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Patricia Franklin Research Page

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Research Interests


Research Interests

  •  Comparative effectiveness research in musculoskeletal health
    • Clinical and biopsychosocial predictors of outcomes after total joint replacement
    • Best practices in biospysychosocial care of osteoarthritis and total joint replacement
    • Orthopedic device surveillance and outcomes
  •  mHealth implementation
    • Improving methods to collect patient reported outcomes and patient-generated data, including accelerometry
    • User centered design for self-management Apps for osteoarthritis and total joint replacement
    • Integrating patient-reported metrics in national data registries
  • Learning healthcare systems
    • Methods to report quality improvement and real-time clinician feedback to improve care
    • Personalized predictions of likely treatment outcomes in osteoarthritis


College of the Holy Cross, AB, 1979

University of Rochester School of Medicine, MD, 1983

University of Rochester, Simon School, MBA, 1986

University of Rochester School of Medicine, MPH, 1989

Residency, General Preventive Medicine

Fellowship, Health Services Research and Administration 

Recent Publications















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Zheng, Hua; Tulu, Bengisu; Choi, Wonchan; and Franklin, Patricia (2017) "Using mHealth App to Support Treatment Decision- Making for Knee Arthritis: Patient Perspective," eGEMs (Generating Evidence & Methods to improve patient outcomes): Vol. 5: Iss. 2, Article 7.
Available at:

Franklin PD, Chenok KE, Lavalee D, Love R, Paxton L, Segal C, et al. Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2017;5(1):17. doi:

Franklin PD. Research Priorities for Optimal Use of Patient-reported Outcomes in Quality and Outcome Improvement for Total Knee Arthroplasty. J Am Acad Orthop Surg. 2017 Feb;25 Suppl 1:S51-S54. doi: 10.5435/JAAOS-D-16-00632. PMID: 27997411

Liu X, Li XB, Motiwalla L, Li W, Zheng H, Franklin PDPreserving Patient Privacy When Sharing Same-Disease Data. ACM J Data Inf Qual. 2016 Oct;7(4). pii: 17.

Li W, Ayers DC, Lewis CG, Bowen TR, Allison JJ, Franklin PD. Functional gain and pain relief after total joint replacement according to obesity status? J Bone Joint Surg Am. 2017 Jul 19;99(14):1183-1189. DOI: 10.2106/JBJS.16.00960. PMID:28719557

Harrold LR, Porter A, Noble, PC, Ayers DC, Allison JJ, Franklin PD. Differential burden of musculoskeletal pain in African Americans and whites patients at the time of total joint replacement surgery. (2017). Orthopedics and Physical Rehabilitation Publications and Presentations. 184. [Preprint]

Platt R, Blake K, Franklin PD, Gaziano M, Hernandez Adrian, Kaushai R, Masica A, NevinJ, Rumsfeld J, Hamilton Lopez M. “Clinician Engagement for Continuous Learning” Perspectives – Expert Voices in Health & Health Care. National Academy of Medicine. Accessed 3/7/2017 at

Franklin PD, Li W, Lemay C, Ayers DC. Are post-TJR readmissions associated with poorer functional gain after TJR? Bone & Joint J (Proceedings). Feb 2017.

Gandek B, Ware JE, Anatchkova M. Validity and Responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS): A Comparative Study Among Total Knee Replacement Patients. Arthritis Care & Res. 2017 Jan 13. doi: 10.1002/acr.23193. [Epub ahead of print]

Lemay CA, Lewis CG, Singh J, Franklin PD. Receipt of pain management information pre-operatively is associated with improved functional gain after elective total joint replacement. J Arthropl 2017 Jan.

Franklin PD. Research Priorities for Optimal Use of Patient-reported Outcomes in Quality and Outcome Improvement for Total Knee Arthroplasty. J Am Acad Orthop Surg. 2016 Dec 9. [Epub ahead of print] PMID: 27997411 

Ayers DC. Implementation of Patient-reported Outcome Measures in Total Knee Arthroplasty. J Am Acad Orthop Surg. 2016 Dec 9. [Epub ahead of print] PMID: 27941415

Franklin PD, Miozzari H, Christofilopoulos P, Ayers DC, Lübbeke A. Important Patient Characteristics Differ Prior to TKA and THA Between Switzerland and the United States. Musculosklet Disord Jan 11;18(1):14. doi: 10.1186/s12891-016-1372-5.

Li W, Procter-Gray E, Churchill L, Crouter S, Kane K, Franklin P, Ockene J, Gurwitz J. (2017) Gender and age differences in levels, types and locations of physical activity among older adults living in car-dependent neighborhoods. The Journal of Frailty and Aging (JFA).

Liu X, Li X, Motiwalla L, Li W, Zheng H, Franklin PD. Preserving Patient Privacy When Sharing Same-Disease Data. Journal of Data and Information Quality (JDIQ), Volume 7 Issue 4, September 2016.doi: 10.1145/2956554

Nguyen USDT, Ayers D, Li W, Harrold L, Franklin PD.  Pre-operative Pain and Function: Profiles of Patients Selected for Total Knee Replacement. J Arthroplasty. 2016 Apr 27. pii: S0883-5403(16)30082-1. doi: 10.1016/j.arth.2016.04.015. [Epub ahead of print] PMID: 27259392

Rolfson O, Wissig S, van Maasakkers L, et al. Defining an International Standard Set of Outcomes Measures for Patients with Hip or Knee Osteoarthritis: Consensus of the International Consortium of Health Outcome Measurement Hip and Knee Osteoarthritis Working Group. Arthritis Care Res (Hoboken). 2016 Feb 16. doi: 10.1002/acr.22868. PMID: 26881821

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.

Lyman S, Lee Y, Franklin PD, et al. HOOS, JR. Validation of the HOOS, JR: A Short-Form Hip Replacement Outcomes Survey. Clin Orthop Relat Res. 2016 Jun;474(6):1472-82. doi: 10.1007/s11999-016-4718-2. Epub 2016 Feb 29 PMID: 26926772

Lyman S, Lee Y, Franklin PD, Li W, et al. Validation of the KOOS, JR: A short-form knee replacement outcomes survey. Clin Orthop Relat Res. 2016 Jun;474(6):1461-71. doi: 10.1007/s11999-016-4719-1. Epub 2016 Feb 29 PMID: 26926773

Rolfson O, Bohm E, Franklin PD, Lyman S, Denissen G, Dawson J, Dunn J, Chenok KE, Dunbar M, Overgaard S, Garellick G, Lübbeke  & the Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries. Patient-reported outcome measures in arthroplasty registries, Part I: Overview and rationale for patient-reported outcome measures. Acta Orthop. 2016 Jul;87 Suppl 1:3-8. doi: 10.1080/17453674.2016.1181815. Epub 2016 May 11.

Rolfson O, Chenok KE, Bohm E, Lübbeke A, Denissen G, Dunn J, Lyman S, Franklin PD, Dunbar M, Overgaard S, Garellick G, Dawson J & the Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries. Patient-reported outcome measures in arthroplasty registries, Part II: Recommendations for selection, administration, and analysis. Acta Orthop. 2016 Jul;87 Suppl 1:9-23. doi: 10.1080/17453674.2016.1181816. Epub 2016 May 26.

Chimenti P, Drinkwater C, Li W, Lemay C, Franklin PD, O'Keefe R. Factors associated with early improvement in low back pain after total hip arthroplasty: a multi-center study. J Arthroplasty. 2015 Jul 17. pii: S0883-5403(15)00642-7. 

Ayers DC, Fehring TK, Odum SM, Franklin PD. Using joint registry data to improve the Accuracy of risk adjustment prediction models for 30-day readmission after THR and TKR. J Bone Joint Surg Am. 2015;97:668-71.

Franklin PD, Nguyen U, Ayers DC, Weissman N, and the FORCE-TJR investigators. Improving the criteria for appropriateness of total joint replacement surgery: comment on the article by Riddle et Al. Arthritis and Rheumatol. 2015; 67(2). 

Ayers DC, Harrold L, Allison JJ, Franklin PD. Reply to the Letter to the Editor: Preoperative Pain and Function Profiles Reflect Consistent TKA Patient Selection Among US Surgeons. Clin Orthop Relat Res. 2015; 473: 395-6.

Harrold L, Pascal S, Lewis C, O’Keefe R, Pellegrini V, Allison J, Ayers D, Franklin PD. Patient Report Improves Post-Hospital Discharge Event Capture in Total Joint Replacement: A novel approach to capturing all post-hospital event data. eGEMS 2014 Oct 22;2(1):1107. doi: 10.13063/2327-9214.1107.

Zheng, Hua; Li, Wenjun; Harrold, Leslie; Ayers, David C.; Franklin, Patricia D. (2014) "Web-based Comparative Patient-reported Outcome Feedback to Support Quality Improvement and Comparative Effectiveness Research in Total Joint Replacement," eGEMs (Generating Evidence & Methods to improve patient outcomes): Vol. 2: Iss. 1, Article 21. DOI:

Franklin PD, Lewallen D, Bozic K, Hallstrom B, Jiranek W, Ayers D. Implementation of patient-reported outcomes in US total joint replacement registries: rationale, status, and plans. J Bone Joint Surg Am, 2014 Dec 17;96(Supplement 1):104-109.

Gandek B. Measurement properties of the Western Ontario and McMaster Universities Osteoarthritis Index: A systematic review.  Arthritis Care Res (Hoboken). 2014 Jul 21. doi: 10.1002/acr.22415. [Epub ahead of print]

Ayers DC, Li W, Harrold LR, Allison JA, Franklin PD. Pre-operative pain and function profiles reflect consistent TKR patient selection among US surgeons. Clinical Orthopaedics and Related Research. 2014; Jun 2014 Epub ahead of print DOI 10.1007/s11999-014-3716-5

Ayers DC and Franklin PD. Hip Outcome Assessment. In Callaghan JJ, Rosenberg AG, Rubash HE, editiors. The Adult Hip (Callaghan, Aaron, Rubash) Lippincott Williams & Wilkins; 2014.

FORCE-TJR In: An Introduction to AHRQ's Third Edition of "Registries for Evaluating Patient Outcomes. AHRQ 2013.

Franklin PD, Harrold LR, Ayers DC. Incorporating patient reported outcomes in total joint arthroplasty registries: challenges and opportunities. Clinical Orthopaedics and Related Research. 2013; 471(11):3482-3488.

Ayers DC. Zheng H, Franklin PD. Integrating Patient-Reported Outcomes (PROs) into orthopedic clinical practice: proof of concept from FORCE-TJR. Clinical Orthopaedics and Related Research. 2013; 471(11):3419-3425.

Franklin PD, Rosal MC. Can knee arthroplasty play a role in weight management in knee osteoarthritis? Arthritis Care & Research 2013 May; 65 (5): 667–668.

Franklin PD, Allison JJ, Ayers DC. Beyond implant registries: a patient-centered research consortium for comparative effectiveness in total joint replacement. JAMA. 2012 Sep; 308(12): 1217-8.

Briggs V, Kaplan MS, Eskander MS, Franklin PD. Injection treatment and back pain associated with degenerative lumbar spinal stenosis in older adults. Pain Physician. 2010 ; 13(6): E347-55.

Franklin PD, Karbassi JA, Li W, Yang W, Ayers DC. Reduction in narcotic use after primary Total Knee Replacement associated with pain relief and satisfaction. J Arthroplasty. 2010 ; 25(6): 12-16. PMID: 20580191.

Pingsheng Liu, Franklin PD, Karbassi JA, Li W, Yang W, Ayers DC. Reduction in narcotic use after primary Total Knee Replacement associated with pain relief and satisfaction. J Arthroplasty. 2010 ; 25(6): 12-16.

Franklin PD, Li W, Ayers DC. The Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes. Clin Orthop Relat Res. 2008 Nov;466(11):2597-604.

Anderson SA, Li X, Franklin PD, Wixted JJ.  Ankle fractures in the elderly: Initial and long-term outcomes.  Foot and Ankle International.  2008 Dec; 29(12): 1184-8.

Li X, Shah A, Franklin PD, Merolli R, Bradley J, Busconi BD.  Arthroscopic debridement of the osteoarthritic knee combined with Orthovisc treatment: a case series and review of the literature.  Journal of Orthopaedic Surgery and Research. Sept, 3:43. 2008.

Wixted JJ, Reed MA, Eskander MS, Millar B, Anderson RC, Bagchi K, Kaur S.  Franklin PD, Leclair WJ. The effect of an orthopedic trauma room on after-hours surgery at a level one trauma center. J Orthop Trauma. 2008 Apr; 22: 234-236.

Brooks DD, Eskander MS, Eskander JP, Sagi HC, Franklin PD, Riew KD, Connolly PJ. The risk of reintubation following anterior cervical spine surgery. Orthopedics. 2008 Mar; 32: 198-.

Franklin PD, Li W, Ayers DC. Patient predictors of variation in functional improvement after total knee replacement. Clinical Orthopedics and Related Research, 2007.

Franklin PD, McLaughlin J, Boisvert CB, Li W, Ayers D. Pilot Study of Methods to Document Quantity and Variation in Independent Patient Exercise and Activity after Total Knee Replacement. J of Arthroplasty, J Arthroplasty. 2006 Sep;21(6 Suppl2):157-63.

Franklin PD, Rosenbaum P, Carey M, Roizen M.  Using sequential email messages to promote health behaviors: evidence of feasibility and reach in a worksite sample. J Med Internet Res. 2006 8(1):e3.

Franklin PD, Ayers DC, Ploutz-Snyder R, Kelly M. Differential Effects of Emotional Health in Total Hip and Total Knee Replacement Functional Outcome. 2006.

Franklin PD, Ploutz-Snyder R, Rosenbaum P, Carey M, Smith N, Roizen M. Using Email and the Internet to Conduct a Health Promotion Trial across Multiple Worksites: Challenges and Lessons Learned. J of Evaluation and Program Planning, (October, 2006).

Ayers DC, Franklin PD, Ploutz-Snyder R, Boisvert C., Trief P. Total Knee Replacement Outcome and Co-existing physical and emotional illness. Clin Orthop Relat Res. 2005; 440:157-61.

Ayers DC, Franklin PD, Trief P, Ploutz-Snyder R, Freund DF. Psychological Attributes of Preoperative Total  Joint Replacement Patients: Implications for Optimal Physical Outcome. J Arthroplasty. 2004 Oct;19 (7 Suppl 2):125-30.








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Understanding the role of patient attributes and post-operative activity on long-term functional outcome following Total Joint Replacement.  The Center for Arthritis and Total Joint Replacement is conducting a series of clinical and outcomes studies evaluating the roles of pre-operative emotional health, co-existing illness, and post-operative rehabilitation exercise adherence on level of post-operative improvement in long-term physical function. For example, a randomized trial of a behaviorally-based, post-surgical exercise and activity program will evaluate patient adherence and long-term physical function.   
Predictors of functional outcome in chronic degenerative conditions of the spine and wrist. Longitudinal studies are evaluating the contribution of patient attributes, emotional support, and co-existing conditions to predicting pain and function in operative and non-operative care of patients with lumbar stenosis and carpal tunnel syndrome

Email and web-based health promotion programs for arthritis and primary prevention. Health promotion via sequential emails and interactive web-based tools is currently being evaluated in a worksite randomized trial. The program is designed to enhance adoption of healthy diets and physical activity. Health-related work productivity and health costs will be evaluated. A multi-component web-based arthritis education program will extrapolate the lessons learned to arthritis self-care. 











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"Defining components of physical therapy achieving maximum function after TKR"
Sponsor: NIH/NIAMS
Patricia Franklin, PI; Carol Oatis, CO-PI

"Patient Osteoarthritis Careplan to Inform Optimal Treatment"
Sponsor: PCORI
Patricia Franklin, PI 

"Improving patient reported outcomes measures for total joint replacement"
Sponsor: AHRQ
Gandek B, PI 

"Use and safety of opioids in patients undergoing total joint replacement"
Sponsor: NIH/NIAMS (sub-award)
Patricia Franklin, PI 

"Comparative effectiveness of pulmonary embolism prevention after hip and knee replacement (PEPPER); balancing safery and efficacy" (sub-award)
Sponsor: PCORI
Patricia Franklin, PI 

"Creating national surveillance infrastructure for prority medical devices"
Sponsor: FDA
Patricia Franklin, PI

"TJR Guru: mobile app for shared informed decision making in total joint replacement surgery"
Sponsor: AHRQ
Hua Zheng, PI

"Improving Orthopedic Outcomes Through a National TJR Registry"
Sponsor: NIH-Agency for Healthcare Research and Quality (AHRQ)
Patricia Franklin, PI

"Perioperative intervention to improve post-TKR support and function"   
Sponsor: NIAMS   
Patricia Franklin, PI; Milagros Rosal, CO-PI

"eHealth tools for knee arthritis patients: treatment choice, outcome assessment, and answers: how will I benefit from total knee replacement surgery?"
Sponsor: Robert Wood Johnson Foundation 
Patricia Franklin, PI

"Technology to Assess Physical Activity and Sedentary Behavior in Aging Adults with Osteoarthritis"
Sponsor: UMass Life Science Moment Fund (LSMF) Awards
Patricia Franklin, PI; Wenjun Li, CO-PI


Patricia Franklin,

Joy McCann Professor Professor

Faculty Appointment in:
  • Orthopedics and Physical Rehabilitation (Medicine)
  • Family and Community Medicine (Medicine)
  • Morningside Graduate School of Biomedical Sciences
  • Clinical and Population Health Research (CPHR)

Phone: 508 856 5748