OSTEOMICS: Identifying Regulators of Bone Homeostasis

Inclusion Criteria: 1. Patients with osteoarthritis undergoing total joint arthroplasty, osteotomy or arthrodesis of any joint (including hip, knee, shoulder, wrist, elbow, ankle). 2. Patient with fractured neck of femurs undergoing hemiarthroplasty or total hip arthroplasty, or other internal fixation procedure. 3. Patients undergoing acute low-velocity or fragility fracture fixation surgery. 4. Patients aged between 18-110 years old with capacity to consent. Since deteriorating bone health including diseases like osteoporosis are primarily conditions of older age there is no practical upper age-limit. However, study involvement is limited by suitability for surgery which encompasses multiple factors considered on an individual case basis including age, frailty, comorbidities, baseline mobility, renal function and ability to consent (for instance due to dementia or delirium). We note that our inclusion criteria is purposefully broad as we aim to deduce trends across a wide range of conditions and backgrounds. Exclusion Criteria: 1. Patients unable to provide informed consent. 2. Patients with suspected/established underlying malignancy. 3. Patients with suspected/established osteomyelitis. 4. Patients with suspected/established bloodborne disease 5. Patients who are currently a subject of a clinical trial involving an investigational medicinal product.