Is a one-year routine check-up needed after hip or knee replacement?

Cost-effectiveness of Routine Follow-up at One Year After Total Hip and Knee Arthroplasty Compared to Check-up on Demand: a Multicenter Hybrid Stepped-wedge Cluster De-implementation Study

This study will see if skipping the routine one-year clinic visit and using check-up on demand is safe and works well for people aged 50 and older after total hip or knee replacement.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 1000 (estimated)
• Ages: 50 Years and up
• Sex: All
• Sponsor: JointResearch (other)
• Locations: 9 sites (Amsterdam and 8 other locations)
• Trial ID: NCT06971757 on ClinicalTrials.gov

What this trial studies

HAKA WP1 compares routine 1-year clinic follow-up (including an x-ray) with a check-up-on-demand approach after primary total hip or knee arthroplasty. Eligible patients aged 50 and older with osteoarthritis who undergo primary THA or TKA are enrolled and assigned to one of the two follow-up strategies. Main outcomes at one year include patient-reported physical function (PROMIS), pain, and healthcare consumption, with the option for extra visits if concerns arise. The goal is to determine whether reducing routine visits can lower healthcare use and costs without worsening patient outcomes.

Who should consider this trial

Good fit: People aged 50 or older scheduled for primary total hip or knee replacement for osteoarthritis who can read Dutch or English, complete questionnaires, and provide informed consent.

Not a fit: Patients undergoing revision surgery, those operated for indications other than osteoarthritis, people with limited ability to report symptoms or access care quickly, or those already enrolled from a prior joint surgery are less likely to benefit from reduced routine follow-up.

Why it matters

Potential benefit: If successful, the approach could reduce unnecessary hospital visits and save time and costs while maintaining patient outcomes and access to care when needed.

How similar studies have performed: Some prior work suggests routine early follow-up often finds few unrecognized problems and that on-demand follow-up is promising, but large-scale randomized evidence confirming safety and cost savings is limited.

Eligibility criteria

Inclusion Criteria:

* Painful and disabled hip or knee joint resulting from osteoarthritis
* Scheduled for primary THA or TKA surgery
* Age 50 years or older at the time of THA or TKA
* Capable and willing to complete questionnaires
* Proficient in Dutch or English
* Willing to provide informed consent

Exclusion Criteria:

* Other indication for surgery than osteoarthritis
* Scheduled for hip or knee revision arthroplasty, except a conversion from unicompartmental knee arthroplasty to TKA or from hip hemiarthroplasty/resurfacing to THA
* Already participating in this study due to a previous hip or knee surgery

Where this trial is running

Amsterdam and 8 other locations

• OLVG — Amsterdam, Netherlands (RECRUITING)
• Amphia — Breda, Netherlands (RECRUITING)
• Deventer Ziekenhuis — Deventer, Netherlands (RECRUITING)
• Admiraal de Ruyter Ziekenhuis — Goes, Netherlands (RECRUITING)
• Martini Ziekenhuis — Groningen, Netherlands (RECRUITING)
• Tergooi MC — Hilversum, Netherlands (RECRUITING)
• Canisius Wilhelmina Ziekenhuis — Nijmegen, Netherlands (RECRUITING)
• ZorgSaam Zeeuws Vlaanderen — Terneuzen, Netherlands (RECRUITING)
• RHOC — Zoetermeer, Netherlands (RECRUITING)

Study contacts

• Study coordinator: Lidy A.C. Roubos, MSc.

Conditions: Hip Arthroplasty, Total, Knee Arthroplasty, Total, total hip arthroplasty, total knee arthroplasty, follow-up, PROMIS physical function, healthcare consumption