Orthopedic devices — including shoulder prostheses and joint replacements for the hip and knee — will be a major focus of the projects initially included in this program. Prosthetic joints are among the most successful and commonly implanted medical devices developed over the last 50 years, and allow millions of people to remain ambulatory and pain-free. With an aging population, the demand for joint replacements will be even greater.
Despite their popularity, existing studies provide limited data to evaluate long-term outcomes. Additionally, little is known about predictors of prosthesis failure. Variations in hospital costs, length of stay and functional outcomes among patients implanted with different types of prostheses need to be integrated with clinical outcomes data to develop more complete information to assist decision-makers.
As part of the study, physician-scientists will evaluate the effectiveness of MRI and laboratory markers to identify early osteolysis — the loss of bone calcium — in patients with a hip prosthesis. The study will seek to identify risk factors for osteolysis that may include younger age, higher body mass index (BMI) and increased activity. If patients can be identified early in the osteolytic process, treatments may be developed to delay or prevent a second surgery, with its related higher cost and increased risk of complications.
The study will also seek to identify discrepancies in outcomes across racial and ethnic groups, as well as variations in health-care costs associated with different prosthesis models.