The Newfoundland Osteoarthritis Study (NFOAS) is a patient-based study launched in 2011 in the province of Newfoundland and Labrador. This study aims at identifying novel biomarkers and pathways associated with the development and progression of osteoarthritis (OA) and the outcomes of total joint replacement therapy, as well as molecular subtypes of OA by employing a systematic and integrative (multi-omics) approach. Findings of this study will expand our understanding of this complex disease and help develop personalized medicine tools for OA management towards a better quality of life for OA patients. It is 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 replacement surgery, and extensive demographic, clinical and epidemiological data on all participants. We also have genome-wide genotyping, transcriptomic, epigenomic, and metabolomic data on majority of our study participants. Our research is supported by Canadian Institutes of Health Research, Arthritis Society (Canada), Canada Foundation for Innovation, Newfoundland & Labrador RDC, Ocean Frontier Institute, and Memorial University of Newfoundland.