Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement or FORCE-TJR, a four-year, $12 million project funded by the Agency for Healthcare Research and Quality, has established the most comprehensive U.S. database on total hip and knee replacement patients and outcomes. With information collected from more than 150 surgeons and more than 30,000 diverse TJR recipients to establish a statistically significant cohort, the database identifies risk-adjusted national benchmarks, including patient risk factors and other clinical measures, to guide surgeon and patient decisions regarding timing of surgery and optimal patient selection.
FORCE-TJR expands traditional collection of data on only device failure or repeat surgeries through its capture of patient-reported measures of pain and function pre- and post-surgery, as well as clinical measures such as readmission and infection rates, adverse events, clinical co-morbidities and other patient risk factors and demographics that may influence patient outcomes.
What’s been interesting so far?
• More than half of joint replacement surgeries now occur in patients under age 65
• Younger patients report the same or greater joint-specific and global pain and decreased function
pre-operatively as older patients
• Patients under age 65 are more obese and more likely to smoke vs. older patients
What does this mean for orthopaedic device manufacturers?
All combined elements of FORCE-TJR offer an ideal means to support post-marketing surveillance of patient-reported outcomes (e.g., pain, functional gain), adverse events and implant failure. The FORCE-TJR team will work with individual manufacturers to define patient and implant cohorts to investigate outcomes of, for example, existing FORCE-TJR patients with particular implants or an independent cohort of patients receiving an implant of interest.
Clinical and patient data from FORCE-TJR, which included over 54,000 components of knee and hip implants from U.S. manufacturers, was merged with the International Consortium of Orthopedic Registries’ component library from the Australian Registry. This combined database will support implant outcome analyses for patient sub-groups with specific clinical profiles, as well as early identification of differences in the performance of various device designs, materials, fixation methods, etc. The FORCE-TJR team will work with implant companies to define data analyses beyond planned research.
Learn more about the project here.