Evaluating the use of non-operative osteoarthritis treatments prior to total knee replacement: a feasibility study

Disease - Osteoarthritis

Lead applicant - Professor Hamish Simpson

Organisation - University of Edinburgh

Type of grant - Clinical Studies

Status of grant - Active

Amount of the original award - £202,752.53

Start date - 1 July 2017

Reference - 21395

Public Summary

What are the aims of this research?

The aim of the OPPORTUNITY study is to assess the feasibility of running a large scale, controlled trial to evaluate whether non-operative osteoarthritis treatments prior to surgery improve outcomes of total knee replacement. This will highlight the strengths and weaknesses of such a trial and determine whether it would be useful to undertake. The non-operative treatments provided before knee replacement surgery will consist of weight loss, an exercise programme, pain relief and footwear review.

Why is this research important?

There is good evidence that pain relief medication, physiotherapy, shock absorbing shoes/insoles and weight loss can reduce pain in people with knee osteoarthritis. Unfortunately, these measures are often not improved before the patient has a total knee replacement, as the uncontrolled pain symptoms make it difficult for people with osteoarthritis to diet or adhere to physiotherapy. However, these steps are important to build up muscles prior to surgery, and a reduction in pain symptoms can help improve quality of life.

The researchers will use people with osteoarthritis, who have just been placed on a waiting list for total knee replacement, to assess the feasibility of a large-scale clinical trial to increase the use and effectiveness of non-operative treatments prior to surgery. Use of patient insight and involvement ensures the trial design is suitable, and allows for the measurement of recruitment rates, making sure participants are adhering to the treatments and continuing to take part in the study.

How will the findings benefit patients?

If this study shows that recruitment and retention of patients would be successful, and the treatment will be acceptable to deliver, then the next stage would be to perform a larger, controlled trial to improve and observe the use of non-operative treatments. The outcomes of this research could have an immediate benefit to people with osteoarthritis by reducing their symptoms prior to surgery and reducing their complication rate post-surgery. Combined, this should improve patient outcome following joint replacement surgery and improve health-related quality of life.