Letter of Intent for Fellow of JRS

Dear Fellowship Oversight Committee,

I am putting my hand up to submit a formal application for founding fellow status in Joint Replacement Surgery as an ACVS Diplomate. This status would recognise my historical and continued interest in canine joint surgery, in particular JRS. I would like to become involved in a multinational Fellowship training program, participating from Australia as an instructor / mentor to those Diplomates pursuing advanced training in this area. I actually wrote my application prior to the first 2021 deadline two years ago, which has been submitted to ACVS, but delays with references, during the beginning of the Covid pandemic, resulted in an incomplete application from my end and as such I effectively did not apply.

I would be honoured to receive the acknowledgment of becoming a Founding Fellow in this subspecialty of orthopaedic surgery. In brief, my interest began when exposed to cemented hip arthroplasty as a surgical intern at Queensland Veterinary Specialists under the mentorship of Drs G. Robbins and R. Eaton-Wells, grandfathers of surgery in Australia. I was accepted into a surgical residency training program, within North America at the University of California, where Drs K. Schulz and P. Vasseur were regularly performing THRs and conducting research in this area. I was fortunate to become proficient in THR during my residency. My research project was to develop an in vitro loaded limb model to study elbow contact patterns (two publications in AJVR / resident research award VOS 1999) and this model has since been used to study SHO and other periarticular osteotomies.

I believe I had both Australian and US recognition and leadership as a joint replacement surgeon, along with suitable credentials (senior author on >3 publications, having extensive clinical experience and having participated in resident and specialist training), prior to the March 2021 deadline, to be eligible for the status of a Founding Fellow.

I believe I have been the leader of canine joint surgery in Australia for many years. It began with being the first Australian vet in 2000 to perform both TPLO and knee arthroscopy for cruciate disease as well as SHO for elbow dysplasia in the years after that (Vet Surgery papers published on: meniscal tears post arthroscopic TPLO S. Kalff 2011, SHO to treat elbow OCD R. Quinn 2014). I was the first vet in Australia to employ a physiotherapist in 2004, install an underwater treadmill and publish on the effect of physical therapy (Underwater treadmill post TPLO, M. Monk 2006 AJVR). I introduced cementless hip, unicompartmental elbow, total elbow (cemented followed by cementless) and knee arthroplasty to Australia. I was President of the Surgery Chapter of the ANZCVS 2013-2015 and organised an Arthroplasty Conference featuring Dr B. Liska as keynote speaker and engineer / CEO BioMedtrix C. Sidebotham. I have been invited to the US multiple times to present my clinical experience with CUE, SHO and TKR at National and industry meetings (Arthrex VA3/ BioMedtrix). I am currently involved in designing a novel THR system with industry in Australia with the goals of offering easier implantation and competitive pricing so more patients have access to this procedure.

I believe, after extensive consultation with KOLs and specialists of all levels of ability, that many surgeons fear and avoid JRS. I would enjoy the opportunity to participate in research and teaching of JRS to others both here in Australia and internationally in the latter part of my career.

Yours sincerely

Dr Chris Preston BVSc MANZCVs FANZCVS DipACVS

Demonstration of Leadership:

Presented at WSAVA, WVOC, ACVS , VOS, CSW (annual Australian National Specialist Conference called College Science Week) on TER, CUE, TKR, THR

Abstract:

Two stage TKR to treat end-stage septic arthritis – 6 cases 2014 WVOC

Unpublished manuscripts:

Early femoral component subsidence using a porous coated press-fit collarless cementless stem (see abstract)

Correlation between femoral offset and stem alignment with mechanical complications after BFX THR (see abstract)

Invited podium presentations:

Clinical experience THR 2007 WSAVA

Clinical experience CUE 2016 VA3

Clinical experience TKR 2016 ACVS

Overview of TKR experience 2018 BioMedtrix Symposium of JRS

My experience with JRS 2019 CSW

THR learning curve 2022 CSW

Novel canine THR system 2022 CSW

Invited panelist 2018 BioMedtrix Symposium of JRS:

Femoral fissures and fractures

The difficult acetabulum

The future of canine TKR

Contributing author on two additional THR papers (not primary nor senior author)

Iwata D, Broun HC, Black AP, Preston CA, Anderson GI.

Vet Comp Orthop Traumatol. 2008;21(3):221-30.

Iwata was primary author, Preston was not senior author

Luxation following Press-fit Cementless Total Hip Replacement in Dogs: Novel Techniques for Predicting and Treating Post-Operative Luxation

2019 Masters Thesis University of Melbourne Dr Isobel Monotti

Supervised Dr I. Monotti, visiting resident external JRS rotation from Melbourne University 2018 (1 point). Dr Monotti gained firsthand exposure to CUE, TER, TKR, primary and revision THR procedures

Manuscript reviewer for Journal of Veterinary Surgery:

Prophylactic cerclage to prevent proximal periprosthetic femur fracture following 184 cementless collared stem total hip replacement in dogs – Veterinary Surgery

3D-printed, Patient-specific Cutting Guides Improve Femoral and Tibial Component Alignment in Canine Total Knee Replacement – Veterinary Surgery

DPO to manage dorsal luxation after THR – Veterinary Surgery

References:

Dr William Liska, Founding Fellow of JRS, Global Veterinary Specialists

Prof Loïc Déjardin, FF MIS, Head of SA Orthopaedics, Michigan State University

Prof Simon Roe, FF JRS, Retired Chief of SA Orthopaedics, North Carolina State University

Dr Isobel Monotti, DECVS