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Nicolas S. Piuzzi, MD, Recipient of the Kappa Delta Young Investigator Award

Nicolas S. Piuzzi, MD, has been honored as the 2025 Kappa Delta Young Investigator Award winner, recognizing his groundbreaking work in utilizing advanced data analytics to enhance patient outcomes in total hip and knee arthroplasty (THA and TKA). His research introduces personalized outcome prediction tools that help optimize the satisfaction and results of patients undergoing these vital surgeries.

Importance of Patient-Reported Outcomes Measures (PROMs)

In recent years, the medical field has increasingly acknowledged the importance of Patient-Reported Outcomes Measures (PROMs), particularly in the context of joint replacement surgeries. Each year, the U.S. sees around 790,000 TKAs and 544,000 THAs performed, with numbers projected to rise due to an aging demographic. To maintain relevancy, health care systems have started to lean towards value-based care models. This change comes as the Centers for Medicare & Medicaid Services (CMS) has mandated that by 2025, hospitals must submit pre- and postoperative PROM data to secure full CMS reimbursement for THA and TKA procedures.

Despite high surgical success rates, troubling figures reveal that 10 to 20% of patients report ongoing pain or dissatisfaction a year after their surgery. Dr. Piuzzi, along with colleagues from the Cleveland Clinic Adult Reconstruction Research Department, aims to address this issue by incorporating data analytics to identify patients at higher risk for poor outcomes.

Comprehensive Data Collection at Cleveland Clinic

In 2015, the Cleveland Clinic launched the Orthopaedic Minimal Data Set Episode of Care database, a platform dedicated to collecting PROMs data specifically for TJA. The system captures critical data following surgery, including demographics, general and joint-specific health information, and severity of disease details. By integrating PROM collection into clinical workflow, the clinic achieves an impressive completion rate of over 97%. To maintain communication, they have developed both passive and active follow-up methods—automated reminders, text messages, and phone calls—to ensure patient participation.

In studies conducted, the team noted that while passive measures captured PROM data from a significant portion of patients, active follow-ups were necessary for nearly 40% of the participants. This reflects the need for a multifaceted approach to ensure a comprehensive understanding of patient outcomes.

Tailoring Surgical Approaches Based on PROMs Phenotypes

Dr. Piuzzi and his team analyzed gathered data to identify multiple phenotypes based on patients' preoperative PROMs. This nuanced analysis considers pain, functionality, and mental health, thereby presenting a clearer picture of each individual's needs. For example, a study involving 4,034 primary THA patients revealed that those with low mental health scores were more likely to report dissatisfaction at one year post-surgery, regardless of pain or function levels.

Understanding these variations enables surgeons to customize their approaches, helping address specific risk factors, which can significantly improve patient satisfaction and outcomes.

A Predictive Model for Enhanced Decision-Making

Given the increasing emphasis on value-based health care, the need for data-driven models to aid decision-making processes is paramount. By creating a comprehensive predictive model, Dr. Piuzzi's team can offer personalized predictions of improvements in pain, function, and quality of life post-surgery. Their model for TKA encompasses factors like demographics, comorbidities, and baseline PROMs, thus facilitating a powerful tool for both patients and clinicians to anticipate outcomes based on preoperative characteristics.

The Relevance of the Kappa Delta Awards

The Kappa Delta Awards celebrate significant contributions to orthopedic research. Initiated by the Kappa Delta Sorority in 1950, these honors aim to promote advancements in musculoskeletal health. With the ongoing innovations spearheaded by researchers like Dr. Piuzzi, there is greater hope for improving the standards of care and patient outcomes in orthopedic surgery.

With over 39,000 members, the American Academy of Orthopaedic Surgeons (AAOS) stands at the forefront of promoting musculoskeletal health, providing essential resources for education and research in the field. The aim remains clear: to enhance treatment quality and improve the lives of countless patients nationwide.

By recognizing pioneering efforts such as those led by Dr. Piuzzi, the Kappa Delta Award not only highlights individual accomplishments but also encourages a broader conversation on the need for tailored, innovative approaches in orthopedic practice.