STAR Trial - Current Research

STAR (Support and treatment after joint replacement)

Many people with severe knee pain because of osteoarthritis have a total knee replacement, which involves replacing the painful knee joint with an artificial joint. Over 75,000 total knee replacements are performed annually by the NHS and as the population continues to age numbers are expected to rise.  People often find that they have pain in the first three months after surgery although most people get better.  About 1 in 5 patients have ongoing pain after 3 months, we call this long-term pain.

The STAR trial: Evaluation of a care pathway for patients with long-term pain after knee replacement. Our proposed study is investigating a new best care pathway to see if it is of benefit to patients with long-term pain after knee replacement. We will recruit 380 patients with pain at 3 months after knee replacement from four hospitals in the UK. Two-thirds of patients will be randomly chosen to receive the STAR care pathway and one-third of patients will receive the usual care that their hospital provides. The STAR pathway involves a clinic appointment with a healthcare professional to better understand the possible causes of pain after knee replacement. People will then be referred to see relevant health professionals for treatment as needed, such as physiotherapists, orthopaedic surgeons, GPs, or pain specialists. We may decide that for some people the most appropriate course of action is to regularly monitor their pain, and then begin treatment if the pain worsens. We will ask everyone in the study to complete questionnaires after 6 months and 12 months to see if the STAR care pathway improves patients’ pain. We will also collect information to compare the cost of providing both treatments. The findings from this study will help us to know if providing the STAR care pathway can improve patients’ outcomes after knee replacement and is good value for money to invest NHS resources.

This project is funded  by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (RP-PG-0613-20001). Due to be completed in 2020.