# Social Determinants and Timeliness of Total Knee Replacement: A National Perspective

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2021 · $721,641

## Abstract

Project Summary
The proposed R01 aims to augment data from the FORCE-TJR national Registry with radiographic readings,
geospatial information and Medicare claims data to quantify timeliness of total knee replacement (TKR), and
investigate the social determinants (SD) affecting timing of TKR. We propose 3 specific aims. Aim 1 applies
validated appropriateness criteria to a representative sample of the FORCE-TJR registry patients to classify
them as either premature or appropriate but with 5 different levels of functional disability. Aim 2 appends this
sample with geospatial information (SD) about their environment and determine the effect of the SD factors on
TKR utilization. Aim 3 determine the effect of the SD factors on improvement after surgery. We examine the
effect of SD factors related to (1) the medical care environment (i.e., access to and practice patterns of medical
care) and (2) the built environment (i.e., all of the physical parts of where we live and work (e.g., homes,
buildings, streets, open spaces, and infrastructure)). Our project will be the first to examine timing of TKR at a
national level, and will provide new knowledge regarding the association of the medical care and built
environments with timeliness of TKR utilization. Our findings will also inform clinical and public policy
interventions aimed at targeting TKR to those who would benefit most from the procedure, and add to evidence
that would support the proposition that improvements to the environment could lead to an overall reduction in
disability pertaining to knee osteoarthritis.

## Key facts

- **NIH application ID:** 10101289
- **Project number:** 1R01AR078342-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Hassan Ghomrawi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $721,641
- **Award type:** 1
- **Project period:** 2021-03-19 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10101289

## Citation

> US National Institutes of Health, RePORTER application 10101289, Social Determinants and Timeliness of Total Knee Replacement: A National Perspective (1R01AR078342-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10101289. Licensed CC0.

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