Richard S Page

Richard S Page
Deakin University · IMPACT - School of Medicine

BMedSci, MB BS, FRACS (Orth), FA Orth A

About

277
Publications
77,765
Reads
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3,651
Citations
Introduction
Richard is an Orthopaedic Surgeon Fellowship trained in shoulder, upper limb, hand surgery and trauma. He is Chair of Orthopaedics at Deakin University and Director of Orthopaedics at Barwon Health. He teaches a range of students and regularly presents invited lectures and scientific papers internationally. His research interests include techniques in shoulder surgery, osteoarthritis and upper limb joint replacement surgery, trauma outcomes and the pathological basis of orthopaedic conditions.
Additional affiliations
January 2019 - January 2021
Australian Orthopaedic Association National Joint Replacement Registry
Australian Orthopaedic Association National Joint Replacement Registry
Position
  • Managing Director
Description
  • Clinical advisor and now Deputy Director for shoulder and upper limb joint replacement surgery outcomes
January 2017 - present
Barwon Centre of Orthopaedic Research and Education (B-CORE)
Position
  • Managing Director
July 2011 - February 2020
Deakin University
Position
  • Managing Director
Education
January 2000 - January 2004
Australian Orthopaedic Association
Field of study
  • Orthopaedics and Trauma
January 1996 - January 2000
Royal Australasian College of Surgeons
Field of study
  • Orthopaedic Surgery
January 1987 - December 1989
University of Tasmania
Field of study
  • Medicine

Publications

Publications (277)
Article
Question Is aspirin monotherapy noninferior to enoxaparin in preventing symptomatic venous thromboembolism (VTE) within 90 days following primary total hip or knee arthroplasty performed for osteoarthritis? Findings In this cluster-randomized, crossover trial that included 9711 patients, treatment with aspirin vs enoxaparin resulted in symptomatic...
Article
Background Two classes of primary reverse total shoulder arthroplasty (rTSA), inlay (in-rTSA), and onlay (on-rTSA) were compared to determine differences in rates of revision. Methods Between 1 January 2012 and 31 December 2020, all primary in-rTSA or on-rTSA procedures were compared from a large national arthroplasty registry by cumulative percen...
Article
Full-text available
Aims: The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population. Methods...
Article
Background: Loss of glenoid fixation is a key factor affecting the survivorship of primary total shoulder arthroplasty (TSA). It is not known whether the lower revision rates associated with crosslinked polyethylene (XLPE) compared with those of non-XLPE identified in hip and knee arthroplasty apply to shoulder arthroplasty. Questions/purposes:...
Article
Background: Demand for publicly funded orthopaedic outpatient services is growing rapidly which affects a health service’s ability to provide timely care. The current study describes the implementation and preliminary evaluation of a novel physiotherapist-led paediatric fracture clinic, which was introduced to provide more timely care to children....
Article
Background and Purpose: To determine intra‐session test‐retest reliability, agree- ment and minimum detectable change (MDC) of the 30 CST across three tests in people with knee osteoarthritis (OA). Methods: A test–retest reliability study was performed with 93 people with mild radiological knee OA. Participants were asked to complete three attempts...
Article
Background The 2021 AOANJRR (Australian Orthopaedic Association National Joint Replacement Registry) report indicated that total shoulder replacement using both mid head (TMH) length humeral components and reverse arthroplasty (RTSA) had a lower revision rate than stemmed humeral components in anatomical total shoulder arthroplasty (aTSA) - for all...
Article
Introduction Proximal humeral fractures account for a significant proportion of all fractures. Detailed accurate classification of the type and severity of the fracture is a key component of clinical decision making, treatment and plays an important role in orthopaedic trauma research. This research aimed to assess the performance of Machine Learni...
Article
Importance: Distal radius fractures are common and are managed with or without surgery. Current evidence indicates surgical treatment is not superior to nonsurgical treatment at 12 months. Objective: Does surgical treatment for displaced distal radius fractures in patients 60 years or older provide better patient-reported wrist pain and function...
Article
Joint replacement (JR) is one of the most common and successful surgical procedures performed in Australia, with over 115 000 pri- mary procedures undertaken in 2019.1 In 2020, most JR surgery was suspended in late March in response to Federal Government directives to allow only emergency and urgent surgery, which did not include elective JR. This...
Article
Background & Objective: The ankle syndesmosis is frequently disrupted in ankle injuries, with higher incidence in concomitant ankle fractures. There is debate regarding the most appropriate surgical management of these injuries, with the development of suture-button devices challenging the conventional approach of surgical stabilisation with syndes...
Chapter
Arthroscopic transhumeral ulnohumeral arthroplasty is an effective treatment for advanced osteoarthritis of the elbow associated with a painful block to end flexion and or extension from bony osteophyte impingement. Optimal results require careful patient assessment and selection. Prerequisites for surgery include at least 40° loss of motion, match...
Chapter
The diagnosis, evaluation and treatment of symptomatic TFCC tears remain a challenge. This is in large part due to the myriad of structures that can be associated with ulna-sided wrist pain. Understanding of the anatomy, biomechanics and function of the ulna-sided complex has improved significantly in the recent years, leading to a more targeted tr...
Chapter
Elbow arthroscopy has come a long way from its beginning in 1931 and has developed from a novelty into a mainstream, accepted, safe and effective orthopaedic procedure. Surgical indications for elbow arthroscopy have increased over the last two decades and will continue to do so as advanced techniques continue to develop. The key elements for a suc...
Chapter
Wrist arthroscopy has come a long way and has developed as a safe and relevant procedure. Initially only being used as a diagnostic instrument, it now can treat a wide range of wrist pathologies. Complimenting this, the equipment being used has also improved and is now better suited and designed for small joints. Arthroscopy is now considered the g...
Chapter
Arthroscopic debridement has developed into a valid treatment option for TFCC tears. The aim is to remove debris causing localized synovitis and as well as unstable tissue that can catch, typically with rotation in ulna deviation. However, limited studies directly compare the outcomes of surgical treatments for TFCC injuries hence evidence-based gu...
Article
Background Shoulder replacement is a reliable treatment for the relief of pain and improvement of function in patients with glenohumeral arthritis, rotator cuff arthropathy, osteonecrosis and fracture. Limited data is available comparing revision rates for the different types of shoulder replacement when used in younger patients. This study aims to...
Article
Background Modularity is an integral element of reverse total shoulder arthroplasty (RTSA). Glenosphere diameter is a key component, but its effect on revision rate is unknown. The aim of this study was to investigate the relationship between glenosphere size and revision rates in RTSA procedures. Methods Data from a large national arthroplasty re...
Article
Full-text available
Introduction Data from clinical trials suggest that CT-confirmed nondisplaced scaphoid waist fractures heal with less than the conventional 8–12 weeks of immobilization. Barriers to adopting shorter immobilization times in clinical practice may include a strong influence of fracture tenderness and radiographic appearance on decision-making. This st...
Article
Full-text available
Background: Distal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive mod...
Research Proposal
Full-text available
Osteoarthritis is a chronic, debilitating disease of synovial joints that results in destruction of the cartilaginous matrix. No disease modifying medication has shown efficacy to date. In Australia the lifetime risk of undergoing a total shoulder arthroplasty is 1 in 60 for males and 1 in 40 for females, with an increasing incidence trend recorded...
Article
Full-text available
Background Radial head arthroplasty is the preferred surgical management for complex, unreconstructable radial head fractures. There has been increasing use of pyrocarbon prostheses, with potential tribology and modulus advantages over metallic counterparts. This study aims to assess clinical and radiological outcomes for radial head replacement fo...
Article
Background: The optimal surgical management of glenohumeral osteoarthritis in young patients remains an unsolved problem. Humeral resurfacing hemiarthroplasty and stemmed hemiarthroplasty using metallic heads are two surgical options that avoid the complications of loosening or wear of the glenoid component seen in total shoulder arthroplasty. Des...
Article
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism....
Article
Purpose: Inferior glenoid labral tears are an uncommon but distinct shoulder injury. Only a small number of studies have reported outcomes following arthroscopic repair. The aim of the current study was to report minimum 2-year outcomes following inferior labral repair and to compare outcomes and risk factors associated with the injury to non-infe...
Article
Background: There has been decreased use of anatomic total shoulder arthroplasty (aTSA) because reverse TSA (rTSA) is increasingly being used for the same indications. Although short-term studies generally have not found survivorship differences between these implant designs, these studies are often small and their follow-up is limited to the shor...
Article
Full-text available
Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...
Article
The coronavirus disease 2019 (COVID-19) impacts surgical flow and work practices in the operating theatre (OT). These arise from the greater risk of morbidity and mortality to patients1 as well as the potential for transmission to perioperative healthcare workers.2 The Victorian Department of Health and Human Services (DHHS) perioperative COVID-19...
Article
Purpose To investigate wellbeing and work impacts in younger people with persistent shoulder pain. Materials and methods People aged 20–55 years with shoulder pain of >6 weeks’ duration (excluding those with recent fracture or dislocation) were recruited from orthopaedic clinics at three major public hospitals. Health-related quality of life (HRQo...
Article
Objectives To compare injury-profiles of females and males presenting to Emergency Departments (EDs) with an Australian Football injury. Design Prospective observational study. Method All patients presenting to one of 10 EDs in Victoria, Australia, with an Australian Football injury were included in the study. Data were prospectively collected ov...
Article
Full-text available
Introduction Shoulder instability injuries are common in sports involving collisions and overhead movements. Arthroscopic Bankart repair and the open Latarjet are two commonly used surgical stabilisation procedures. There is a lack of knowledge surrounding movement strategies, joint loading and muscle strength after each of these procedures. This s...
Article
Importance The burden of injury and costs of wrist fractures are substantial. Surgical treatment became popular without strong supporting evidence. Objective To assess whether current surgical treatment for displaced distal radius fractures provided better patient-reported wrist pain and function than nonsurgical treatment in patients 60 years and...
Article
Full-text available
Background and purpose — The increase in shoulder arthroplasty may lead to a burden of revision surgery. This study compared the rate of (2nd) revision following aseptic 1st revision shoulder arthroplasty, considering the type of primary, and the class and type of the revision. Patients and methods — All aseptic 1st revisions of primary total rever...
Article
Full-text available
Background We are performing a combined randomised and observational study comparing internal fixation to non-surgical management for common wrist fractures in older patients. This paper describes the statistical analysis plan. Methods/design A Combined Randomised and Observational Study of Surgery for Fractures In the distal Radius in the Elderly...
Article
Background: Rotator cuff-related shoulder pain (RCRSP) is a common and disabling musculoskeletal condition. Internet-based and telerehabilitation delivery of recommended care may improve access to care and improve adherence and outcomes. Objective: The primary aim of this pilot randomized controlled trial was to assess the feasibility of a 12-week...
Article
Full-text available
This systematic review and meta‐analysis investigated the association between consumption of ultraprocessed food and noncommunicable disease risk, morbidity and mortality. Forty‐three observational studies were included (N = 891,723): 21 cross‐sectional, 19 prospective, two case‐control and one conducted both a prospective and cross‐sectional analy...
Article
This study aimed to use a predictive simulation framework to examine shoulder kinematics, muscular effort, and task performance during functional upper limb movements under simulated selective glenohumeral capsulorrhaphy. A muscu-loskeletal model of the torso and upper limb was adapted to include passive restraints that simulated the changes in sho...
Preprint
BACKGROUND Rotator cuff–related shoulder pain (RCRSP) is a common and disabling musculoskeletal condition. Internet-based and telerehabilitation delivery of recommended care may improve access to care and improve adherence and outcomes. OBJECTIVE The primary aim of this pilot randomized controlled trial was to assess the feasibility of a 12-week i...
Article
Ten patients with painful early-stage knee osteoarthritis underwent transcatheter arterial embolization of neoangiogenic branches from genicular arteries. At 12 months, 6 patients had responded to treatment according to study criteria. Median pain, function, and quality-of-life scores had improved by 15.4%, 21.3%, and 100%, respectively, for the 10...
Article
Background Rotator cuff tears (RCT) are a common cause of shoulder disability, yet both conservative and surgical treatment strategies can lead to poor results in some patient populations. Enhanced understanding of the genetic processes associated with RCT can assist in the development of more effective management options, and help predict individu...
Article
Objective To estimate the lifetime risk of primary shoulder arthroplasty in Australia and examine changes over time. Methods For this retrospective population‐level analysis, de‐identified individual‐level data on all primary partial (PSA) and total shoulder (TSA) arthroplasty procedures performed in Australia from 2008‐2017 (N=38,868) were obtain...
Article
Full-text available
Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective su...
Preprint
Full-text available
This study aimed to use a predictive simulation framework to examine shoulder kinematics, muscular effort and task performance during functional upper limb movements under simulated selective glenohumeral capsulorrhaphy. A musculoskeletal model of the torso and upper limb was adapted to include passive restraints that simulated the changes in shoul...
Article
Background: There is an increasing trend toward the use of reverse total shoulder arthroplasty (RTSA) over stemmed hemiarthroplasty (HA) for the management of proximal humeral fractures. There are limited data available comparing the revision rates for RTSA and HA in the setting of a fracture. The aim of this study was to compare the revision rate...
Article
Background In order to develop and implement prevention strategies for falls, comprehensive epidemiological data are required. Therefore, this study mapped emergency presentations for falls across the western region of Victoria, Australia, encompassing urban, regional and rural areas. Methods This cross-sectional study utilised electronic data for...
Article
Full-text available
Humeral avulsion of the glenohumeral ligament (HAGL) and posterior labral tears are less common injuries in comparison to Bankart lesion in traumatic shoulder instability. The association of rotator cuff tears with posterior capsulolabral lesions is even rarer. We present an unreported combination of HAGL with posterior labral tear and partial arti...
Article
Background Dart-throwing motion (DTM) is an important functional arc of the wrist from radial extension to ulna flexion. An aim of partial fusion surgery of the wrist is to maintain maximal functional motion while addressing the pathology. The radioscapholunate (RSL) fusion, accompanied with partial resection of the distal scaphoid, is thought to a...
Article
Full-text available
Background The most effective method and modality for measuring glenoid version for different shoulder conditions is uncertain. Computed tomography (CT) imaging exposes the patient to radiation, and standard magnetic resonance imaging (MRI) does not consistently image the entire scapula. This study investigates the reliability of a new method for a...
Article
Adhesive capsulitis (AC) is a disabling condition of the shoulder joint affecting 2‐5% of the general population. Our understanding of the molecular mechanisms is limited. The present study aimed to determine potential biomarkers of AC through transcriptomic analysis. This multi‐centre study investigated patients undergoing arthroscopic capsulotomy...
Article
Purpose: Lifetime risk estimates can serve as a marker for disease burden in a population and enable health funders and the health workforce to plan for healthcare demand. While the lifetime risk of hip and knee arthroplasty have previously been estimated at national lev- els, this approach has not yet been applied to shoulder arthroplasty. This st...
Article
Introduction Volar plating for distal radius fractures has become common. Screw prominence on the dorsal side from long screws can lead to tendon injury. Methods for detecting screws that penetrate the far cortex involve X-ray or ultrasound. These have focused on the distal row of screws. No studies have addressed screw penetration in the diaphysis...
Article
Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favo...
Article
Background Outcomes following one-surgeon single-anaesthetic sequential bilateral knee arthroplasty (seq-BTKA) compared to two-surgeon single-anaesthetic simultaneous bilateral knee arthroplasty (sim-BTKA) are largely unknown. The current study compared revision rates and all-cause mortality following seq-BTKA versus sim-BTKA using data from the Au...
Article
Full-text available
The work of Professor Richard Page and Dr Stephen Gill, the Barwon Centre for Orthopaedic Research and Education (B-CORE), uses sophisticated and modern technologies to examine gene expression and molecular pathways in painful conditions of the shoulder, including frozen shoulder. Ultimately, they hope to improve quality of life and treatment outco...
Article
Background: The advantages of simultaneous bilateral total knee arthroplasty (sim-BTKA) remain controversial. This study investigated the effects of two-surgeon sim-BTKA compared to separate admission staged BTKA regarding intraoperative and post-operative outcomes and health service costs. Methods: Patients underwent sim-BTKA or staged BTKA bet...
Research Proposal
Full-text available
What genetic polymorphisms or gene expression patterns are associated with rotator cuff tears in humans? Searches All searches were completed on 23rd July 2019, on MEDLINE, Embase and Web of Science. MEDLINE: No restrictions were applied. Embase: No restrictions were applied. Web of Science: Restrictions removed review articles, books, book chapter...
Article
OBJECTIVES: To examine the association between discharge destination (home or inpatient rehabilitation) for adult patients treated in hospital for isolated lower limb fractures and patient-reported outcomes. DESIGN: Review of prospectively collected Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) data. SETTING, PARTICIPANTS: Adults (18-64...
Article
Background: Improved short-term outcomes have been demonstrated with higher surgical volume in shoulder arthroplasty. There is however, little data regarding long-term outcomes. Method: Revision data from the Australian Orthopaedic Association National Joint Replacement Registry from 2004-2017 was analyzed according to 3 selected surgeon volume...
Chapter
Distal biceps rupture is an uncommon injury, usually affects males in their fourth decade or older, and accounts for just 3% of all biceps ruptures. The functional results of non-operative treatment are generally poor, and acute injuries are best treated early with surgical repair. Missed or untreated chronic injuries present a challenge to reconst...
Article
Full-text available
Contemporary data are required to plan interventions and identify gaps in health service provision. As part of the larger Ageing, Chronic Disease and Injury study, we mapped joint replacements across the western region of the Australian state of Victoria. Primary total joint replacement data were extracted from the Australian Orthopaedic Associatio...
Article
Clinical quality registries (CQRs) are an important component of healthcare surveillance and improvement. CQRs have proven to be cost effective for improving clinical care and patient outcomes. The Australian Orthopaedic Association National Joint Replacement Registry is an example of a highly successful internationally recognized CQR, which captur...
Data
Expression profiling by high throughput sequencing Summary We compared genes from tissue of patients with adhesive capsulitis (AC) with those having surgery for shoulder instability to determine potential biomarkers specific to AC through transcriptomic analysis. Our results presented increased expression of PDGFB, COL18A1 and MMP9 in patients wit...
Article
Full-text available
Background: Some unfavorable local events following shoulder arthroplasty occur without the patient experiencing symptoms and yet may be detected on diagnostic imaging, thereby serving as indicators of complications that may require revision. Our aim was to create a standardized protocol for an image-based monitoring process for assessing patients...
Article
Background: In order to implement intervention strategies to prevent falls from height, epidemiological data are needed. The aim of this study was to map emergency presentations for falls from height in residents aged ≥40 yr of the western region of Victoria, Australia. Methods: Emergency presentations following a fall from height (≥1 m) were ob...