MDNews - Minnesota

++++++++++++++++++++ ORTHOPEDICS +++ +++ ++++++++++++++++++++ + + Revolutionizing Joint Replacement Research AS THE NUMBER OF JOINT REPLACEMENT PROCEDURES PERFORMED IN THE UNITED STATES CONTINUES TO RISE, THE USE OF AN EVIDENCE-BASED SURGICAL APPROACH IS BECOMING INCREASINGLY VITAL. FOR MORE THAN 20 YEARS, THE HEALTHEAST JOINT REPLACEMENT REGISTRY (HJRR) HAS PROVIDED INVALUABLE DATA TO ORTHOPEDIC SURGEONS IN ST. PAUL, MN, AND ACROSS THE COUNTRY. H JRR WAS AMONG the earliest orthopedic registries created in the United States, with more than 29,000 hip, knee, shoulder and small joint replacement procedures from St. John's Hospital, St. Joseph's Hospital and Woodwinds Health Campus recorded in its growing database. In fact, HJRR became the first community-based orthopedic registry in the nation when it was established in 1991. Although HJRR has made significant research contributions since its conception, the registry began as a cost analysis tool. "In its earliest iteration, it wouldn't have been described as a joint regis- try," says Terence Gioe, M.D., Chief of Orthopedic Surgery at Minneapolis VA Health System and adjunct professor at the University of Minnesota. "It was really an outgrowth of a process designed to get a better handle on total joint implant costs in the HealthEast system." When Dr. Gioe and other members of the HealthEast staff launched HJRR, they gathered limited data to determine which prostheses were most effective and cost-efficient. However, the HJRR team soon realized the database could have enormous potential if they added new data points, such as body mass index or comorbidities data. "Once the database was up and run- ning, and we made it more robust, we realized that it was a much more powerful research tool than we had envisioned that it might be," Dr. Gioe says. "We realized that we had some really good information and that we needed to go back and make sure that we added additional data to the database retrospectively." Reaping the Benefits of Community Collaboration Armed with supplemental data, the HJRR became a uniquely powerful research tool. Today, it remains one of only a few community-based orthopedic registries in the United States. Most American joint registries draw their data from single institutions, such as academic medical centers. These databases typi- cally provide results from subspecialists working in closely controlled operat- ing environments. In contrast, HJRR provides data from general orthopedic surgeons working in community hospital settings across the metropolitan St. Paul, MN, area, enabling practitioners to compare their own results with those of their peers. "Evaluating our outcomes in the registry creates a team approach among surgeons who are collectively trying to do a better job and achieve better outcomes," says Daniel Hoeffel, M.D., orthope- dic surgeon at Summit Orthopedics. "Though we may have differences of opinion, the mission and goals are clear for all." HJRR data allows surgeons to make evidence-based choices when faced with surgical complications, such as venous thromboembolism or joint dislocation. In addition, surgeons can utilize the database to evaluate implant device performance and choose prostheses that are effective both in terms of costs and outcomes. "As surgeons, we base our decisions about implant selection on outcomes and results, not on marketing," Dr. Hoeffel says. "The HJRR is absolutely in line with drivers that we currently face in orthopedic surgery: quality, value and continued research." Affecting Change in Implant Selection To date, HJRR has put forth a number of studies that have significantly altered "The HealthEast Joint Replacement Registry has been a very forward- looking initiative. It enables the orthopedic surgeons to participate in a data-driven, evidence-based effort to optimize quality care and safety, patient satisfaction and cost." — Jack Drogt, M.D., President of Summit Orthopedics 12 | Twin Cities MD NEWS ■ MDNEWS.COM PHOTO COURTESY OF DEPUY ORTHOPAEDICS INC

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