The University of Massachusetts Medical School (UMMS) has received a $12 million grant, with which it intends to begin compiling assessments of key factors related to total joint replacement (TJR) surgery. These surgeries include knee and hip replacement surgeries. The medical school plans to compile a national database that will include more than 33,000 patients who have had total joint replacements and develop tools with which to assess the success and failure of the surgery. Ultimately, they hope the study will help with both research and to guide clinical care and health care policy, according to a release from the University. The grant was awarded by the Agency for Healthcare Research and Quality (AHRQ).
According to information supplied by UMMS, currently more than 700,000 adults in the United States have knee or hip replacement surgery each year. That number is expected to grow “significantly” in the next 20 years as the population ages and as younger patients opt for total joint replacement surgery options. The proposed national database will include diverse patients treated by 130 orthopedic surgeons representing all regions of the country and varied practice settings. UMMS will lead six high volume sites across the country and one community network in recruiting patients into the registry.
The registry will provide information about such issues as joint replacement failure and technical or mechanical issues, as well as the impact of the replacement on the patient’s mobility, function, pain and quality of life, according to the UMMS release. Additionally, data will be compiled reflecting the disparities of TJR among certain ethnic, socioeconomic or demographic groups, and the value of TJR in younger patients.
It will be interesting to see if information compiled in this new database reflects the recent recall of hip replacement parts issued by Johnson & Johnson’s orthopedic subsidiary DePuy. Announced at the end of August 2010, the recall is expected to affect as many as 93,000 people. At issue are the DePuy ASR XL Acetabular System and the DePuy ASR Hip Resurfacing System. The systems were recalled due to an unusually large incidence of revision surgeries required by patients who had received these parts.
Patients are reporting a variety of symptoms, including pain, swelling and problems walking, which do not resolve or get worse over time after receiving the hip replacement. These symptoms may indicate serious problems such as loosening, when the implant does not stay attached to the bone in the correct position; fracture, where the bone around the implant may have broken; and dislocation, where the two parts of the implant that move against each other are no longer aligned. Making matters worse, improperly fitting hip replacement parts can rub against each other, dislodging metal shavings that can damage tissue in the hip area.
The UMMS study will evaluate joint function after TJR surgery, taking into account such factors as the type of implant, surgical approach, type of hospital or surgical center, recovery plan and ongoing care. It is expected that the compilation of the patient database will greatly expand physicians’ knowledge about the TJR process and outcomes.
Participating high volume centers recruiting patients to the registry are:
- UMass Memorial Medical Center, Worcester, Mass.
- University of Rochester Medical Center, Rochester, N.Y.
- University of Maryland Medical Center, Baltimore, Md.
- Baylor College of Medicine, Houston, Texas
- Connecticut Joint Replacement Institute at St. Francis, Hartford, Conn.
- Kaiser Permanente Georgia
Additionally, a community practice network of 26 orthopedic offices with more than 100 surgeons also will participate. For more information, visit www.ahrq.gov.