Osteoarthritis, Osteoarthritis, Hip, Osteoarthritis, Knee, Osteo Arthritis Knee
Conditions
Brief summary
Total joint replacement is a highly successful treatment option for people affected by severe osteoarthritis (OA), however, the mismatch between resources and demand for this surgery means that many patients face long wait times while enduring worsening pain and disability. The Alberta Hip and Knee Program is a centralized intake system for patients referred for total joint replacement assessment. Over 3000 patients are assessed annually at the Calgary location (Alberta Hip and Knee Clinic at Gulf Canada Square) where previously patients waited an average of 43 weeks for a surgical consult then an additional 30 weeks until surgery. Given that many elective surgeries in Alberta have been cancelled in response to the COVID19 pandemic, these wait times have increased significantly, with no clearing of the surgical backlog for the foreseeable future. Long wait times for patients can become a spiral of more debility, less mobility, and subsequent weight gain. The current standard of care for patients with obesity awaiting surgery provides little support or guidance beyond general advice about the importance of a healthy weight and remaining active. This waiting period represents an untapped window of opportunity to intervene and help patients with obesity and OA to lessen their disease burden and improve overall health, while addressing patient priorities such as regaining lost function and improving quality of life. Many patients with osteoarthritis also have obesity. The best practices in obesity treatment requires a multidisciplinary approach. Our aim is to conduct a pilot randomized controlled trial (RCT) to evaluate the feasibility of incorporating the multidisciplinary Alberta Obesity Centre program into the clinical care pathway for patients with obesity and OA while they await surgical evaluation at the Alberta Hip and Knee Clinic at Gulf Canada Square. The results of this feasibility trial will help inform a larger scale trial that will be powered for clinical and health economics outcomes.
Interventions
BEHAVIORALAlberta Healthy Living Program
Weight management services
BEHAVIORALAlberta Obesity Centre Program
Multi-disciplinary obesity management
BEHAVIORALOsteoarthritis advice
Living Your Best Life with Osteoarthritis Handbook
BEHAVIORALPhysiotherapy
GLA:D physiotherapy programs.
Sponsors
University of British Columbia
University of Calgary
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
parallel-arm randomized trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* body mass index (weight in kilograms divided by height in metres squared) greater than 30 * symptomatic osteoarthritis (referred to the Alberta Hip and Knee Clinic for assessment for total joint replacement surgery)
Exclusion criteria
* Currently following a specialized or therapeutic diet * pregnant or breastfeeding * diagnosed with type 1 diabetes * unable to read or speak English * unable to use email * unable to use virtual platforms such as Zoom
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine the number of adults with osteoarthritis and obesity that are eligible to participate in the trial | 0-12 months | The number of patients approached |
| The number of these adults with osteoarthritis and obesity who would be willing to take part in this trial | 0-12 months | The number of patients who actually enroll |
| The characteristics of these adults with osteoarthritis and obesity who are willing to take part in the trial | 0-12 months | Patient sex, gender, age, and medical history |
| The number and percentage of participants retained at 12-months | 0-12 months | Number and percentage of patients attending at 12-month follow up and reasons for drop-out |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in blood lipid profile | 0-12 months | blood lipids |
| Change in glycemic control | 0-12 months | glycated hemoglobin (HbA1c) |
| Change in body mass | 0-12 months | Change in body mass (weight loss) |
| Change in medication usage | 0-12 months | All prescription medications will be tracked and recorded by a study physician |
| Change in quality of life | 0-12 months | Quality of life measured by the Alberta Bone and Joint Health Institute Hip and Knee Replacement Outcomes Tool |
| Decision to proceed with joint replacement surgery | 12 months | Yes/no decision to proceed with joint replacement surgery |
| Change in waist circumference | 0-12 months | waist circumference (centimetres) |
| Change in blood pressure | 0-12 months | blood pressure (millimetres of mercury) |
Countries
Canada
Outcome results
None listed