Published 12/18/2024
Earlier this year, the American Joint Replacement Registry (AJRR) eclipsed 4.3 million hip and knee arthroplasty procedures in its database, a milestone announced in the 11th edition of its Annual Report released in November.
AJRR is the world’s largest national registry of hip and knee joint replacement data by annual procedural count, and it is the cornerstone of the AAOS Registry Program, whose mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data.
The AJRR 2024 Annual Report analyzes more than 3.7 million of those procedures and reflects data submitted between 2012 and 2023 from 1,447 institutions across all 50 states and the District of Columbia. It marks an 18 percent growth in procedures from the previous year. To view the full AJRR Annual Report, visit aaos.org/AJRRannualreport.
“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 AJRR wouldn’t be possible without the support and contributions of our participating sites, surgeons, and industry partners,” he added.
Celebrating the power of data
The AJRR 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. Some notable findings in the 2024 Annual Report include:
- AJRR continues to facilitate the capture of patient-reported 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 PRO Performance Measure. By the end of 2023, 631 sites out of 1,447
(44 percent) had submitted PROMs, which is a 27 percent increase in sites compared to the previous AJRR 2023 Annual Report. - Across all PROMs, there was a substantial improvement in PROs preoperatively to 1 year postoperatively, especially in physical function and knee-related outcomes. PROMs such as the Hip Disability and Osteoarthritis Outcome Score–Joint Replacement and Veterans Rand 12-Item Health Survey Physical Health Component indicate meaningful improvements for both physical and mental health metrics (with higher rates of improvement among physical health metrics), emphasizing the positive impact of knee arthroplasty on patients’ physical function.
- ASCs continue to play an increasingly important role in the delivery of total joint arthroplasty care in the United States. There are now 62,110 procedural cases reported by ASCs in AJRR, a 70 percent increase since 2022.
- Hospital discharges to home versus a skilled nursing facility maintain an upward trend. Approximately 92 percent 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 past 4 years to less than a quarter of revision THA patients. These data demonstrate 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 robotics has increased substantially over the past few years. The percentage of elective primary THA cases utilizing robotic assistance is now over 6 percent. However, in 2023, there was a decline in computer-assisted navigation.
- For the first time this year, AJRR updated the categories for total knee arthroplasty constraints. The updated categories offer increased granularity in reviewing trends.
“It’s clear that AJRR is shaping the future of orthopaedic care by empowering surgeons with on-demand dashboards that deliver comprehensive data analytics,” Dr. Huddleston said. “This growing national registry will continue to drive evidence-based decisions and advance patient outcomes for years to come.”
For slides with figures and data tables as featured in the report, visit aaos.org/AJRRannualreport.