Frequency and Complications of Major Orthopedic Procedures in Medicare Beneficiaries

NCT ID: NCT02281747

Last Updated: 2026-01-16

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Total Enrollment: 521292 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2014-10-24
• Study Completion Date: 2029-05-31

Brief Summary

Background:

• Orthopedic procedures are common in the United States. These include joint replacement and spine surgeries. Researchers want to study data about these procedures over time. They want to see if treatment has gotten better. They also want to find ways to change the care that people get before and after they have these procedures. These changes may lower the risk of problems people can have during and after treatment. They may also improve people s results.

Objectives:

• To study a series of questions about surgery, medicine, treatments, and outcomes for orthopedic procedures.

Eligibility:

• Data from the U.S. Centers for Medicare and Medicaid Services from 1999 to 2015.

Design:

• Researchers will look at data for people ages 20-100.
• No new participants will be used in this study.
• The study will last 6 years.

Detailed Description

Major orthopedic procedures, including total joint replacement and spine surgeries, are among the most common procedures in the population. Learning about how often these surgeries are performed can give indications of whether the treatment of arthritis and other musculoskeletal conditions has been improving over time. Learning about the complications associated with these surgeries can give indications about ways to alter the care of patients before and after surgeries that may decrease the risk of complications and improve patient outcomes. We will analyze Medicare and Medicaid data from 1999 to 2015 to examine a series of questions, including whether the use of joint replacement surgery has changed over time among patients with rheumatoid arthritis and ankylosing spondylitis, to see if rheumatoid arthritis medications are associated with some types of surgical complications, to see if anticoagulation medication after joint replacement is associated with the risk of complications, to see if regional differences in surgery rates can be explained by differences in patient characteristics, and to determine the surgical treatment for hip fractures that is associated with the fewest long-term complications. From the Framingham Heart Study Cohort, we will study the changes in the incidence of hip fractures and the risk factors for osteoporosis over time.

Conditions

Rheumatoid Arthritis; Ankylosing Spondylitis

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

affected with arthritis

arthritis may be either rheumatoid, osteoarthritis, or ankylosing spondylitis

No interventions assigned to this group

unaffected with arthritis

in some analyses, the comparison is by arthritis status. in other analyses, it is within arthritis status by clinically relevant subgroups.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

Medicare beneficiaries will be excluded (or censored) if they do not have both Part A and Part B coverage, or enrolled in Medicare Advantage plans (Part C), as detailed claims for these beneficiaries are not available. We will also exclude dual-eligible (Medicare and Medicaid recipients) as these subjects have distinct clinical conditions (e.g. blindness) that distinguishes them from most Medicare beneficiaries. There will be no exclusions based on gender, race, ethnicity, or cognitive impairment.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Robert A Colbert, M.D.

Role: PRINCIPAL_INVESTIGATOR

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Locations

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 9

Bethesda, Maryland, United States

Countries

United States

Other Identifiers

15-AR-N010

Identifier Type: -

Identifier Source: secondary_id

999915010

Identifier Type: -

Identifier Source: org_study_id