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Outcomes Research
Tracking Surgical Outcomes
hree invaluable databases were established in the 1990s at the Hospital for Joint Diseases to track surgical outcomes, each a constantly growing bank of information on patients who have undergone orthopaedic procedures. Analysis of these data has the great potential to improve future patient health and quality of life.
The HJD Registries represent a revolutionary trend in medical investigations: outcomes research. In the traditional approach to clinical research, a well-defined set of patients is studied for the purpose of determining the effectiveness of a particular medical device, procedure, or strategy. Outcomes research extends the conventional concept by considering a broad range of outcomes and focusing on patient-centered and societal concerns.
Since being dubbed the “third revolution in medical care” by the New England Journal of Medicine in 1988, outcomes research has had unprecedented growth. It has increased in importance as awareness has grown that medical professionals must follow up on the results of their interventions in a systematic manner. The quality monitoring of orthopaedic procedures thus made possible is aimed at evaluating and improving quality of surgery as well as patient well-being.
Total Joint Replacement Registry
Every year the lives hundreds of thousands of Americans are vastly improved by receiving artificial hips and knees. Until recently, however, there has existed no central repository of information concerning the long-term outcomes of these operations. The Hospital for Joint Diseases Total Joint Replacement Registry is one such database. Hundreds of data points are recorded for every hip or knee replacement surgery at our institution—representing more than three thousand total-joint patients since inception of the Registry in 1997—including information on type of replacement, surgical approach, type of fixation, implant type, and patient history. The information thus made available to both clinicians and researchers is invaluable in helping them find ways to improve the outcomes of these surgeries.
Evaluation of this information thus promises not only to increase accuracy and efficiency in orthopaedic practice, but also to make it possible to provide more cost-effective patient care.
Geriatric Hip Fracture Registry
The Geriatric Hip Fracture Registry focuses on the risks, causes, and outcomes of elderly patients who have sustained hip fractures. Established in the early 1990s, this registry has enrolled thousands of patients. Analysis of Registry data has influenced how patients are managed not only at the Hospital for Joint Diseases but throughout the world. Future outcomes research from this registry aims to continue to increase our understanding of these injuries and to help identify patients at risk for complications, improve its prevention, and develop strategies to maximize clinical outcomes and minimize complications.
Shoulder Evaluation Unit
The Shoulder Evaluation Unit studies shoulder function over the full spectrum of shoulder disorders and provides data for clinical research studies in this important area.
As one example, the Shoulder Evaluation Unit was instrumental in assessing the merits of an experimental technique for treating shoulder instability, a common syndrome that typically experienced by young people involved in strenuous activities and is characterized by symptoms ranging from the inability to use one’s arm in a normal fashion to to serious and painful shoulder dislocation. It was found that patients who underwent the new splitting procedure experienced complete restoration of proprioceptive ability and strength six months after their surgery—in contrast with patients treated in the traditional way, who required twice as long to recover.
Tracking Surgical Outcomes
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The HJD Registries represent a revolutionary trend in medical investigations: outcomes research. In the traditional approach to clinical research, a well-defined set of patients is studied for the purpose of determining the effectiveness of a particular medical device, procedure, or strategy. Outcomes research extends the conventional concept by considering a broad range of outcomes and focusing on patient-centered and societal concerns.
Since being dubbed the “third revolution in medical care” by the New England Journal of Medicine in 1988, outcomes research has had unprecedented growth. It has increased in importance as awareness has grown that medical professionals must follow up on the results of their interventions in a systematic manner. The quality monitoring of orthopaedic procedures thus made possible is aimed at evaluating and improving quality of surgery as well as patient well-being.
Total Joint Replacement Registry
Every year the lives hundreds of thousands of Americans are vastly improved by receiving artificial hips and knees. Until recently, however, there has existed no central repository of information concerning the long-term outcomes of these operations. The Hospital for Joint Diseases Total Joint Replacement Registry is one such database. Hundreds of data points are recorded for every hip or knee replacement surgery at our institution—representing more than three thousand total-joint patients since inception of the Registry in 1997—including information on type of replacement, surgical approach, type of fixation, implant type, and patient history. The information thus made available to both clinicians and researchers is invaluable in helping them find ways to improve the outcomes of these surgeries.
Evaluation of this information thus promises not only to increase accuracy and efficiency in orthopaedic practice, but also to make it possible to provide more cost-effective patient care.
Geriatric Hip Fracture Registry
The Geriatric Hip Fracture Registry focuses on the risks, causes, and outcomes of elderly patients who have sustained hip fractures. Established in the early 1990s, this registry has enrolled thousands of patients. Analysis of Registry data has influenced how patients are managed not only at the Hospital for Joint Diseases but throughout the world. Future outcomes research from this registry aims to continue to increase our understanding of these injuries and to help identify patients at risk for complications, improve its prevention, and develop strategies to maximize clinical outcomes and minimize complications.
Shoulder Evaluation Unit
The Shoulder Evaluation Unit studies shoulder function over the full spectrum of shoulder disorders and provides data for clinical research studies in this important area.
As one example, the Shoulder Evaluation Unit was instrumental in assessing the merits of an experimental technique for treating shoulder instability, a common syndrome that typically experienced by young people involved in strenuous activities and is characterized by symptoms ranging from the inability to use one’s arm in a normal fashion to to serious and painful shoulder dislocation. It was found that patients who underwent the new splitting procedure experienced complete restoration of proprioceptive ability and strength six months after their surgery—in contrast with patients treated in the traditional way, who required twice as long to recover.