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The Joint Commission introduces new and revised Advanced Total Hip and Total Knee Replacement Certification requirements

Thursday, January 23 2020

Maureen Lyons
Corporate Communications

(OAKBROOK TERRACE, Illinois, Jan. 23, 2020) – The Joint Commission has introduced new and revised requirements, effective July 1, 2020, for hospitals, critical access hospitals and ambulatory surgery centers that participate in the Advanced Total Hip and Total Knee Replacement (THKR) Certification program.  The standards include 11 new and 11 revised elements of performance (EPs).

The new and revised standards require THKR programs to:

  • Use transfer protocols with standardized handoffs to support the continuity of care. 
  • Take action to optimize the patient’s health condition prior to surgery.
  • Provide program-specific orientation for staff who are caring for patients undergoing hip and knee replacements. 
  • Offer an overview of total hip and total knee replacement to the patient, family and caregivers (i.e. classes, videos, brochures) and confirm understanding.
  • Establish care pathways to promote standardized care delivery during the preoperative, intraoperative and postoperative phases.  
  • Follow current American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines.
  • Implement and promote best practices for the care of patients recovering from total hip or knee replacement.  
  • Use an established performance improvement process to monitor, at a minimum, infection (mechanical and wound) and blood management, including interoperative blood loss, transfusion rates and more. 

For a complete list of the standards changes, please access The Joint Commission’s new R3 Report. The report provides the requirement, rationale and reference for each EP. 

In addition to an extensive literature review and public field review, expert guidance was obtained from a standards workgroup comprised of clinicians with expertise in THKR from The Joint Commission and AAOS, as well as a Standards Review Panel (SRP) comprised of representatives from organizations or professionals who provide a “boots on the ground” point of view and insights into the practical application of the standards.

The Joint Commission’s THKR certification focuses on the pre-surgical orthopedic consultation to the intraoperative, hospitalization or ambulatory surgical center admission, rehabilitation activities and follow-up visit with the orthopedic surgeon. 

The prepublication version of the standards is available online until July 1, 2020. After July 1, the new requirements may be accessed in E-dition® or the standards manual. 


About The Joint Commission
Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 22,000 health care organizations and programs in the United States. An independent, nonprofit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at