Kaiser Permanente’s Joint Replacement Registry Improves Patient Outcomes While Reducing Costs

Within the US, over 600,000 total hip and total knee replacements are performed each year. By the year 2030, that number is projected to exceed 4 million. Annual hospital costs associated with these procedures are projected to exceed $65 billion by 2015. The projected increases in the demand for total joint replacements and the costs associated with these procedures will challenge our already overburdened US health care system. Kaiser Permanante’s Total Joint Replacement Registry helps its surgeons and patients make informed decisions about which implant to use or in which patients the risks and potential costs of failure make surgery unwise.


Excerpted from The Permanente Journal article:

“Within the US, over 600,000 total hip and total knee replacements are performed each year. By the year 2030, that number is projected to exceed 4 million. Annual hospital costs associated with these procedures are projected to exceed $65 billion by 2015. Although patients who undergo total joint arthroplasty (TJA) are often of retirement age, recent studies have shown that patients below age 65 represent 35-45% of all TJA recipients in the US. As TJA is marketed more as a lifestyle operation than as a final option to retain mobility for end-stage arthritis, the proportion of patients below age 65 may increase.

The projected increases in TJA demand and the costs associated with these procedures will challenge our already overburdened US health care system. One potential method to address this pending crisis is through comparative safety and clinical effectiveness research aimed at reducing the need for TJA revision surgery. Registries are one example of clinical effectiveness studies that can help surgeons and patients make informed decisions about which implant to use or in which patients the risks and potential costs of failure make surgery unwise. These studies can also identify the relative value of TJA over alternative treatments or the effectiveness of one implant brand or design over another. Although implants vary widely in cost, there is little evidence to support the use of new, more expensive designs instead of more established, traditional designs.

The goals of the Kaiser Permanente (KP) Total Joint Replacement Registry (TJRR) are: 1) to monitor revision, failure, and rates of key complications (e.g., infection, venous thromboembolic disease such as blood clots and embolism, and mortality); 2) to identify patients at risk for poor clinical outcomes following TJA; 3) to identify the most effective techniques and implant devices (best practices and implant constructs); 4) to track implant usage and costs; and 5) to monitor and to support implant recalls and advisories in cooperation with the US Food and Drug Administration.”

Link to full journal article: http://xnet.kp.org/permanentejournal/sum08/joint-replacement.html

Keywords: clinical effectiveness, total hip replacements, total knee replacements, joint replacement, total joint replacement registry, total joint arthroplasty, TJA, Kaiser Permanente, KP, Southern California, registries

For More Information:

Jean Sud
Senior Manager, Public Policy & Communications
Kaiser Permanente, The Permanente Federation
1 Kaiser Plaza
Oakland, CA 94612
tel. 510.271.6317
Jean.L.Sud@kp.org
www.kaiserpermanente.org

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