Dr. Jesse Wolfstadt

• 2024–present; Granovsky Gluskin Chair in Complex Orthopaedic Reconstruction, Mount Sinai Hospital, Sinai Health, Toronto
• 2024–present; Head, Granovsky Gluskin Division of Orthopaedics, Mount Sinai Hospital, Sinai Health, Toronto 
• 2020–present; Assistant Professor (Cross-Appointment), Institute for Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto
• 2020–present; Associate Member, School of Graduate Studies, University of Toronto, Toronto
• 2018–present; Courtesy Staff Privileges, Department of Surgery (Orthopaedics), Women’s College Hospital, Toronto
• 2018–present; Fellowship Instructor, Adult Lower Extremity Reconstruction Fellowship, Division of Orthopaedics, Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto
• 2018–present; Assistant Professor, Division of Orthopaedics, Department of Surgery, University of Toronto, Toronto
• 2018–present; Staff Orthopaedic Surgeon, Division of Orthopaedics, Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto

• Insall Traveling Fellowship, The Knee Society, USA; 2023
• Canadian Orthopaedic Association Emerging Leaders Program; 2022–2023
• U.S. Department of Veterans Affairs National Quality Scholars Fellowship Program (NQSFP); 2018–2020
• Trauma Fellowship, Auckland City Hospital, Auckland, New Zealand; 2018
• Lower Limb Reconstruction and Traumatology Fellowship, St. Michael’s Hospital, University of Toronto, Toronto; 2017
• Adult Lower Extremity Reconstruction Fellowship, Mount Sinai Hospital, University of Toronto, Toronto; 2016–2017
• MSc, Quality Improvement and Patient Safety, Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto; 
• MD, Faculty of Medicine, University of Toronto, Toronto; 
• BSc (Honours), Kinesiology and Health Science, York University, Toronto;

• 2025 – Distinguished Educator Award, Sinai Health, Toronto
• 2023–2024 – MD Program Teaching Award for Excellence, Faculty of Medicine, University of Toronto, Toronto
• 2022–2023 – MD Program Teaching Award for Excellence, Faculty of Medicine, University of Toronto, Toronto
• 2022 – Orthopaedic Chair’s Teaching Award for contributions to orthopaedic education as voted by the residents, Division of Orthopaedics, Department of Surgery, Temerty Faculty of Medicine, Toronto
• 2021 – CIHR Fellowship Program, Canadian Institutes of Health Research (CIHR), Health Research Training B-HP committee, Canada
• 2020 – Surgical Skills Centre DH Gales Outstanding Educator Award, Department of Surgery, University of Toronto, Toronto
• 2019 – Distinguished Educator Award, Sinai Health, Toronto
• 2018–2019 – MD Program Teaching Award for Excellence, Faculty of Medicine, University of Toronto, Toronto
• 2016 – Most Outstanding Graduate 2015/16 Academic Year, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto
• 2015 – James P. Waddell Orthopaedic Resident Award for clinical and academic excellence, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto
• 2015 – Paul McGoey Teaching Award for outstanding orthopaedic resident of the year, St. Michael’s Hospital, Division of Orthopaedic Surgery, Toronto

DIFFIR

The Distal Femur: Fixation versus Replacement (DIFFIR) trial is a multi-centre randomized controlled study investigating the optimal surgical treatment for fragility fractures of the distal femur in older adults. Currently, open reduction internal fixation (ORIF) is the standard of care, but distal femoral replacement (DFR) has been proposed as a potential alternative. Despite its growing use, there is little high-level evidence directly comparing the two approaches. This study aims to fill that gap by evaluating outcomes of ORIF versus DFR in patients 65 years or older.

Participants will be followed for two years to assess outcomes and determine which surgical approach provides better results for this population.  

pDIFFIR

The Periprosthetic Distal Femur: Fixation versus Replacement (pDIFFIR) trial is a multi-centre randomized controlled study investigating the optimal surgical treatment for fragility periprosthetic distal femur fractures of those with prior knee replacements in older adults. Standard treatment with open reduction internal fixation (ORIF) has shown variable results, while distal femoral replacement (DFR) has been proposed to be another alternative, despite its limited supporting evidence. Existing data have largely been retrospective, with a few high-quality comparisons. Thus, this trial was designed to provide prospective robust data by comparing ORIF and DFR to determine the optimal surgical approach for these complex fractures.  

Participants will be followed for two years to evaluate outcomes and help define best practice for managing geriatric periprosthetic distal femur fractures. 

PROVISION 

The Perioperative Vitamin C to Reduce Persistent Pain after Total Knee Arthroplasty (PROVISION) trial is a multi-centre pilot randomized controlled study. This pilot trial aims to assess the feasibility of recruiting and following patients undergoing total knee arthroplasty randomized to perioperative vitamin C or placebo. It will evaluate site compliance and determine the resources needed for a larger trial. Secondary objectives include exploratory analyses on persistent pain (at 3 and 12 months), pain characteristics, analgesic use, development of Complex Regional Pain Syndrome, physical and emotional function, cognitive outcomes, patient satisfaction, quality of life and adverse events.

Participants will be followed for one year to inform the design of a future large-scale trial aimed at improving pain outcomes after knee replacement surgery. 

PREVENA

This pilot randomized controlled trial will evaluate the feasibility and effectiveness of the Prevena™ Peel & Place™ negative pressure wound therapy (NPWT) system compared to standard NPWT (granufoam with 3M™ V.A.C. Ulta or ActiV.A.C.) in patients undergoing surgery for knee prosthetic joint infection (PJI). NPWT has proven benefits in wound healing and reducing surgical site infections but also poses logistical challenges such as delays in coordinating home care support and equipment; this ultimately prolongs hospital stays and patients remained admitted longer than medically necessary.  

The Prevena offers advantages including portability, a seven-day wear time, reduced need for dressing changes, and improved patient mobility. This study hypothesizes that its use will reduce hospital stay by three days compared to standard NPWT.

20 patients will be randomized (10 per group) to receive either Prevena or standard NPWT. All patients will receive NPWT at –125 mmHg for two weeks postoperatively. Outcomes assessed over one year include length of stay (primary outcome), alternate level of care days, surgical site infection, PJI recurrence, emergency department visits, readmissions, outpatient wound care and quality-adjusted life years (QALYs). A cost-effectiveness and cost-utility analysis will also be conducted. The findings of this study will provide critical insights into the feasibility and cost effectiveness of the Prevena in the surgical management of knee PJI. 

Stiffness + LDI 

The Treatment of Acquired Idiopathic Stiffness in Revision Total Knee Arthroplasty with Hinged Knee Prosthesis With or Without Low Dose Irradiation (LDI) trial is a multi-centre randomized controlled trial that will investigate whether low-dose irradiation (LDI) improves outcomes for patients with acquired idiopathic stiffness (AIS) after total knee arthroplasty (TKA). AIS is a debilitating complication caused by excessive scar formation, leading to pain, loss of motion and functional impairment. While revision surgery with a hinged prosthesis allows removal of scar tissue, many patients continue to experience stiffness and poor outcomes.

LDI is a safe, established therapy with anti-fibrotic effects, used in other conditions involving abnormal scar formation. Retrospective studies and a recent systematic review suggest LDI may improve and sustain range of motion (ROM), but it has never been systematically studied in AIS. This trial aims to evaluate whether LDI reduces pathological scar formation and improves ROM, patient-reported function and overall outcomes without increasing complications.

Patients will be randomized to receive either standard revision surgery with hinged prosthesis alone (control) or the same surgery plus a single session of postoperative LDI (intervention). The primary outcome is ROM at one year. Secondary outcomes include patient-reported function, repeat surgeries, complications and healthcare utilization.  

ROADMAP 

The Randomized Arthroplasty infection worldwide Multi-domain Adaptive Platform (ROADMAP) trial is an international study testing different treatments for prosthetic joint infections (PJIs) of the hip and knee. These infections are serious complications after joint replacement, often leading to repeat surgeries, long courses of antibiotics, and reduced quality of life. The Canadian arm (led by Dr. Kandel, Michael Garron Hospital) will recruit about 580 patients, making up a quarter of the total sample size worldwide.

The study will examine four main areas of treatment: 

1. Types of surgery.
2. Length of antibiotic treatment.
3. Use of preventative (prophylactic) medications.
4. Role of rifampin-based therapies.

The primary outcome is whether treatment works at 12 months, measured by infection control, keeping the joint in place and survival without the need for lifelong antibiotics.

ROADMAP uses an adaptive design. This approach aims to improve patient outcomes, reduce complications and create clearer guidelines for managing PJIs worldwide.