Osteoarthritis Preoperative Package for care of Orthotics, Rehabilitation, Topical and oral agent Usage and Nutrition to Improve ouTcomes at a Year (OPPORTUNITY)

Opportunity project

Osteoarthritis the fastest growing cause of disability, with a lifetime risk of 45%, and is predicted to be the fourth leading cause of disability worldwide by 2020. In general, patients with more severe osteoarthritis require knee replacement surgery, with approximately 85,000 knee replacement surgeries conducted annually in the UK. However, dissatisfaction with the outcome of surgery is reported in around 20% of these cases, which is partially attributed to poor pre-operative health and physical function.

The overall aim of the randomised controlled OPPORTUNITY trial is to investigate the feasibility of a pre-operative care package to improve patient health and physical functioning prior to surgery as a means of improving post-operative outcomes, in comparison to standard care. This pre-operative intervention consists of a weight loss programme, exercise, painkiller advice, and provision of insoles. This study aims to recruit ~60 participants who are listed for total knee replacement surgery at selected hospitals in NHS Lothian and Leeds Teaching Hospitals NHS Trust, in collaboration with the University of Edinburgh and the University of Leeds. The primary outcomes of this feasibility study are: recruitment rates, retention rates, and intervention adherence. Secondary outcomes include: knee pain, physical function, weight loss, and patient satisfaction.

In addition, a process evaluation will further explore acceptability, feasibility, adherence, and possible barriers to the implementation of this intervention using various qualitative and quantitative methods. Specifically, the following elements will be investigated: context; fidelity; exposure; reach; recruitment and retention; contamination; the control arm, and; mechanisms of impact. This will provide valuable data to inform the design and developmental of a full-scale trial.



Hamish Simpson, University of Edinburgh
Elaine Kinsella, University of Edinburgh
Hemant Pandit, University of Leeds
Phillip Conaghan, University of Leeds
David Hamilton, University of Edinburgh
Catherine Hankey, University of Glasgow
Colin Howie, University of Edinburgh
Sarah Kingsbury, University of Leeds
Gordon Murray, University of Edinburgh
John Norrie, University of Edinburgh
Chris Tuck, University of Edinburgh
Catriona Keerie, University of Edinburgh

MRC/CSO Social and Public Health Sciences Unit logo 800 wide