American Joint Replacement Registry Surpasses 4 Million Captured Hip and Knee Arthroplasty Procedures

ROSEMONT, Ill. (November 7, 2024)—The American Joint Replacement Registry (AJRR) surpassed 4 million hip and knee arthroplasty procedures[1] in its database in March, a milestone announced in the 11^th edition of its Annual Report released today. Published by the American Academy of Orthopaedic Surgeons (AAOS) Registry Program, the 2024 report analyzes more than 3.7 million of those procedures and reflects data submitted between 2012-2023 from 1,447 institutions across all 50 states and the District of Columbia. It marks an 18% growth in procedures from the previous year.

To view the full AJRR Annual Report, click here.

“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.”

National Registry for Orthopaedics Celebrates the Power of Data
With the collection and reporting of U.S. hip and knee arthroplasty data, the report aims to provide valuable information to the musculoskeletal community: orthopaedic surgeons, hospitals, ambulatory surgery centers (ASCs), private practices, device manufacturers, payers and most importantly patients. Its analyses can drive clinicians to alter practice and improve patient outcomes.

Some notable findings in the 2024 Annual Report include:

• AJRR continues to facilitate the capture of patient-report outcomes (PRO) data. 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.
• 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.
• Hospital discharges to home versus a skilled nursing facility maintain an upwards trend. 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.
• The utilization of both computer navigation and robotics has increased substantially over the past few years. The percentage of elective primary THA cases utilizing robotic assistance is now over 6%. However, in 2023, there has been a decline in computer assisted navigation.
• For the first time this year, AJRR has updated the categories for Total Knee Arthroplasty constraints. This offers increased granularity in reviewing trends.

“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.

For slides with figures and data tables as featured in the report, email [email protected].

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AAOS Registry Program
The AAOS Registry Program’s mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data. The American Joint Replacement Registry (AJRR), the Academy’s hip and knee replacement registry, is the cornerstone of the AAOS’s Registry Program, and the world’s largest national registry of hip and knee joint replacement data by annual procedural count, with more than 3 million procedures contained within its database. Additional registries include the Fracture & Trauma Registry (FTR), the Musculoskeletal Tumor Registry (MsTR), the Shoulder & Elbow Registry (SER), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS. 

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues; and it leads the health care discussion on advancing quality.

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[1] 4,300,274 procedures submitted to AJRR from Jan. 1, 2012 – March 31, 2024