American Joint Replacement Registry Releases 11th Annual Report 

The American Joint Replacement Registry (AJRR) surpassed 4 million hip and knee arthroplasty procedures. This milestone was announced in the 11th edition of its Annual Report. 

The report was published by the American Academy of Orthopaedic Surgeons (AAOS) Registry Program, analyzing over 3.7 million of those procedures and reflecting data submitted between 2012 and 2023 from 1,447 institutions across all 50 states and the District of Columbia. It marks an 18% growth in procedures from the previous year.

The report aims to provide valuable information to the musculoskeletal community: orthopaedic surgeons, hospitals, ambulatory surgery centers (ASCs), private practices, device manufacturers, payers, and patients. Its analyses can drive clinicians to alter practice and improve patient outcomes.

“Surpassing 4 million captured hip and knee arthroplasty procedures solidifies AJRR’s status as the largest orthopaedic registry by annual procedure count,” said James I. Huddleston, III, MD, FAAOS, chair of the AJRR Steering Committee. “This achievement reflects our collective commitment to improving patient care and gathering data that can influence the quality and effectiveness of treatments across the nation. The success of the AJRR wouldn’t be possible without the support and contributions of our participating sites, surgeons, and industry partners.”

In the report, AJRR updated its PRO data collection portal and the procedure and patient-reported outcome measures (PROMs) file upload specifications in February 2024 to support data capture and reporting on behalf of sites for the Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting (IQR) PRO Performance Measure (PRO-PM). By the end of 2023, 631 sites out of 1,447 (44%) have submitted PROMs, which is a 27% increase in sites compared to the previous 2023 AJRR Annual Report.

Across all PROMs, there is a substantial improvement in PROs from preoperative to 1-year postoperative, especially in physical function and knee-related outcomes. PROMs related to physical health, such as HOOS JR and VR-12 Physical Health Component, indicate greater improvements compared to mental health metrics, emphasizing the positive impact of knee arthroplasty on patients’ physical function.

The utilization of both computer navigation and robotics has increased substantially over the past few years. The percentage of elective primary THA cases using robotic assistance is now over 6%. However, in 2023, there has been a decline in computer-assisted navigation.

“It’s clear that the AJRR is shaping the future of orthopaedic care by empowering surgeons with on-demand dashboards that deliver comprehensive data analytics. This growing national registry will continue to drive evidence-based decisions and advance patient outcomes for years to come,” said Dr. Huddleston.

Approximately 92% of patients are now being discharged to home following elective primary total hip arthroplasty (THA), with far fewer patients being discharged to skilled nursing facilities compared to just a few years ago. 

The percentage of patients discharged to a skilled nursing facility following revision THA declined over the last four years to less than a quarter of revision hip arthroplasty patients. 

This data demonstrates surgeons’ and musculoskeletal care teams’ ongoing commitment to transitioning patients safely back to their home environment, as well as their interest in patient preoperative optimization and care coordination.

Ambulatory surgery centers (ASCs) continue to play an increasingly important role in the delivery of total joint arthroplasty care in the U.S. There are now 62,110 procedural cases reported by ASCs, a 70% increase since 2022.

For the first time this year, AJRR has updated the categories for Total Knee Arthroplasty constraints. This offers increased granularity in reviewing trends.