Patients Prospectively Recruited in Knee and Hip Arthroplasty.

Hip and knee replacement arthroplasties relieve pain and improve
physical functioning and quality of life. However, some patients suffer
from persisting pain or are not satisfied with the outcome. Several
studies have suggested risk factors for poor outcome after hip and knee
replacement arthroplasty; however, most studied cohorts are relatively
small (n<800), which makes correcting for confounding factors
problematic. This larger cohort (n=3000) enables us to study all
suggested risk factors and the possible correlations between them, while
correcting for confounding factors.
By determining risk factors for poor outcome after hip and knee
replacement arthroplasty, it will be possible to influence these
factors, in order to optimalise the outcome of hip and knee replacement
arthroplasty.



Aseptic loosening is the main cause of failure of hip and knee
replacement arthroplasty in the long term. Several studies have
suggested variances in immunomodulating genes as a possible contributor
to aseptic loosening; however, group sizes were too small to draw any
firm conclusions (n<90). In this current study, we aim to study the
influence of immunomodulating genes on aseptic loosening in a larger
patient cohort (n=3000) A better understanding of the underlying process
of aseptic loosening will make it possible to determine the prognosis of
prosthesis loosening more accurately.



Osteoarthritis is the most frequent indication for hip and knee
arthroplasty. Conversely, the indication for hip and knee replacement
arthroplasty can be viewed as the final stage in the pathophysiology of
osteoarthritis. Recent studies showed that genetics play an important
role in the pathophysiology of osteoarthritis. By comparing genetic
variations between patients in final stage osteoarthritis and matched
controls with a less severe clinical manifestation of osteoarthritis, a
better understanding of the pathophysiology of osteoarthritis can be
obtained.

1. What are the determinants of quality of life of hip and knee replacement arthroplasty at long term follow-up?

2. Which genetic factors are associated with aseptic loosening in hip and knee replacement arthroplasty?

3. Which genetic determinants predispose to hip or knee replacement arthroplasty due to osteoarthritis?

Patients will be sent questionnaires on Quality of Life every year, until revision hip or knee surgery takes place.



Questionnaires used are: Oxford Hip Score, Oxford Knee
Score, HOOS, KOOS, Squash, EQ-5D, SF-36, IPQ en comorbiditeit according to
CBS.

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