Karen Metropulos, AJRR Content Writer02.16.18
In 2017, the American Joint Replacement Registry (AJRR) achieved a major milestone—entering over one million arthroplasty procedures into its database. The AJRR 2017 Annual Report gives the most comprehensive picture to date of U.S. hip and knee replacement patterns. The annual report collects data from 2012-2016 and contains 860,080 procedures. Reflecting rapid and accelerating growth, the Registry’s one million milestone was achieved in March of last year.
“The Registry has seen significant participation growth since our previous report—a 101 percent increase in procedures, a 57 percent increase in reporting institutions, and a 50 percent increase in surgeons,” said Daniel J. Berry, M.D., past chair, AJRR Board of Directors. “Growth leads to more and better data, enables more actionable analysis, and yields insights that improve surgical decision support.”
THA and TKA Surgical Insights
Following are some key findings related to surgical practice for total hip arthroplasty (THA) and total knee arthroplasty (TKA) based on analysis of the most recently reported AJRR data. Which surgical procedures are increasing or decreasing? Revision burden is a measure of arthroplasty success; what is the trend across registries? What is the most common knee implant design? How are patient demographic profiles changing? Questions like these (and more) are addressed in detail throughout the annual report. The comprehensive findings from last year’s report will be of interest to orthopedic surgeons, hospitals, medical device companies, government agencies, and other healthcare stakeholders.
Richard Price, senior vice president of payment and healthcare delivery policy at AdvaMed, said, “AdvaMed recommends that CMS support hospital participation in the AJRR in order to further advance the development of quality measures related to THA/TKA. Supporting the AJRR…as an alternative for meeting quality reporting requirements would provide an invaluable resource to improve patient outcomes. The joint registry will allow the tracking of implant performance from the time of the index procedure and the identification of any complications or issues that may be related to the care of the patient with that device.”
AJRR Key Findings About THA
AJRR Key Findings About TKA
What’s Ahead for the Registry?
AJRR is now able to collect three levels of data, including patient-reported outcome measures (PROMs) as well as comorbidity and operative complication data. As a result, the Registry will be able to risk-adjust participant data, greatly enhancing its value to all stakeholders. The exciting focus going forward is the reporting of risk adjusted longitudinal data, which will be shared in future AJRR annual reports.
Karen Metropulos has spent over 15 years in the healthcare industry leading product innovation, Centers of Excellence, and digital content/relationship value equations for online physician communities. Professional settings have included healthcare systems, PwC healthcare consulting, online start-ups, and not-for-profit membership organizations.
“The Registry has seen significant participation growth since our previous report—a 101 percent increase in procedures, a 57 percent increase in reporting institutions, and a 50 percent increase in surgeons,” said Daniel J. Berry, M.D., past chair, AJRR Board of Directors. “Growth leads to more and better data, enables more actionable analysis, and yields insights that improve surgical decision support.”
THA and TKA Surgical Insights
Following are some key findings related to surgical practice for total hip arthroplasty (THA) and total knee arthroplasty (TKA) based on analysis of the most recently reported AJRR data. Which surgical procedures are increasing or decreasing? Revision burden is a measure of arthroplasty success; what is the trend across registries? What is the most common knee implant design? How are patient demographic profiles changing? Questions like these (and more) are addressed in detail throughout the annual report. The comprehensive findings from last year’s report will be of interest to orthopedic surgeons, hospitals, medical device companies, government agencies, and other healthcare stakeholders.
Richard Price, senior vice president of payment and healthcare delivery policy at AdvaMed, said, “AdvaMed recommends that CMS support hospital participation in the AJRR in order to further advance the development of quality measures related to THA/TKA. Supporting the AJRR…as an alternative for meeting quality reporting requirements would provide an invaluable resource to improve patient outcomes. The joint registry will allow the tracking of implant performance from the time of the index procedure and the identification of any complications or issues that may be related to the care of the patient with that device.”
AJRR Key Findings About THA
- Median number of procedures performed by AJRR surgeons is 12.
- 2016 revision burden is 8.6 percent. It has been decreasing across all national registries.
- The majority of early (less than 3 months) linked revisions are for dislocation, infection, and periprosthetic fracture.
- Hemiarthroplasty is approximately 11 percent of total hip arthroplasty.
- THA for femoral neck fracture continues to grow; the majority utilize cementless stems and bipolar heads in all age groups.
- Ceramic head use is increasing each year, with the “tipping point” from an even distribution between ceramic and CoCr heads occurring at age 68.
- Male patients predominate in younger age groups, but females represent the majority of procedures as the population ages.
AJRR Key Findings About TKA
- Median number of procedures performed by AJRR surgeons is 22.
- 2016 revision burden is 5.1 percent. It has remained constant across all national registries.
- The majority of early linked TKA revisions continue to be for infections.
- Posterior-stabilized designs are the most common design used in primary TKA, but ultra-congruent design use has increased steadily over time.
- Mobile-bearing design use remains consistently around 8-9 percent of primary TKA.
- Highly cross-linked polyethylene is used in the majority of primary TKA procedures, but reflects a downward trend. Conventional UHMWPE is decreasing; antioxidant polyethylene is increasing.
- The AJRR continues to report over 90 percent patellar resurfacing in primary TKA in contrast to many other national registries.
What’s Ahead for the Registry?
AJRR is now able to collect three levels of data, including patient-reported outcome measures (PROMs) as well as comorbidity and operative complication data. As a result, the Registry will be able to risk-adjust participant data, greatly enhancing its value to all stakeholders. The exciting focus going forward is the reporting of risk adjusted longitudinal data, which will be shared in future AJRR annual reports.
Karen Metropulos has spent over 15 years in the healthcare industry leading product innovation, Centers of Excellence, and digital content/relationship value equations for online physician communities. Professional settings have included healthcare systems, PwC healthcare consulting, online start-ups, and not-for-profit membership organizations.