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Outcomes of cemented and hybrid primary total hip arthroplasty in osteoarthritis: A New Zealand regional study
(The University of Waikato, 2026) Pearce, Amy; Hebert-Losier, Kim; Joshi, Chaitanya
Introduction: Primary total hip arthroplasty (THA) for osteoarthritis (OA) success is typically assessed using implant survival as the primary outcome; however, revision surgery alone underestimates the true burden of suboptimal outcomes (e.g., pain or poor function). Secondary outcomes, or patient-reported outcomes (PROMs), therefore provide a complementary assessment of THA success. During the last two decades, fully cemented THAs have been progressively replaced by uncemented ones, despite limited long-term comparative evidence. Although national registry data allow analysis of broad implant category types, they may lack implant and PROM detail compared to regional registries. This Thesis evaluates whether changes in implant design and fixation strategy have translated into significant and meaningful improvements in implant survival and patient outcomes in the Bay of Plenty region of Aotearoa New Zealand (NZ). Aims: This Thesis aimed to evaluate long-term survival and PROMs of an early generation cemented, modern cemented, and modern hybrid primary THA for OA, and identify patient factors or funding source associated with these outcomes. The work first synthesised existing evidence comparing cemented and hybrid fixation. It then compared survival between the earlier generation THA and its modern cemented successor of the same lineage. Thereafter, the work identified long-term PROMs in earlier generation cemented THA and then compared 10-year PROMs between the two cemented THA generations. Finally, survival and PROM outcomes of the hybrid THA were compared with the modern cemented. Influential patient and funding factors of primary and secondary outcomes were identified across all studies. Methods: This Thesis comprised a systematic literature review and linked retrospective cohort studies using prospectively collected arthroplasty survival and PROM data from the NZ joint registry (NZJR) and Tauranga Orthopaedic Research Inc. registry for the Bay of Plenty region. Patients undergoing primary THA for OA between 2003 to 2023 with earlier generation cemented, modern cemented, or modern hybrid THAs were included. PROMs included the Oxford Hip Score (OHS), McMaster University Osteoarthritis index (WOMAC), and Veterans Rand 12-item health survey (VR-12). Baseline differences were addressed using propensity score weighting. Implant survival was analysed using Cox regression, and PROMs were analysed longitudinally including changes from baseline. Multivariable models examined the influence of sex, ethnicity, age at surgery, body mass index (BMI), American Anesthesiologist Society (ASA) rating, and funding source (public versus private) on outcomes. Results: In the literature, five studies compared survival and three compared PROMs between cemented and hybrid primary THA for OA. Survival outcomes were no different between THAs in three studies, but cemented survival was superior in two studies. PROMs were no different in the three available studies.
Education in the Te Aroha district in the nineteenth century
(Historical Research Unit, University of Waikato, 2016) Hart, Philip
Establishing a school at Te Aroha was delayed while the Education Board waited to see whether the settlement would become permanent. In the interim, temporary arrangements were made. Although some praised the building finally erected, others noted such defects as being cold in winter, and residents met some of the costs of necessary improvements. Details are given of all the teachers, of the development of the school, of the number of pupils, and of the quality of the teaching. At Waiorongomai there was same sequence of erecting and improving the school, and details are given of all the teachers and their teaching. In both communities, residents had to raise money through holding entertainments to fund necessary improvements. Examples of the curriculum are given, along with school inspectors’ reports on the effectiveness of the teaching. Patriotism was emphasized, and corporal punishment was a normal method of control. Irregular attendance handicapped many children’s success, and some parents clearly did not care about sending their children to school regularly. To vary the school year, there were occasional events such as Arbor Day, and a ‘treat’ was held at the end of every year. Providing religious education provoked controversy; and some attempts were made to provide much needed adult education. To conclude, the life of a particularly popular teacher, James William Rennick, is given in as much detail as is available. (Note that ‘most of the early records’ of the Te Aroha school ‘were destroyed by fire’, making a complete history of its early years impossible.)
Neighbourly and unneighbourly behaviour in the Te Aroha district
(Historical Research Unit, University of Waikato, 2016) Hart, Philip
As is to be expected, many examples could be found of neighbourly and unneighbourly behaviour. Because of the nature of their work, miners and indeed settlers generally had to help each other, and ‘fair play’ was a desired ideal. Residents mingled at weddings, funerals, farewells, and patriotic socials. When people were in need, assistance was given and money was raised by special events, and when fires broke out, everyone did their best to save both life and property. Despite such neighbourly acts, there were plenty of examples of quarrelsome residents and rude behaviour. In small settlements, prying and gossiping were endemic. Disliked residents were mocked, some practical jokes were malicious, and some libels were spread. In particular, local government politics provoked much bitterness over minor matters, and rivalry between Te Aroha and Waiorongomai could be friendly in sport but unfriendly on some issues. A detailed example of one prominent resident, Charles Ahier, is provided to illustrate how a pillar of the community was vilified and how he vilified his critics. Newspapers sometimes provided biased reporting, fanning the flames of petty disputes. But overall, squabbles were outweighed by positive interactions.
“Eles Deturpam o Que Tu És”: Coloniality, resistance, and the reconfiguration of colonial power in Quilombos of Amapá, Brazil
(The University of Waikato, 2026) Farias da Silva, Brenda; Norris, Adele N.
This thesis examines the persistence and reconfiguration of colonial structures in Brazil’s northern region, focusing on the state of Amapá – a critical borderland of Amazonian modernity. With a particular focus on Quilombos (formerly-enslaved Black settlements), it addresses the central argument that coloniality, understood as the enduring matrix of power, race, and knowledge established during the European conquest, continues to shape the present. While state and corporate narratives portray the Amazon region as a site of sustainable progress, this study aims to demonstrate how colonial logics of isolation, extractivism, and silencing persist under the banner of development and conservation. A decolonial and interpretive methodology combining qualitative semi-structured interviews was employed to answer three interrelated questions: (1) How have colonial structures of racial, spatial, and epistemic domination persisted and been reconfigured in Brazil’s northern region, particularly in Amapá? (2) How do Quilombola women from Amapá experience and resist intersecting forms of racialized labor and territorial dispossession? (3) How do decolonial frameworks enhance our understanding of the relationship between racial capitalism, gendered violence, and the afterlives of slavery in northern Brazil? Participants’ narratives, practices, and silences were analyzed as contributions to theorize coloniality, survival, and epistemic disobedience. The findings reveal that racial capitalism in Amapá operates not only through extractive economies but also through established colonial regimes that devalue subaltern knowledge while maintaining racial hierarchies. The legacies of historical servitude and land dispossession persist through bureaucratic omission and policy frameworks that privilege private and corporate interests over collective rights. In response, communities articulate diverse forms of resistance that merge political action, cultural continuity, and strategic silence. Ultimately, this thesis argues that decolonial practices are not abstract ideals but lived behaviors emerging from the endurance and creativity of those who continue to resist distortion and erasure. Research findings contribute to decolonial theory by reterritorializing coloniality within the Amazonian frontier and advancing a decolonial research praxis grounded in ethical rigor, linguistic fidelity, and co-produced knowledge. Findings offer critical insight into how racial capitalism and epistemic domination are contested through localized acts of survival, reinterpretation, and creation.
Pictures in the substantiation of organisation: a study of radiology
(The University of Waikato, 1992) McArthur, William; Bettison, David; Goldsmith, Michael
The motivation for this study is an interest in technologically produced imagery and its effect on the contemporary world. Natural events, pictures, diagrams, paintings, spectacular performing arts, icons, etc, are persistent features in the repertoire of language for expressing and constituting knowledge. Much of present day common sense knowledge, however, is constituted through observation made in direct, yet technologically mediated ways. From television to computer graphics and radiographs, a plethora of technologies offer visual experience of a kind available only through techno-scientific means. Using technical instruments requires constructs created by user’s and see-er’s. Language that evolves, is often interpretable only through a unique cultural practice dependent on expertise. Technically produced imagery raises issues of individual and collective interpretation. The thesis method is eclectic to discern the complexity this involves. Intertwining of technical and scientific modes of professional conduct is examined through the implication of Galilean discovery, by way of the technical effects of glass in the 17th Century, and Roentgen’s accidental discovery through x-rays in the late 19th Century. Field work centers on issues pertinent to technologically mediated knowledge. This involved a small group of radiologists in the hospital of a provincial New Zealand city. Engaged variously in difficult radiographic interpretation, they are teaching newly qualified doctors entering the radiological profession to successfully “see” the imagery evoked by the radiograph. Medical practitioners, and especially radiologists, are a profession required specifically to develop skills of image and sign interpretation. Fundamental to their accountability is intersubjective agreement on what is “seen” on a radiograph and other technical equipment. The third dimension of “depth” has to be accurately imputed to a two dimensional radiograph. Radiological “objectivity” is the outcome of collective discourse. Central to this discourse is a specific employment of particular metaphors. Metaphorical transferrence occurs during the process of diagnosis as the interpreter moves between what is seen on the radiograph and his or her medical repertoire. Diagnosis through the inspection of visual items involves the skilled (but often intuitive) decoding of complex systems of iconic and symbolic (conventional, arbitrary) signs. Diagnosis is sanctioned by collective agreement accomplished through dialogue. The basis of the radiological code is an inextricable use of metaphor and metonymy in the syntagmatic construction of an image. The nature of what is seen on the radiograph is based on the notion of caricature. This implies that the person who can interpret a radiograph is able to “see” in it the embodiment of some image which may be completely obscure to the uninitiated. Caricature interpretation is fundamental to constituting the typifications of daily life. This has particular significance in what might be termed a “techno visual” life-world.