Watch Dr. Ayers discuss FORCE-TJR (click on image above).

Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement and Quality Improvement (FORCE-TJR) is an independent, unbiased, expert data collection, analysis, and reporting system to guide best total joint replacement (TJR) surgical practices to assure patients achieve optimal pain relief and functional gain with minimal adverse events and implant failures.

FORCE-TJR originated in 2010 with an award from the Agency for Healthcare Research and Quality (AHRQ) and includes a national sample of US patients and surgeons. As of 2015, more than 25,000 patients have been enrolled from more than 150 surgeons in 23 states. The unique AHRQ cohort forms the basis for clinical benchmarks in TJR outcomes and risk-adjustment models. In 2015, FORCE-TJR opened membership to additional surgeons and patients from members across the country and is currently enrolling new members


​Meaningful data

FORCE-TJR data are collected primarily from patients and include patient-reported outcomes (PRO) of pain and function, early post-operative adverse events, and implant failures.

FORCE-TJR’s benchmark database includes a nationally representative sample of patients with complete outcomes from more than 85% of TJR patients- more than any US registry. This design and high response rate assures valid, longitudinal data so new members can immediately get risk-adjusted, stable benchmarks for best practice and outcomes. Patient-reported data are augmented with clinical data from surgeons and hospitals.

From comparative effectiveness to quality improvement

Beyond research, the FORCE-TJR registry provides comprehensive, comparative arthroplasty practice feedback to TJR surgeons to support quality improvement efforts. These data can be used to meet regulatory requirements such as the CMS Patient Quality Reporting System, and value-based contracting for accountable care. Site-specific comparisons of patient risk factors and outcomes allow surgeons to understand the similarities and differences among their patients and practices and to distinguish themselves by documenting outcomes.

  • Patient reported outcome data are collected directly from patients, before and after TJR.
  • PROs are supplemented by data on early post-operative adverse events and implant failures—anywhere the patient receives care.
  • Quarterly reports provide important risk-adjusted, comparative information on how YOUR patient outcomes compare.
  • Implant survivorship is collected over time directly from patients and validated with CMS data to assure complete monitoring of patients who move or seek care elsewhere.