Longitudinal Leiden Orthopaedics Outcomes of OsteoArthritis Study

The number of people undergoing total hip, total knee or shoulder replacement
surgery is growing. The majority of these patients has a favorable outcome with
respect to pain, function and quality of life. In a small group of patients
however the results are disappointing. Until now, despite the availability of
hip, knee and shoulder registries and a considerable number of studies on the
outcomes in terms of prosthesis survival, joint function and quality of life,
few studies have focused on the impact of total hip, knee and shoulder surgery
on societal participation (physical activity, sports, paid and unpaid work) and
on health care usage, including rehabilitation. Information to patients on more
general less favourable outcomes, ranging from complications to the sequelae
after joint replacement surgery is often lacking. For that matter, an analysis
of including patient reported outcome before and after revision surgery,
progression of osteoarthritis in other joints (after the replaced joint) as
well as presence of more general complications like and venous thromboembolism
are important before a patient can make well balanced decision with his
orthopaedic surgeon to have a joint arthroplasty. These collected data will
give input to preventive measures reducing less favourable outcome to patients,
is lacking as well. Moreover, concerning the predictors of outcome, currently
available studies did not comprehensively include the role of personal factors
such as treatment expectancies nor preoperative pain sensitisation on outcome.

Given the above mentioned gaps in knowledge, the aim of this project is to
1) Describe the midterm and long-term outcomes of (primary and revision) total
hip, total knee and shoulder replacement surgery in terms of health status as a
whole, including the levels of body functions and structures, daily activities,
participation in society, health care usage, and complications of joint
replacement surgery, such as venous thrombosis as well as progression of the
*disease* osteoarthritis in other joints.
2) Determine which factors predict the outcomes of elective primary and
revision total hip, total knee and shoulder replacement surgery, as mentioned
under aim 1.
The results of this analysis will contribute to a better selection of patients
who will profit most from elective primary and revision total hip, total knee
and shoulder replacement surgery and to tailored rehabilitation treatment
strategies, as well as prevention of complications after joint replacement
surgery.
The aims will be achieved by setting up a structure for building a large,
standardized database regarding the outcomes of hip, knee and shoulder
replacement surgery, called LOAS (Longitudinal Leiden Orthopaedics Outcomes of
Osteoarthritis Study). The structure of this database will be aimed to be like
*The String of Pearls Initiative* (*Het Parelsnoer Initiatief*,
www.parelsnoer.org).

This project has a multicenter, longitudinal (prospective) design, and includes
all consecutive patients undergoing hip or knee surgery in 9 general hospitals
and one university hospital in the region Zuid-Holland, Noord-Holland and
Overijssel in The Netherlands. The duration of the study is 23 years in total,
with the inclusion period being 13 years and the duration of follow-up 10
years. For longer-term follow-up additional ethical consent will be requested.

This study is observational in nature, is embedded in standard treatment
(primary total hip, total knee or shoulder arthroplasty surgery in patients
with hip, knee and shoulder osteoarthritis) and mainly consists of
questionnaires.