HAKA: Routine Follow-up at 10 Years After Hip- or Knee Arthroplasty: Wasting Resources or Appropriate Healthcare?

Condition(s) studied

Investigational drug(s) / intervention(s)

Routine Follow-Up (RFU): Standard follow-up care with scheduled X-ray, clinical visit and questionnaires at 10 years after surgery

Active Check-Up on Demand (ACOD): X-ray, clinical visit and questionnaires at 10 years after surgery when requested by the patient or healthcare provider.

Passive Check-Up on Demand (PCOD): X-ray and clinical visit (without questionnaires) at 10 year when requested by the patient or healthcare provider.

Study summary

After undergoing total hip or total knee arthroplasty, current guidelines recommend routine follow-up with an X-ray within 3 months and again at 1 year. Follow-up at 5 years (for hip arthroplasties) or every 5 years (for knee arthroplasties) is also considered worthwhile according to the guideline. However, these follow-up appointments require considerable time from patients, caregivers, and healthcare professionals, and it is unclear whether they are truly beneficial. It is possible that a single follow-up within 3 months is sufficient. This could potentially prevent over 100,000 unnecessary hospital visits per year, resulting in significant cost savings. If patients or healthcare providers have concerns, they can always request an additional follow-up.

The HAKA trial consists of three different work packages (WPs). This trial (WP2) investigates the 10-year follow-up, WP1 examines the 1-year follow-up, and WP3 is a qualitative study exploring the experiences and perceptions of patients and healthcare professionals. The aim of the HAKA trial is to safely reduce routine follow-up appointments after total hip or knee arthroplasty and to revise current clinical guidelines accordingly.

Eligibility

Primary outcome measure(s)

• Number of complications — Assessed until 11 years after implantation
  The total number of post-operative complications per patient will be recorded.
• Type of complications — Assessed until 11 years after implantation
  Complication types will be recorded and categorized (e.g., infection, periprosthetic fracture, loosening, malalignment, dislocation, prosthetic wear).
• Healthcare consumption — Assessed at 10 years after implantation and then at 3 months, 6 months and 12 months.
  Healthcare consumption related to THA and TKA FU (number of X-rays and clinical visits)

Trial sites (1)

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