The Multiknee Trial
Effectiveness and cost-effectiveness of a multidisciplinary intervention in total knee arthroplasty – a multicenter randomized controlled trial
Project owner:
Lovisenberg Diaconal Hospital.
Principle Investigator:
Principle Investigator MultiKnee
CO-PIs
Anners Lerdal, RN, PhD, Research Director
Arild Aamodt, MD, PhD, Orthopaedic Surgeon.
Summary:
One in five patients report chronic pain following total knee arthroplasty (TKA). This population of non-improvers are characterized by a poorer psychological state prior to surgery. Thus, psychological interventions such as cognitive behavioral therapy (CBT) may improve pain and function both for patients with osteoarthritis (OA) and those undergoing TKA.
Project period: 2018 - 2028
Material and methods:
The MultiKnee trial is conducted at three of the largest orthopaedic centers in Norway: Lovisenberg Diaconal Hospital Oslo, Martina Hansens Hospital, Bærum, and Kysthospitalet Hagevik, Os. The inclusion of 282 patients was completed in 2024 and patients will be followed for 2 years. The study is pre-registered at ClinicalTrials.gov: NCT03771430 11/12/2018. The full protocol for the study is available at: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04924-z
Aims and sub-studies:
The MultiKnee trial is a multicenter randomized controlled trial to test the effectiveness of patient education, exercise therapy and internet-delivered CBT (iCBT) either instead of, or in addition to TKA, compared to usual care consisting of TKA surgery and usual care follow-up.
PhD dissertations
Unni Olsen (2024): Advancing the understanding of preoperative factors and patient experiences related to pain and physical function after total knee arthroplasty
Turid Rognsvåg (2025): A multidisciplinary intervention tailored to knee osteoarthritis patients at risk of chronic pain after total knee arthroplasty
Scientific publications
Buset Bergvad, Ingvild; Lerdal, Anners; Lindberg, Maren Falch.
Cross-cultural adaptation and validation of a Norwegian version of the Goodman Satisfaction Score (GSS-NO) for patients with total hip and knee arthroplasty. Acta Orthopaedica 2025. PMID: 39804812. DOI: 10.2340/17453674.2024.42703
Olsen, Unni Solveig Johansen; Sellevold, Vibeke Bull; Gay, Caryl; Aamodt, Arild; Lerdal, Anners; Småstuen, Milada Cvancarova; Dihle, Alfhild; Lindberg, Maren Falch. Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study. BMC Musculoskeletal Disorders 2024 ;Volum 25.(1) PMID: 38167008 DOI: 10.1186/s12891-023-07125-y
Rognsvåg, Turid; Buset Bergvad, Ingvild; Furnes, Ove Nord; Indrekvam, Kari; Lerdal, Anners; Lindberg, Maren Falch; Thorgaard Skou, Søren; Stubberud, Jan; Badawy, Mona. Exercise therapy, education, and cognitive behavioral therapy alone, or in combination with total knee arthroplasty, in patients with knee osteoarthritis: a randomized feasibility study. Pilot and Feasibility Studies 2024 ;Volum 10. s. PMID: 38419024 DOI: 10.1186/s40814-024-01470-y
Rognsvåg, Turid; Kismul Nordmo, Ingrid; Buset Bergvad, Ingvild; Fenstad, Anne Marie; Furnes, Ove Nord; Lerdal, Anners; Lindberg, Maren Falch; Skou, Søren Thorgard; Badawy, Mona. Digital health literacy in Norwegian patients with hip and knee arthroplasty: normative data from a cross-sectional study. Acta Orthopaedica 2024 ;Volum 95. s. 677-684
Olsen, Unni; Lindberg, Maren Falch; Rose, Christopher James; Denison, Eva Marie-Louise; Gay, Caryl; Aamodt, Arild; Brox, Jens Ivar; Skare, Øystein; Furnes, Ove; Lee, Kathryn A.; Lerdal, Anners. Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis. PLOS ONE 2023 ;Volum 18.(3). PMID: 36961863 DOI: 10.1371/journal.pone.0283446
Olsen, Unni; Lindberg, Maren Falch; Rose, Christopher James; Denison, Eva Marie-Louise; Gay, Caryl; Aamodt, Arild; Brox, Jens Ivar; Skare, Øystein; Furnes, Ove Nord; Lee, Kathryn; Lerdal, Anners. Factors Correlated with Physical Function 1 Year after Total Knee Arthroplasty in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis. JAMA Network Open 2022 ;Volum 5.(7) s. 1-15 PMID: 35816307 DOI: 10.1001/jamanetworkopen.2022.19636
Lindberg, Maren Falch; Aamodt, Arild; Badawy, Mona; Bergvad, Ingvild Buset; Borchgrevink, Petter Chr.; Furnes, Ove Nord; Gay, Caryl; Heir, Stig; Holm, Inger; Indrekvam, Kari; Kise, Nina Jullum; Lau, Bjørn; Magnussen, Jon; Nerhus, Tor Kjetil; Rognsvåg, Turid; Rudsengen, Daniil; Rustøen, Tone; Skou, Søren Thorgaard; Stubberud, Jan Egil; Småstuen, Milada Cvancarova; Lerdal, Anners.
The effectiveness of exercise therapy and education plus cognitive behavioral therapy, alone or in combination with total knee arthroplasty in patients with knee osteoarthritis – study protocol for the MultiKnee trial. BMC Musculoskeletal Disorders 2021 ;Volum 22:1054. s. 1-14 PMID: 34930194 DOI: 10.1186/s12891-021-04924-z
Rognsvåg, Turid; Lindberg, Maren Falch; Lerdal, Anners; Stubberud, Jan Egil; Furnes, Ove Nord; Holm, Inger; Indrekvam, Kari; Lau, Bjørn; Rudsengen, Daniil; Skou, Søren T.; Badawy, Mona. Development of an internet-delivered cognitive behavioral therapy program for use in combination with exercise therapy and education by patients at increased risk of chronic pain following total knee arthroplasty. BMC Health Services Research 2021 ;Volum 21.(1) s. 1-14 PMID: 34696785 DOI: 10.1186/s12913-021-07177-7