Donald Howie

Donald Howie

Adelaide Medical School

Faculty of Health and Medical Sciences


Professor Howie is Clinical Director of the Royal Adelaide Hospital Orthopaedic and Trauma Service, Head of the University of Adelaide Discipline of Orthopaedics and Trauma and Co-Clinical Director of the Centre for Orthopaedic and Trauma Research, University of Adelaide, established 2012. As a senior orthopaedic surgeon, he has an international reputation specialising in joint replacement, focussing on complex revisions and hip reconstruction in young patients.

Professor Howie has an international reputation as both a practicing surgeon and scientist, with regular invitations as a guest lecturer at international meetings. He has been a previous Chairman, Hip Section, Asia Pacific Orthopaedic Association, and is an invited member of the 60-member International Hip Society (the first of only two Australians). He is also a recently invited member of the American Hip Society. Professor Howie is a reviewer for JBJS(Br) and CORR, highly ranked journals in the discipline, and is on the editorial board of/or reviewer for 5 other orthopaedic journals. He has had continuous funding by the NHMRC over 20 years. He has to date 105 publications (periprosthetic bone loss, implant wear, clinical management, RCTs). His work has been cited 2521 times and his H-index is 28 (Thomson ISI).

A major aim of my professional career has been to foster interdisciplinary collaboration in research between those involved in clinical management, basic science, bioengineering, pathology and epidemiology. This has been successful to the extent that our Department, with its collaborators, is recognised internationally as one of the leading academic centres in orthopaedics.

Major scientific achievements have been in the field of joint replacement and prosthesis loosening, the subject of my doctoral thesis, and, more particularly, research into the tissue response to prosthesis-derived wear particles and the causes and management of pathological bone loss around total joint replacement. For example, my animal model was the first to confirm periprosthetic bone loss from wear particle induced inflammation. An important focus of our research has been the collection of human tissue at the time of revision surgery and implant retrieval which has been underway for over two decades. This has allowed us to focus on studies of human cells. More recently our bone biology research has found a direct link between metal and polyethylene particles and key mediators of human osteoclast formation and bone resorption in periprosthetic tissues and that particles directly induce a change in the phenotype of mature osteoblasts and osteocytes, consistent with a net loss of bone adjacent to orthopaedic implants.

From the clinical perspective, 25 years ago I recognised the need for a consistent and long-term approach to clinical outcomes research and established a prospective patient outcomes database that, to this day, remains an important source of clinical and patient-derived data and has facilitated a number of important publications on outcomes of joint replacement. My appreciation of the need for epidemiological expertise in undertaking clinical research led to collaboration with an epidemiologist and to us successfully undertaking one of the largest international multi-centre randomised controlled trials in orthopaedic surgery. This RCT established that large articulations in THR significantly reduced the incidence of dislocation, leading to major changes in clinical practice. Other RCTs in THR are currently underway.

Close collaboration with international centres of expertise led to the establishment of one of the first radiostereometric analysis (RSA) facilities in Australia, enabling accurate assessment of implant migration and polyethylene wear and novel investigations into the use of RSA to monitor fracture and soft tissue healing. The current application is based on our approach to joint replacement research, which is to combine in one research team the capability to use the internationally recognised best surrogate measures that predict the success or failure of joint replacement, in this study, the use of RSA for to measure prosthesis wear.

  • Appointments

    Date Position Institution name
    2011 - ongoing Co-Director University of Adelaide
    2000 - 2009 Affiliate Member Hanson Institute
    1992 - ongoing Clinical Director of Orthopaedic and Trauma Service Royal Adelaide Hospital
    1989 - ongoing Honorary Associate Institute of Medical and Veterinary Science
    1988 - ongoing Professor and Head University of Adelaide
  • Awards and Achievements

    Date Type Title Institution Name Country Amount
    2012 Award Australian Orthopaedic Association Award for Orthopaedic Research - - -
    1995 Award Advance Australia Award for Outstanding Contribution in Medicine. - - -
  • Education

    Date Institution name Country Title
    1987 University of Adelaide Australia Ph.D.
    1984 Royal Australasian College of Surgeons Australia F.R.A.C.S.
    1974 Monash University Australia M.B.,B.S.
  • Research Interests

Research Funding  1989-current 
National Health and Medical Research Foundation
Howie DW, Pearcy MJ, Haynes D. Wear particle induced bone resorption causing joint prosthesis loosening. $133,454. 1991-1993.
Howie DW, Pearcy MJ, Graves SE. Osteolysis and loosening of prostheses. $193,333. 1994-1996.
McGee MA, Howie DW Equipment grant. Automatic tissue processor and grinder to process implant-bone sections.$20,000. 1996.
Vernon-Roberts B, Howie DW, Leong AS-Y, Haynes DR, Graves SE. Cell biology and drug control of loosening of joint prostheses. $161,100. 1996-1998
Findlay DM, Haynes DR, Howie DW, To BL. Requirements for human osteoclast generation. $177,335. 1998-2000.
McGee MA, Howie DW, Field J, Findlay MA  NHMRC equipment grant: -86degree freezer  . $6,000. 1999.
Howie DW,  Graves SE, Holubowycz O, McGee MA Hip instability following metal on metal versus metal on polyethylene total hip replacement: A randomised clinical trial.$183,505. 1999-2001.
Hearn TC, Krishnan J, Howie DW. NHMRC Equipment Grant – Orthopaedic Scanning Workstation $10,000. 1999
Howie DW, Holubowycz OT, McGee MA.   The effect of head size on hip instability and wear following total hip replacement.  $187,174. 2000-2002.
Haynes DR, Findlay DM, Vernon-Roberts B, Howie DW. Cell regulation in periprosthetic bone loss. $318,630. 2000-2002
Findlay DM, Haynes D, Howie D, McGee M.  The factors that cause bone loss around orthopaedic hip prostheses. $350,000. 2003-2005.
Findlay D, Haynes D, Howie D, Atkins G, Crotti T.  Bone loss causes implant failure. $505,000. 2006-2008
Howie D, Field J, Forwood M, Morgan D, McGee M, Hearn T. Determination of irradiation dose efficacy for use in impaction grafting at revision joint replacement.  $393,550. 2007-2009
Howie D, Nivbrant B.   Radiostereometric analysis of the effect of a large articulation on prosthetic wear and migration after hip replacement.  $183,700.  2008-2010.
Haynes DR, Atkins GJ, Howie DW, Crotti T. Finding ways to make orthopaedic implants last longer. $387,750.  2009-2011.
Howie DW. The risks and benefits of contemporary total hip replacement.  $476,313. 2010-2012
Howie DW, Solomon LB. A randomised controlled trial examining stability of new types of highly porous surfaced acetabular components in total hip replacement $209,795. 2012-2014
Findlay DM, Atkins GJ, Haynes D, Howie DW. The role of osteocytes in particle induced osteolysis. $441,669. 2013-2015.  

Total NHMRC funding $4,338,308

 

Peer Reviewed
Howie DW. Total joint arthroplasty implant analysis.Adelaide Bone and Joint Research Foundation, Inc. $53,250. 1989
Howie DW. The implant interface. Royal Adelaide Hospital Research Review Committee. $22,000. 1989.
Howie DW. A study grant for Ms M. McGee, Technical Officer, for training in Utah Implant Analysis Laboratory and UCLA Bone Implant Lab. Adelaide Bone and Joint Research Foundation, Inc. $4,050. 1989
Howie DW,  Steele-Scott CM. Cemented versus cementless joint arthroplasty. Australian Orthopaedic Association. $6,200. 1989
Howie DW, McGee MA. Histological analysis of failed resurfacing hip arthroplasty components. Royal Australasian College of Surgeons, W Norman Fellowship. $28,000. 1990
Howie DW, Pearcy MJ. A rat model of wear particle induced bone resorption. Adelaide Bone and Joint Research Foundation. $8,180. 1990
Howie DW, Pearcy MJ, McGee MA. Femoral tapered stem total hip arthroplasty model in sheep. Royal Adelaide Hospital Research Review Committee.$14,000. 1990.
Howie DW, McGee MA Histological assessment of the failure mechanisms of retrieved cemented and cementless arthroplasty implants. Clive and Vera Ramaciotti Foundations. $20,000. 1991
Howie DW, Pearcy MJ. Femoral bone strength, morphometry and imaging related to initial fixation of total hip arthroplasty components. Australian Orthopaedic Association. $9,200. 1991
Howie DW, Pearcy MJ. Wear particles and joint prosthesis loosening.Royal Australasian College of Surgeons. $5,000. 1991
Howie DW, Graves SE, McGee MA, Pearcy MJ. Bone Graft Substitute Materials for Fractures and Traumatic Bone Loss. Royal Adelaide Hospital, Research Review Committee. $16,000. 1992
Howie DW, McGee MA, Pearcy MJ. Histological assessment of the implant-bone interface of retrieved joint replacement implants prepared using ground histology methods. University of Adelaide.  $1,642. 1992.
Howie DW, Pearcy MJ, Brumby SA, McGee MA The Influence of Femoral Component Surface Finish and Design on Loosening of Cemented Hip Arthroplasty. Australian Orthopaedic Association. $9,000. 1992
Pearcy MJ, Fraser RD, Howie DW. Mechanics of the spine, ligaments, joints and orthopaedic devices. Adelaide Bone and Joint Research Foundation.  $16,850. 1992
McGee MA,  Parkinson IH, Pearcy MJ, Howie DW. Quantitative elemental analysis of tissues surrounding failed joint replacements - correlation with histological parameters. JD&JH Gunn Medical Research Foundation. $8,000.  1993
Pearcy MJ, Fraser RD, Howie DW. Mechanics of the spine, joints and orthopaedic devices. Adelaide Bone and Joint Research Foundation. $17,750. 1993.
Howie DW. Joint replacement Registry - pilot study. Australian Orthopaedic Association. $10,000. 1994.
Howie DW, Pearcy MJ, Graves SE. Osteolysis and loosening of prostheses. Royal Adelaide Hospital Special Purposes Fund. $15,000. 1994.
Howie DW, Pearcy MJ, Graves SE. Osteolysis and loosening of prostheses. Royal Australasian College of Surgeons. $10,000. 1994.
Howie DW, Pearcy MJ, Graves SE. Osteolysis and loosening of prostheses. Australian Orthopaedic Association.  $6,661. 1994
Howie DW, Lambert LL, McGee MA. Clinical Trial of SF-36. $5,000. South Australian Health Commission. 1995
Howie DW, Pohl AP,  Fraser RD, Graves SE, Sandow MJ,  Pearcy MJ. Relationship between biocompatiblity of implant materials and clinical results of surgery.        Bristol-Myers Squibb/Zimmer Unrestricted Grant Programme. $350,000. 1995.
Haynes DR, Vernon-Roberts B, Howie DW. The pathobiology of cell-implant interactions. Australian Research Council. $9,000. 1996.
McGee MA, Howie DW, Costi K. Metal concentrations in serum and urine of patients undergoing metal-on-metal or metal-on-polyethylene total hip replacement. Australian Orthopaedic Association. $7,500. 1999
Howie DW,  McGee MA, Holubowycz O Dislocation and subluxation following total hip Replacement: incidence costs and outcomes.Australian Orthopaedic Association. $9,000. 1999
Haynes DR, Findlay DM, Howie DW. Cell regulation and periprosthetic bone loss. Uni of Adel  Medical School. $10,000. 1999
Haynes DR, Howie DW, Findlay D, McGee MA. Osteoclastogenic mediators in premature failure of joint replacement prostheses. Royal Adelaide Hospital Research Review Committee. $13,570.1999.
Costi K, McGee MA, Howie DW. The mid-term success of total hip and knee replacement surgery:Survivorship and outcomes analyses of cases documented on a prospective joint replacement outcomes database Australian Orthopaedic Association. $13,571. 2001
Findlay DM, Howie DW, Atkins GJ. The cells and molecules involved in human osteoclast formation. The Rebecca L. Cooper Medical Research Foundation Ltd. $16,000. 2001
Howie DW, Costi K, McGee MA. A clinical review of the mid-term success of total hip and knee replacement surgery, and factors influencing success. Royal Adelaide Hospital Research Review Committee. $7,500. 2003.
Howie D.   Irradiated versus non-irradiated bone graft in femoral impaction grafting at revision hip replacement – in-vivo. University of Adelaide. $12,000.  2005.
Howie DW, Neale SD, McGee MA, Taylor DJ, Findlay DM.  The factors influencing the progression of osteolysis around hip replacement. Uni of Adelaide Research Development Award. $10,000. 2006
Howie DW, Taylor DJ. Understanding the natural history of osteolysis progression around total hip replacement. Australian Orthopaedic Association Research Foundation. $15,969. 2006
Howie D, Costi J, Carbone A, Callary S, McGee M. Irradiated versus non-irradiated bone graft in femoral impaction grafting – in vitro assessment of initial prosthesis/bone construct stability. . Australian Orthopaedic Association Research Foundation.  $24,550. 2006
Howie DW, Nivbrant B, Holubowycz O.Radiostereometric analysis of the effect of a large articulation on wear and migration after hip replacement – an RCT. Uni of Adelaide Research Development Award.  $12,000. 2006.
Howie D, McGee M, Taylor J.   The detection of periprosthetic osteolysis around total knee replacements in a human cadaver model. Australian Orthopaedic Association Research Foundation. $26,955.  2007.
Howie D. Polyethylene wear and migration of acetabular components following total hip replacements with a large articulation  Royal Adelaide Hospital/IMVS Research Committee, $20,000. 2008.
Howie DW, Holubowycz O, Callary SA. Polyethylene wear and migration of acetabular components following total hip replacement with a large articulation.  Australian Orthopaedic Association Research Foundation.  $23,225. 2008.
Solomon LB, Chehade MC, Howie DW, Callary SA, Carbone T, Stevenson A. A review of treatment methods and radiographic and clinical outcomes of patients  with tibial plateau fractures. Australian Orthopaedic Association Research Foundation. $28,725. 2008.
Howie DW.  University of Adelaide RIBG. RSA Calibration Cage. $25,000. 2012
Callary SA, Costi K, Solomon LB, Abrahams J, Howie DW. Defining the acceptable upper limits of early migration of acetabular components in revision total hip replacement. Royal Adelaide Hospital Research Review Committee. $30,000. 2014.
Callary SA, Costi K, Howie DW, Solomon LB. Electronic storage and access of Joint Replacement and Reconstruction patient data and radiographs. $22,665. RAH Research Foundation - Infrastructure Block Grants. 2014.

Total other peer reviewed funding $973,013

 

Industry
Howie DW, Pearcy MJ, Haynes DR,  Rogers SD. Comparison of the effects of metal alloy particles on human monocytes in vitro. Sulzer International, Switzerland. $39,270. 1995-1996.
Howie DW, McGee MA, Knight T.Prospective non-interventional study documenting peri and postoperative blood loss associated with total hip replacement surgery. Bioplasma. CSL. $7,500. 1999.
Howie DW. Establishment of a Radiostereometric Analysis Facility. Zimmer Ltd. $120,000. 2000
Findlay DM, Howie DW. Interaction of human osteoblasts with tantalum and trabecular metal. Zimmer Ltd.  $42,200. 2001-2002
DW Howie, M McGee, OT Holubowycz. Comprehensive literature review of primary total hip replacement. Zimmer Ltd.  $27,770. 2001-2002
Howie DW, Findlay DM, McGee MA A grant for bone research, including a pilot study of Zometa in osteolysis of hip replacement. Novartis Pharmaceuticals Australia Pty Ltd. $50,000. 2001-2002
Howie DW, Findlay DM, McGee MA. Sheep OP-1 femoral impaction grafting pilot study.Stryker Biotech. $107,472. 2001-2002.
Howie DW. Collarless polished taper outcomes and profiles study. Zimmer Ltd $28,000. 2002
Howie DW, Holubowycz OT, McGee MA. RSA of wear of large versus standard diameter Longevity cross-linked polyethylene liners and migration of acetabular components in a randomised clinical trial of total hip replacement.  Zimmer Ltd. $180,542. 2002
Howie DW, Findlay DM, McGee MA, CarboneA, Bruce W.  Sheep Hemiarthroplasty Model of Femoral Impaction Allografting. Evaluation of hydroxyapatite (HA) as a bone graft substitute. Apatech UK. $54,926. 2002-2003.
Howie DW, Page T, McGee MA. Literature review of THR-Phase 2. Zimmer Ltd. $44,774. 2002-2003.
Howie DW, Taylor J, Findlay DM, McGee MA, Pannach S. The use of bisphosphonates for the treatment of bone loss around total hip replacement prostheses. Novartis Pharmaceuticals Australia Pty Ltd. $44,000. 2003
Howie D. Upgrade of Radiostereometric Analysis Facility. Zimmer Ltd. $48,000. 2005.
Howie DW, Holubowycz OT.   A multi-centre randomised controlled trial comparing fixation of tantalum trabecular metal versus titanium fibre metal acetabular components with screws. Zimmer Ltd. US$73,300. 2005-2007.
Chehade MJ, Solomon LB, Pohl AP, Howie DW, Carbone T, Taylor A. Health outcomes of patients with fractures of the hip according to fracture type, treatment and patient preinjury mobility. Stryker Australia Pty Ltd. $60,000, 2008-2009.
Howie DW, Holubowycz OT. Randomised controlled trial of 36 vs 28 mm articulations in total hip replacement – 7 years follow-up. Zimmer Ltd.  $258,000, 2011-2013.
Howie DW, Callary SA, Holubowycz OT. Radiostereometric (RSA) analysis of the stability of trabecular metal acetabular reconstructions at revision THR in the presence of severe bone loss. Zimmer, $48,766. 2014.

Total Industry funding $1,234,520

  • Past Higher Degree by Research Supervision (University of Adelaide)

    Date Role Research Topic Program Degree Type Student Load Student Name
    2016 - 2020 Principal Supervisor Acetabular Component Migration Following Revision Total Hip Replacement Doctor of Philosophy Doctorate Part Time Mr John Matthew Abrahams
    2010 - 2017 Principal Supervisor Wear of Highly Cross-Linked Polyethylene in Primary Total Hip Replacement Doctor of Philosophy Doctorate Part Time APrf Stuart Adam Callary
    2009 - 2015 Co-Supervisor A Comparison of Wear of 36mm and 28mm Metal-on-Highly Cross-Linked Polyethylene Articulations in Primary Total Hip Replacements Master of Surgery Master Part Time Dr Mario Giuseppe Tedesco Zotti
    2002 - 2009 Principal Supervisor Computed Tomography Technique for the Measurement of Bone Defects Adjacent to Uncemented Acetabular Components of Total Hip Replacement Master of Surgery Master Part Time Dr Roumen Botev Stamenkov
  • Other Supervision Activities

    Date Role Research Topic Location Program Supervision Type Student Load Student Name
    2018 - ongoing Principal Supervisor Measuring acetabular coverage on supine and standing radiographs in dysplastic hips The University of Adelaide Undergraduate Medical Research Project Other Part Time Amey Bahnushali
    2018 - ongoing Principal Supervisor Retrospective review of peri-prosthetic femoral fractures following primary total hip replacement The University of Adelaide Undergraduate Medical Research Project Other Part Time Darcy Noll
    2016 - 2018 Principal Supervisor Migration of highly porous acetabular components The University of Adelaide Undergraduate Medical Research Project Other Part Time Thomas Robertson
  • Memberships

    Date Role Membership Country
    2012 - ongoing - Hip Society, USA – Emeritus Member -
    2004 - 2007 - Hip Section Chairman – AsiaPacific Orthopaedic Association -
    1998 - ongoing - Girdlestone Orthopaedic Society United Kingdom
    1997 - ongoing - International Orthopaedic Association -
    1996 - ongoing - Overseas Member Calcar Club United Kingdom
    1995 - ongoing Board Member Asia Pacific (formerly Western Pacific) Orthopaedic Association - Hip Section -
    1994 - 1997 - Overseas Fellow British Orthopaedic Association (by invitation) -
    1994 - ongoing - Corresponding Fellow, New Zealand Orthopaedic Association (by invitation) -
    1993 - ongoing - Australian Arthroplasty Society -
    1992 - ongoing - International Hip Society -
    1991 - ongoing - Australian and New Zealand Orthopaedic Research Society -
    1989 - ongoing - Asia Pacific (formerly Western Pacific) Orthopaedic Association -
    1989 - 2007 - Societe Internationale De Chirurgie Orthopedique et de Traumatologie (S.I.C.O.T.) -
    1987 - ongoing - Fellow Australian Orthopaedic Association -
    1987 - ongoing - Orthopaedic Research Society (American) -
    1984 - ongoing - Royal Australasian College of Surgeons -
    1982 - 1986 - Associate Australian Orthopaedic Association -

Connect With Me
External Profiles

Other Links