URMC Joins National Effort to Set Quality Guidelines for Joint Replacement

Oct. 3, 2010
$12M program centers on standards of care for knee, hip replacement surgeries

The growing obesity epidemic and aging of baby boomers has driven demand for total joint replacement procedures to combat excruciating arthritis pain. Yet as more than 700,000 people go under the knife each year, doctors are without patient-centered outcomes research to show how the surgery impacts the quality of life for patients.

The University of Rochester Medical Center’s Department of Orthopaedics today joins a consortium of top academic medical centers in a $12 million effort to build a national registry for total joint replacement surgery. This database will help orthopaedists around the country improve care and make health policy decisions.

The URMC team, led by Orthopaedics Chair Regis J. O’Keefe, M.D., Ph.D., and Stephen Kates, M.D., associate professor, will collaborate with University of Massachusetts, University of Maryland and Baylor University as well as more than 130 private orthopedic surgeons to create the National Orthopaedic Outcome Registry, which will include more than 33,000 patients.

Regis O'Keefe, M.D., Ph.D.

The four-year grant is from the Health and Human Services’ Agency for Healthcare Research and Quality, and is the largest grant the Medical Center has been awarded from the federal agency charged with improving health care.

“This grant comes after a highly competitive process and it clearly recognizes the caliber of science that is underway at our institution,” O’Keefe said. “We will lead the nation in setting policy and standards of care and determining how joint replacement care should be done in the United States and how we can improve our patients’ quality of life.”

The limited research available today shows wide variations in doctors’ decisions about when and how to replace joints and broad differences in patients’ mobility and pain levels following surgery. Current data is limited to patients who receive Medicare coverage and the new registry will provide diverse information from all geographic regions of the country and a variety of clinical settings to assess outcomes and quality measures.

Stephen L. Kates, M.D.

This research project includes analysis of complication rates following surgery, creation of tools to determine success and failure, racial and ethnic disparities in total joint replacement procedures, and costs throughout the nation.

The Medical Center Orthopaedics department conducts the most National Institutes of Health-funded research in the country for the past four years. In conjunction with the Evarts Joint Center at URMC-affiliated Highland Hospital, the expert team leads the region in joint replacements and pain management programs for people with forms of arthritis, which affects more than 60 million people each year.

The Agency for Healthcare Research and Quality (AHRQ) is the federal agency charged with improving the quality, safety, efficiency and effectiveness of health care for all Americans. As one of 12 agencies within the Department of Health and Human Services, AHRQ supports health services research that will improve the quality of health care and promote evidence-based decision making. For more information, go to