In 2024, the AAOS Registry Program surpassed 4.5 million procedures, collecting data from more than 1,600 sites and 16,640 surgeons within the five registries. This national initiative provides valuable real-world data that informs advancements in patient care and reinforces evidence-based practices.

Significant improvements were made to the registries this year, including collaboration with the Blue Cross Blue Shield Association (BCBSA) to allow quality outcomes data from the American Joint Replacement Registry (AJRR) and American Spine Registry (ASR) to be evaluated for current and prospective provider applicants for designation as a Blue Distinction^® Center (BDC).

“Since launching in 2017, the AAOS Registry Program has brought tremendous value to orthopaedics, transforming how data can be leveraged to improve patient care,” said William J. Maloney, MD, FAAOS, Registry Oversight Committee chair. “Data from the registries were presented at 11 conferences this year, meaning we have been able to tap into the information collected to pull out key insights that inform practice change. The program continues to expand, from our ongoing collaborations with quality programs to a newly launched quality scorecard for AJRR to expanding our technology partnerships to align with best practices and to make it easier for participants to submit data. We are excited at the trajectory of the Registry Program and look forward to continued growth in 2025.”

BCBSA collaboration
AJRR and ASR collect data from millions of spine, total hip arthroplasty (THA), and total knee arthroplasty (TKA) procedures. The partnership will allow BCBSA to use quality outcomes data from consenting registry participants to evaluate current and prospective provider applicants for designation under BCBSA’s BDC for Knee and Hip Replacement and BDC for Spine Surgery programs.

Registry participants include hospitals, ambulatory surgery centers, and private practice groups, which can leverage the power of their submitted data to improve quality of care and assess outcomes to benefit their patients.

Both registries provide a pathway for reporting patient-aggregated, de-identified, site-level data from consenting registry participants. For the 2025 evaluation cycle, providers submitted quality-measurement data for evaluation under BCBSA’s BDC for Knee and Hip Replacement and/or BDC for Spine Surgery designations, via either authorized AJRR/ASR reports or manually, via each BDC program’s Provider Survey. AJRR and ASR participation and performance-data submission will be required for future application cycles.

Inaugural registry releases 11th Annual Report
Last year marked several successes and growth for AJRR, the first registry developed in the Registry Program, as it reached 4 million hip and knee arthroplasty procedures in March, solidifying AJRR as the largest orthopaedic registry by annual procedure count. Published in November 2024, the 11th edition of the AJRR Annual Report analyzed more than 3.7 million procedures, reflecting data submitted between 2012 and 2023 and marking an 18 percent growth in procedures from 2023.

A major AJRR advancement last year included launching the Quality Improvement Scorecard on the Institution and Surgeon Dashboards in RegistryInsights^®. The scorecard enhances transparency, allowing participants to track performance, benchmark against national standards, and support practice improvements.

In early 2024, AJRR implemented the Centers for Medicare & Medicaid Services (CMS) Inpatient Quality Reporting THA/TKA Patient-Reported Outcomes Performance Measure. This performance measure focuses on patient-reported outcomes to assess improvements in pain and functional status following these procedures.

FTR hits 19,000+ procedures
The Fracture & Trauma Registry (FTR) released its second Fact Sheet, showing the significant progression of the registry, which grew to 19,092 procedures submitted by 25 sites from 2016 to June 20, 2024. This milestone highlights the growing value of the registry in advancing fracture and trauma care.

This year also marked an important step forward with the implementation of the FTR Powered by PatientIQ solution at two leading institutions: St. Luke’s University Health Network in Pennsylvania and Stanford Medicine in California. PatientIQ simplifies data collection by integrating into the surgeons’ workflow, automating key aspects of procedure-data submission, and reducing barriers to tracking evidence-based practices.

Development also began on FTR SmartForms, created in collaboration with Duke University, to facilitate easy and efficient point-of-care data entry by clinicians. These forms are designed for sites to integrate directly into their systems to capture the provider-entered details essential to the registry’s value. The SmartForms ensure accurate reflection of fracture nuances and treatments while minimizing provider burden. The anticipated rollout is late 2025.

MsTR releases SmartForms and onboarding toolkit
The Musculoskeletal Tumor Registry (MsTR) issued the 2024 Fact Sheet in conjunction with the Musculoskeletal Tumor Society at its Annual Meeting in September. The report utilized data from 709 procedure records from six institutions, submitted from Nov. 21, 2022, to Aug. 1, 2024.

After analyzing the 2023 Fact Sheet data, the MsTR Steering Committee recognized the need for more comprehensive, provider-entered information to truly capture the nuances of bone and soft-tissue tumors. The implemented changes included making the submission of provider-entered details a requirement for participation and developing improved data-validation processes to ensure the quality, accuracy, and relevance of submissions. This update has led to a curated set of high-quality data that offer more meaningful insights.

Another significant achievement in 2024 was the release of the MsTR standardized SmartForms in the EPIC Community Library, which were developed in collaboration with the University of Iowa. These SmartForms are tailored to capture essential sarcoma details, including tumor location, type, and treatment, directly within electronic health records at the point of care. This ensures precise and efficient documentation, improving data accuracy.

The AAOS Registry Program developed an MsTR Toolkit designed to simplify the participation process and support each site. This was coupled with a Lunch & Learn session in October 2024 that provided an overview of the MsTR and included data elements, methods of data collection, and technical implementation.

Looking ahead, the MsTR is developing the Alternative Entry Pathway as an easy entry point for sites to start with essential data and transition into full participation once the site secures the necessary resources. That will be launched in mid-2025.

SER introduces advanced data visualization
Now in its fifth year, the Shoulder & Elbow Registry (SER) 2024 Annual Report encompassed data from more than 56,000 procedures submitted from Jan. 1, 2015, to Dec. 31, 2023, at 82 participating facilities across 40 states. The Annual Report includes 36,296 submitted procedures, a 44 percent increase in procedures since the 2023 report. A dedicated elbow-procedure section was included, which analyzed a total of 1,544 procedures, including neuroplasty and/or transposition, radial head arthroplasty, removal of implant/hardware removal, and total elbow arthroplasty.

The SER made substantial enhancements to the RegistryInsights dashboard, including advanced data visualization and new report-card features, empowering participants with actionable outcomes data.

ASR updates dashboard
The ASR, a collaborative effort between the American Association of Neurological Surgeons and AAOS, issued the 2024 Fact Sheet, providing access to a national data-collection program from procedures submitted from January 2015 to June 30, 2023. It includes two modules: Degenerative Lumbar Spine and Degenerative Cervical Spine.

ASR introduced several dashboard updates in 2024, including three new filters to enhance benchmarking capabilities: institution type, teaching status, and bed count. Additionally, ASR expanded its metrics and incorporated reporting for the Blue Distinction Program metrics from BCBSA.

ASR hosted a Data Alignment Workshop during the 2024 Spine Summit with representation from surgeons, payers, regulators, and the medical device industry. The workshop emphasized the importance of delivering a robust data set that serves as a single source of truth, and plans were made to enhance the Registry’s granularity and filtering capabilities for procedures and diagnoses, expand automation in data-collection processes, and integrate imaging selectively for specific projects.

Visit aaos.org/registries to learn more.

Molly Todd Rudy is a freelance writer for AAOS Now.