Dr. Hawker's research has expanded understanding of the determinants and consequences of care fo people with osteoarthritis, especially joint replacement surgery. Her findings resulted in a shift in research emphasis from area variations in use of ‘preference-sensitive' surgeries to disparities in access and appropriate health care use. Tools and measures to assist clinicians and patients in their osteoarthritis treatment decision making have been developed, evaluated and implemented. Knowledge gained through her research has informed the establishment of a national strategy for arthritis for Canada, and is informing the development of models of care for osteoarthritis locally, nationally and internationally.