Before you get a good answer, sometimes you need to ask the right question. The Priority Setting Partnership (PSP) for Hip and Knee Replacement for Osteoarthritis (OA) reached the end of its process in March this year, producing a list of ten priority areas for further research funding. These are questions that the combined group of healthcare professionals and patients / carers have concluded need addressing first to help continued progress in treating this area of patient health.
An article in this week's Telegraph uses this as proof that good research starts off with the patients. The project is the 20th supported by the James Lind Alliance, who have previously focused on conditions from asthma to schizophrenia, moving each area of research forward.
The ten priorities, which will be addressed by NDORMS and others, are:
- What are the most important patient and clinical outcomes in hip and knee replacement surgery, for people with OA, and what is the best way to measure them?
- What is the optimal timing for hip and knee replacement surgery, in people with OA, for best post-operative outcomes?
- In people with OA, 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 OA?
- 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 OA?
- What is the most effective pre- and post-operative patient education support and advice for improving outcomes and satisfaction for people with OA following hip/ knee replacement?
- What is an ideal post-operative follow up period and the best long-term care model for people with OA who 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?