Since its inception in 2008, the AJRR has received data on more than 80,000 procedures. In 2013, 123 hospitals submitted data, showing 43,823 total procedures performed with 38 percent defined as hip procedures and 62 percent listed as knee surgeries. Revision procedures accounted for 6.6 percent of all surgeries, according to the report.
Osteoarthritis (OA) represented 81.3 percent of all diagnostic codes for primary or revision hip procedures, and femoral neck fracture comprised 11.7 percent of all primary total hip arthroplasties. Total or partial hip replacement represented 90 percent of all hip procedures. The report also showed OA represented 97.5 percent of diagnostic codes for primary knee surgeries, while total knee replacement accounted for 95.3 percent of procedure codes.
"The annual report is our first public dissemination of information as it relates to total joint replacement in the United States," said AJRR Board Chairman William J. Maloney, M.D. "The goal is for the AJRR to be a quality registry where we are tracking outcomes and looking at implant performance, hospital performance and surgeon performance and looking at risk factors for failure. The data gets more robust and rich as time passes because we are able to track those different factors longitudinally."
The report indicated 151 of 222 revisions were performed less than three months after primary hip or knee procedures vs. nine revisions after one year. The leading cause of early revision procedures was infection (in both primary hip and knee arthroplasty) followed closely by periprosthetic fracture for primary hip arthroplasty.
The leading articulation type was a metal head with a polyethylene liner (71.9 percent), while a metal head with a metal liner was used least (0.1 percent), the report showed. For implanted knee components, 75 percent involved highly cross-linked polyethylene inserts and 25 percent were standard polyethylene.
"Surgeons will be able to look at what the national trends are and compare it to their practice," Maloney noted. "The AJRR is the start of our ability to track what is happening and hopefully be able to identify problems earlier in the process so that less patients are exposed to substandard surgery and technology."
The American Joint Replacement Registry is a multi-stakeholder, independent, non-profit organization for data collection and quality improvement initiatives in total hip and knee replacements. As of February 2015, the AJRR contains hip and knee procedural data from nearly 450 hospitals and 2,900 surgeons in all 50 states. The registry is increasing at a rate of 2,500 procedures each week; to date, it contains information on more than 190,000 procedures.