In this month’s newsletter, we would like to introduce PhD graduate, Melanie Amarasooriya from the College of Medicine and Public Health.
Melanie’s recently submitted thesis, “Assessment of in vivo kinematics of the normal and scapholunate instability wrist using dynamic CT scan” received outstanding results from the examiners.
We asked Melanie to share what led her to a Phd and why it is important, the most enjoyable and hardest parts of a PhD journey and what the future holds.
What was the topic of your PhD and why was it important to you?
Assessment of in vivo kinematics of the normal and scapholunate instability wrist using dynamic CT scan.
As a hand and wrist surgeon it gives me a deep and broad understanding of the subject. And it answers the questions that many of us have. Also sheds a light as to how we should progress in future research.
Tell us about your research
Scapholunate instability (SLI) is the most common carpal instability, accounting for 5% of wrist sprains. The diagnosis of SLI is often missed. Even when diagnosed and treated, the clinical outcomes are far from ideal. Possible reasons for this include the poor understanding of the biomechanics of SLI and objective dynamic assessment not being a major part of its management.
In large joints, such as the knee or shoulder, surgical decisions are largely supported by dynamic assessment. The wrist, due to its complex anatomy, precludes such dynamic clinical assessment. In this context, dynamic (4D) CT provides a unique advantage due to its ability to scan the patients’ wrist during movement. This doctoral thesis presents concepts and techniques to objectively measure kinematic changes in SLI compared to a normal wrist. These objectively measurable parameters enable better diagnosis, aid in surgical decision-making, and provide insights into designing reconstruction techniques for SLI.
Tell us about yourself
I am an orthopaedic surgeon from Sri Lanka, came for my fellowship in hand and upper limb surgery to Adelaide. I worked with Prof Greg Bain from Flinders University (Photo) for my fellowship, and then decided to get enrolled for a PhD on “Wrist Biomechanics”. I am the first and the only woman trained as an orthopaedic surgeon in my country. I have a family that lives in Melbourne, and a 12-year-old son, that is the biggest blessing in my life.
What led you to undertake a PhD? What inspired or motivated you?
Being an upper limb surgeon I was curious about how the wrist works and its biomechanics.
Working with Greg inspired me to explore that at a deeper and a more meaningful level.
What was one of the most enjoyable parts of the journey?
Analysing the results was the most enjoyable part. Any PhD candidate would work through hard times that seems endless, collecting data and organising them. Then when we analyse them, we can interpret them, create the story trying to explain all those findings. It is the most enjoyable and rewarding part of the PhD.
In addition, I really enjoyed presenting in conferences, where you would meet people with similar interests and brainstorm together.
What has been one of the hardest parts of the journey?
Finances. The transition from being in a very comfortable position of an ‘consultant orthopaedic surgeon’ to a “full time student” in a new environment was not easy.
My supervisor being an orthopaedic surgeon himself, really understood and supported me to navigate this.
What was the highlight of your student life at Flinders?
Being elected to the student’s union, FUSA.
In the year 2021/2022, even as a ‘non-Australian’ immigrant, a woman and a mature student (Whatever the minority, I represent that), I received the highest number of votes in the student election. That was a surreal moment. I took up the position of post graduate student officer; and represented FUSA at the academic senate
How did your supervisors support you during your candidature?
The supervisors were the strength I had.
My principal supervisor Prof Greg Bain found me two significant grants to support me financially. He also personally funded the high-end computer equipment worth of Aud 12000, that the study needed. He spent time and energy, to develop new concepts through this project. He mentored me to persevere and push boundaries. Hence, I have dedicated my thesis to Prof Bain. I would not have completed this one time without his guidance.
My associate supervisor Dr Al-Dirini helped me with the technical concepts. Also, he was there supporting me at every challenge, shared his experience, motivated me to progress and make right decisions.
Kim, Dr Kimberley Bryant, my associate supervisor is also someone I am eternally grateful for. In addition to her role in supporting the project, she was the person who taught me the skills and importance of paying attention to details, time management, being organised, being efficient.
How did you overcome any challenges of doing a PhD?
Dedicated myself to work, trying to avoid time thinking and analysing too much. Reached out regularly to my support groups, supervisors, colleagues, family and friends.
I also worked as a tutor in Flinders and Adelaide Universities, so teaching medical students. That helps financially and also to break the monotony.
What advice would you give to those who are about to undertake a PhD?
It is hard work and define your “why”. If you have a strong reason as to why you should do this, you will persevere during challenging times. Be honest and intrinsically motivated.
Break your PhD to little chunks of time. Reward yourself with something you love when reaching the milestones. I would schedule a conference I am presenting at least every 6 months, that gave me something to look forward to.
Start writing early. My 1st chapter at was written in the first year itself and I modified close to submission. That helps with timely completion.
How has your PhD helped you in the role you are in now?
From a technical point of view, the PhD has given me a deep understanding of the subject matter in my filed as a wrist surgeon/ clinician. Now as a clinician I can make better decisions and also teach others. In addition, I have gained the skills to be analytical and logical and to communicate better in scientific forums. I have had lot of networking opportunities to connect with people with similar academic interests that massively helped my career progress.
What have you been doing since you completed?
I am clinically working as a consultant orthopaedic surgeon in Sri Lanka. Also, I teach medical and biomedical engineering students as a lecturer in the University of Moratuwa, Sri Lanka. I am actively involved in Trauma Secretariat of Sri Lanka and travel around the country teaching junior medical officers. Also, I am an ATLS (international) instructor. I supervise few medical and engineering students on their research projects.
Have you published anything?
- Amarasooriya M, Al-Dirini R, Bryant K, Bain GI. Scaphoid kinematics in scapholunate instability: a dynamic CT study. Skeletal Radiol. 2023 Aug;52(8):1557-1566. doi: 10.1007/s00256-023-04323-6. Epub 2023 Mar 23. PMID: 36951995; PMCID: PMC10276782.
- Amarasooriya, M., MacLean, S., Bain, G.I. (2022). Clinical Biomechanics of the Wrist. In: Bhatia, D.N., Bain, G.I., Poehling, G.G., Graves, B.R. (eds) Arthroscopy and Endoscopy of the Elbow, Wrist and Hand. Springer, Cham.
- Bain GI, Amarasooriya M. Scapholunate instability: why are the surgical outcomes still so far from ideal? J Hand Surg Eur Vol. 2023 Mar;48(3):257-268. doi: 10.1177/17531934221148009. Epub 2023 Feb 17. PMID: 36799288.
- MacLean, S., Amarasooriya, M., & Bain, G. I. (2022). Functional Anatomy of the Wrist.Arthroscopy and Endoscopy of the Elbow, Wrist and Hand: Surgical Anatomy and Techniques, 553-561.
- Amarasooriya M, Jerome TJ, Tourret L. Current Concepts in Scapholunate Instability Without Arthritic Changes. Indian J Orthop. 2023 Mar 7;57(4):515-526. doi: 10.1007/s43465-023-00839-0. PMID: 37006727; PMCID: PMC10050294.
- Amarasooriya M, Al Dirini R, Bryant K, Ian Bain G. Radiocarpal and midcarpal kinematics in scapholunate instability: a four-dimensional CT study in vivo. J Hand Surg Eur Vol. 2024 May 23:17531934241242676. doi: 10.1177/17531934241242676. Epub ahead of print. PMID: 38780127.
These are my publications relevant to thesis. In addition I have done over 10 Australian and International presentations.