were given either gabapentin 600 mg (N = 22) or placebo (N = 48) 2 hours before spinal anesthesia. Prior to administering the study medication, baseline anxiety levels were measured using a visual analog scale (VAS). Two hours after the ingestion of gabapentin or placebo, and prior to surgery, patients again rated their anxiety using a VAS.nnnRESULTSnAnxiety scores did not differ significantly between the groups either before (P = 0.95) or 2 hours after (P = 0.61) ingestion of gabapentin or placebo. Baseline anxiety and postdrug anxiety scores failed to demonstrate a significant association with maximal postoperative pain at rest, maximal postoperative pain with movement, and cumulative morphine consumption 48 hours after surgery.nnnCONCLUSIONSnAdministration of gabapentin 600 mg prior to surgery does not reduce preoperative anxiety.


Journal of Arthroplasty | 2014

Patient-Reported Compliance with Thromboprophylaxis Using an Oral Factor Xa Inhibitor (Rivaroxaban) Following Total Hip and Total Knee Arthroplasty

Andrew D. Carrothers; Sebastian R. Rodriguez-Elizalde; Benedict A. Rogers; Helen Razmjou; Jeffrey Gollish; John J. Murnaghan

This prospective study examines patient non-compliance (NC) for an oral factor Xa inhibitor (Rivaroxaban) when used as venous thromboembolic (VTE) prophylaxis following lower limb arthroplasty. A total of 3145 patients underwent surgery from May 2010 to December 2011. At 6 weeks patients completed an anonymous self-administered questionnaire. Postoperatively 2947 (94%, 2947/3145) received Rivaroxaban. 2824 (96%, 2824/2947) completed all in-hospital doses. Seven percent (203/2824) of patients did not attend the 6-week follow-up. Two thousand one hundred sixty-three (83%, 2163/2621) completed all prescribed doses, 98 (4%, 98/2621) were NC and 360 (14%, 360/2621) had incomplete data. Gender, age, body mass index and preoperative hemoglobin all correlated with NC (p < 0.05). Type and side of surgery did not correlate with compliance (p > 0.05). Patient-reported NC for Rivaroxaban is 4% which compares favorably to other VTE prophylaxis modalities.


Clinical Infectious Diseases | 2016

Elimination of screening urine cultures prior to elective joint arthroplasty

Michael J. Lamb; Laura Baillie; Dariusz Pajak; Jan Flynn; Vikas Bansal; Andrew E. Simor; Mary Vearncombe; Sandra Walker; Susan Clark; Jeffrey Gollish; Jerome A. Leis

Discontinuing routine processing of screening urine cultures prior to elective joint arthroplasty resulted in substantial reduction in urine cultures ordered and antimicrobial prescriptions for asymptomatic bacteriuria, without any significant impact on incidence of prosthetic joint infection. This simple change would be scalable across institutions with potential for significant healthcare savings.


Journal of Arthroplasty | 2014

Acetabular Cup Revision Combined With Tensor Facia Lata Reconstruction for Management of Massive Abductor Avulsion After Failed Total Hip Arthroplasty

Michael Drexler; Tim Dwyer; Yona Kosashvili; Rajesh Chakravertty; Mansuor Abolghasemian; Jeffrey Gollish

We report on 17 patients with massive abductor avulsions after total hip arthroplasty (THA) treated with medialization of the acetabular component and tensor fascia lata (TFL) reconstruction. All patients had severe limp, positive Trendelenburg sign, and avulsion of the abductor insertion confirmed on MRI. Mean age was 69 years (range, 50-83 years), and mean follow-up period was 36 months (range, 18-78 months). After surgery, 9 patients had no limp (47%), 8 patients had a mild limp, and abductor power improved from mean 2.5/5 to mean 3.8 (P < 0.0001). At latest follow-up, the Harris Hip Score was excellent in 6 hips (37%), good in 7 (43%) hips, and fair or poor in 3 (23%). Two patients with mild limp were not satisfied with their procedure.


BMC Musculoskeletal Disorders | 2006

Modeling early recovery of physical function following hip and knee arthroplasty

Deborah Kennedy; Paul W. Stratford; Steven Hanna; Jean Wessel; Jeffrey Gollish


International Journal of Orthopaedic and Trauma Nursing | 2014

The benefit of early identification of anemia preoperatively in patients undergoing hip and knee joint arthroplasty

Diane Bentley; Jeannie Callum; Jan Flynn; Jeffrey Gollish; John J. Murnaghan; Yulia Lin

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Hance Clarke

Sunnybrook Health Sciences Centre

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John J. Murnaghan

Sunnybrook Health Sciences Centre

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Joseph Kay

Sunnybrook Health Sciences Centre

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Helen Razmjou

Sunnybrook Health Sciences Centre

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J. Andrion

Sunnybrook Health Sciences Centre

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