Measuring Suitability for Joint Replacement Surgery

Currently, clinical trials of disease modifying drugs for OA primarily consider structural (x-ray and MRI) and symptomatic variables (including joint replacement surgery) as markers for the evaluation of study outcomes. However, the decision to proceed with joint replacement surgery is not only related to the progression of the disease, but also to other factors, such as patients’ personal preferences for OA treatment, concomitant diseases, referring physician’s opinions, and the structure of the health care system.

An initiative by the OARSI and OMERACT societies to identify the best outcome measures that can be used in clinical trials resulted in the development of a new set of questions, or “tools”, to assess OA pain and function. These tools are intended to identify subjects for whom joint replacement surgery is indicated. By testing these tools in the context of joint replacement consultation, the objective of this study is to establish a set of criteria that can be used to establish the need for joint replacement surgery in future clinical trials.

This is an international study taking place in ten different countries. In Canada, the participating study sites are located in Toronto, Edmonton and Red Deer. Patients with OA will be recruited from orthopaedic surgeon’s offices prior to their first consultation for joint replacement surgery. Subjects are asked to complete a questionnaire regarding their pain and function of their affected joint Following consultation, the surgeon will be asked to document whether the patient has been recommended for joint replacement surgery and if not, then why not. This information will be used to establish a set of criteria for considering joint replacement surgery using this set of pain and function measurement tools.


Gillian Hawker, Aileen Davis, Nizar Mahomed, Allan Gross, Hans Kreder, Allyson Jones, Tim Pearce


Melissa French, Jennifer MacInnis


Last modified: Sept. 6, 2009