The Newfoundland Osteoarthritis Study (NFOAS) is a patient-based study aimed at identifying novel biomarkers including genomic, epigenomic, and metabolimic markers associated with the development and progression of osteoarthritis as well as the outcome of the total joint replacement therapy. It was a major initiative to create a biobank of human joint tissues. To date, we have collected cartilage, synovial fluid and blood samples from 1100 patients who underwent total hip or knee joint replacment surgery. We also have extensive demographic, clinical and epidemiological data on all participants.