The FORCE-TJR research program is a national leader in generating real-world evidence from representative surgical practices and patients.

Blending direct-to-patient data collection methods for patient-generated data with clinical and biologic data, the FORCE-TJR research team is answering diverse research questions to improve orthopedic practice and patient outcomes.

To date, more than $23 million of federal (AHRQ, NIAMS, PCORI, FDA) and foundation funds have supported innovative data collection and analytic methods that are changing how orthopedic care is delivered. For example, new PCORI-funded research will evaluate the use of individualized outcome prediction models to support shared patient-surgeon treatment decisions. The FORCE-TJR team is committed to leading best practices in prospective cohort and registry design, device surveillance methods, and outcome improvement research.

Research Collaborators

We work with with a diverse, multidisciplinary team to drive our research agenda.

Meet the Collaborators

Comparative Research

We link PROs with clinical data sources to support comparative effectiveness research

Registry and Evidence

Latest Findings

We are answering diverse questions to improve orthopedic practice and patient outcomes

Latest Findings


You are showing me information about my patients that I would never be able to collect on my own. This is great.

Surgeon Participant, Colorado Springs, CO

It's important to participate [in FORCE-TJR] so people who have knee replacements in the future can benefit from my experience.

Knee Replacement Patient, Worcester, MA



  • Paper Framework for Patient-reported data capture; Lessons learned As the value of measuring and collecting patient reported outcomes is consistently recognized, lessons learned from the FORCE-TJR experience, in particular, served to guide a much needed framework to PRO implementation. Lavallee D, Chenok K, Love R, et al. Incorporating Patient-Reported Outcomes in Healthcare to Engage Patients and Enhance Care. Health Aff (Millwood). 2016 Apr 1;35(4):575-82. doi: 10.1377/hlthaff.2015.1362 Read more
  • Paper Negative impact of musculoskeletal comorbidities
 The burden of musculoskeletal comorbidities- specifically moderate or severe pain in the lumbar spine and non-operative hips and knees- is associated with poorer function at 6 months after surgery. Read Paper
  • Paper The Essential Role of Patient-Centered Registries in an Era of Electronic Health Records This article by Patricia Franklin, David Ayers and Elise Berliner explores how "Smartly designed registries such as the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) database can overcome the shortcomings of institutional EHRs and complement EHR data for the purposes of quality and value monitoring and comparative outcomes research". Read more

  • Webinar Educational: Incorporating Patient-Reported Outcomes Into Health Care To Engage Patients And Enhance Care Tuesday, December 6th​ | 3:00 - 4:00pm EST View Slides
  • Webinar Improving Outcomes and Patient Experience through Shared Decision-Making Training Tuesday, December 5th​ | 5:00 - 6:00pm EST Description: Patient Centered Care is predicated on the ability to provide care that is respectful of and responsive to patients taking into consideration their values and preferences for care. Shared decision-making supports patient centered care through collaboration between patients and their care teams. This webinar will provide a foundational knowledge to support patient engagement including strategies for incorporating shared decision-making into clinical practice. Click Here to Register