Hip & Knee Replacement for Osteoarthritis Top 10
- What are the most important patient and clinical outcomes in hip and knee replacement surgery, for people with osteoarthritis, and what is the best way to measure them?
- What is the optimal timing for hip and knee replacement surgery, in people with osteoarthritis, for best post-operative outcomes?
- In people with osteoarthritis, what are the pre-operative predictors of post-operative success (and risk factors of poor outcomes)?
- What (health service) pre-operative, intra-operative, and post-operative factors can be modified to influence outcome following hip and knee replacement?
- What is the best pain control regime pre-operatively, peri-operatively and immediately post-operatively for hip and knee joint replacement surgery for people with osteoarthritis?
- What are the best techniques to control longer term chronic pain and improve long term function following hip and knee replacement?
- What are the long-term outcomes of non-surgical treatments compared with operative treatment for patients with advanced knee/hip osteoarthritis?
- What is the most effective pre and post-operative patient education support and advice for improving outcomes and satisfaction for people with osteoarthritis following hip/knee replacement?
- What is an ideal post-operative follow up period and the best long term care model for people with osteoarthritis that have had hip/knee replacement?
- What is the best way to protect patients from the risk of thrombotic (blood clots, bleeding) events associated with hip/knee replacement?
The following questions were also discussed and put in order of priority at the workshop:
- What are the differences in characteristics between those patients who benefit from knee/hip joint replacement and those who do not?
- What is the most effective Enhanced Recovery Programme for patients with osteoarthritis undergoing knee/hip joint replacement surgery?
- What non-surgical treatments can reduce the need for hip/knee replacement?
- What is the optimum pre-operative management for best outcome for knee/hip replacement for people with osteoarthritis?
- Are patients with a history of metal allergy at risk of poor/failed outcome due to an allergic response to the metal hip/knee implant?
- Are shared decision-making support (aids) for guiding patient choice of hip/knee replacement effective (and cost effective) in managing patients with hip/knee osteoarthritis?
- What is the best type of prosthesis/implant for best and safest outcomes?
- What factors contribute to deterioration and post-operative stiffness following knee/hip joint replacement surgery?
- What is the cost-effectiveness of knee/hip joint replacement and the best financial model for the management of patients with osteoarthritis?
- Does attendance at a pre-operative 'hip/knee school' reduce the length of post-operative stay in people with osteoarthritis undergoing knee/hip joint replacement?
- What causes and what is the best treatment for prolonged orthostatic hypotension in patients following hip/knee replacement surgery?
For more details of the Top 10 questions identified by this PSP, please see the document below.