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Consortium to Improve Knee Surgery Outcomes

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Duke Health News 919-660-1306

DURHAM, N.C. -- Orthopedic surgeons from Duke University Sports Medicine and seven other Southeast sports medicine centers have formed a consortium to gather and analyze data on knee surgery in order to improve surgical outcomes.

Dubbed the Cartilage Repair Centers America (CRC America), the consortium plans to enroll more than 5,000 knee surgery patients annually during the next five years, and the researchers believe that correlating the results of the surgery with patient satisfaction, they will go a long way to improving patient care.

Duke will serve as the data collection site for the consortium. Other members of the consortium include: the Florida Orthopedic Institute, Tampa; Alabama Sports Medicine, Birmingham; Tulane University, New Orleans; a private practice in Mobile, Ala.; the Campbell Clinic, Memphis, Tenn.; the Moore Clinic, Columbia, S.C.; and Atlanta Sports Medicine and Orthopedics Center.

While it is common for medical researchers to collect vast quantities of data during clinical trials for drugs and then use that data to determine the best course of treatment, surgeons face unique challenges. Surgery is as much a craft as it is a science, and its practitioners have their own unique styles or approaches which can make it difficult to compare the outcomes from surgeon to surgeon.

With the establishment of CRC America, the participating centers believe that they will be able to take advantage of the immense power of data collected during multi-center trials to improve the outcomes of their patients undergoing knee surgery. Not only will they collect data on the surgery itself, but just as importantly, the researchers say, this data will be correlated with patient satisfaction.

"In orthopedics, patient satisfaction is such an important aspect of treatment," said Laurence Higgins, M.D., Duke orthopedic surgeon who serves as medical co-director and chairman of the of the scientific committee of CRC America. "So much of what we do is to relieve the pain that our patients are experiencing. Even if we perform a particular procedure perfectly by technical standards, but the patient still feels pain, that outcome is less than perfect.

"In cardiology or cancer, physicians have for decades used large clinical trials to guide them in finding out the best treatment for their patients," Higgins said. "This database we are building will give us such a powerful tool, one that is unprecedented now in the field of orthopedic surgery."

The consortium is made up of both academic and private sports medicine practices, which Higgins said will given the database a "real-world" representation of patients. According to Higgins, cartilage problems are the most common source of knee pain, and more than 2 million Americans are diagnosed annually with cartilage problems, whether they are caused by trauma, injury or wear-and-tear.

In recent years, there have been numerous advances in cartilage repair strategies, with the use of biologic options coming into widespread use, including autologous chondrocyte implantations, in which a patient's own cells are used to "grow" new cartilage for repair.

"This consortium represents the first and largest efforts to date to create a comprehensive and detailed database of outcomes using these new procedures," Higgins said.

"There has been a critical lack of information about patient experience and treatment outcomes since the introduction of biologic procedures were first introduced to treat knee cartilage injury," said orthopedic surgeon Scott Gillogly. M.D., director of Atlanta Sports Medicine and medical co-director of the consortium. "The CRC will fill that need with a comprehensive database of information from thousands of patients treated at our member centers -- and that information will have a direct and positive impact on patient care in the years ahead."

In addition to treating patients with knee injuries and collecting data on their outcomes, consortium members also plan a number of educational opportunities and conferences to make the knowledge available to all orthopedic and sports medicine surgeons.

The consortium is funded for five-years for $600,000 in unrestricted grants from 10 different companies in the areas of artificial joints, pharmaceuticals, physical therapy and exercise equipment and nutrition. Higgins said that by the end of the five-year period, the researchers expect to have gathered enough data to receive funding from the National Institutes of Health for larger trials.

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