Osteoarthritis and arthroplasty

Leader: Professor Ashley Blom with Mr Michael Whitehouse and Dr Nicki Walsh

Overall aims

To establish an evidence-based integrated patient pathway in osteoarthritis (OA) from diagnosis, through non-surgical self-management, to post-surgical outcome across community, primary and secondary care services.

Projects and activities

We have increased the proportion of older patients receiving cemented hip replacements from 40 to 92 per cent across Bristol, resulting in better outcomes for patients and savings at North Bristol NHS Trust of £170,000 per year. We are working with the West of England Academic Health Science Network to take this forward on a regional scale.

In primary care, we have shown that integrated exercise and self-management group programmes for lower limb OA improve pain and function in the long-term, and are a more cost-effective strategy than GP care alone. Dr Nicki Walsh is working with the local clinical commissioning groups to explore ways of rolling this out more widely, including an internet-based resource providing programme materials, and community-based delivery to achieve greater reach.

Our ongoing analysis of National Joint Registry data is providing internationally significant findings that are changing practice nationally and internationally. We are focussing on long-term outcome, including patient outcomes and implant survivorship.

Research in progress

  • Investigating the clinical and cost-benefits of physical activity and self-management interventions for people with multiple joint pain
  • Developing a patient-facing website to support physical activity and self-management
  • Working with leisure centres to determine the feasibility of locating physical activity and self-management interventions for OA within these locations
  • A multi-centre randomized controlled trial in different ways of treating infected joint replacements
  • Predicting and improving outcome following hip and knee replacement