SPONSORED RESEARCH: Social Determinants and Timeliness of Total Knee Replacement

December 18, 2025

Pictured Above: Patricia Franklin, MD, MPH, MBA

Read a Q&A Below

Patricia D. Franklin, MD, MPH, MBA and the team at Northwestern University’s Feinberg School of Medicine Department of Medical Social Sciences (MSS) received a sub-award to an NIAMS R01 entitled: " Social Determinants and Timeliness of Total Knee Replacement." The study is led by Hassan Ghomrawi, PhD at University of Alabama (prime awardee). Co-investigators at Northwestern include Franklin, Julia Lee, PhD (Preventive Medicine), and Rowland Chang MD, MPH (Rheumatology).

What are the aims of the project? 

Total joint replacement surgery (TJR), which includes both knee and hip replacements, is among the most common and costly procedures in the Medicare budget.  TJR is an effective treatment to relieve pain and improve physical function in people with arthritis with knee and hip pain. However, there is a long-standing disparity in the use of TJR and in its outcomes. Most research has evaluated individual clinical and personal predictors of successful outcomes after surgery. This research will define and evaluate novel geo-coded and social metrics and assess the association between these metrics and access to TJR surgery and surgical outcomes.

What are your next steps?

The research is led by an investigator at the University of Alabama and I am a co-investigator and lead of the Northwestern team. The study is analyzing data from a large cohort that I prospectively collected and is evaluating the association of novel geo-coded social metrics and the timing of and outcomes of TJR. The team first defined arthritis severity using clinical and patient-reported metrics and then defined novel geo-coded metrics. I am now testing the association of these metrics with symptom severity at the time of surgery and outcomes after surgery.

What do you hope will come out of this funded research?

I hope that the novel geo-coded metrics will improve our ability to identify people at risk of limited access to TJR. Ultimately, I hope this information will guide the development of new strategies to enhance equitable use of TJR in aging adults with advanced knee and hip arthritis.