American Joint Replacement Registry Project

The American Academy of Orthopaedic Surgeons (AAOS) is actively engaged in creating an U.S. joint registry and in June 2009, the American Joint Replacement Registry (AJRR) was incorporated in Illinois.

In 2006, there were more than 1 million hip and knee replacements in the U.S Of these, approximately 7.5% were revisions, resulting in 77,000 procedures at a cost of more than $3.2 billion.
Registries in Sweden, Great Britain, Canada and Australia have seen up to a 10% reduction in revision rates.
A modest 2% decrease in the U.S. revision rate would yield a savings of $65.2 million in one year.
Based on the projected group of these procedures through 2030, the potential savings could exceed $1.3 billion over 20 years.

When a patient has a hip or knee implanted into his body, the device used was chosen by his orthopaedic surgeon based on the patient’s stature and lifestyle as well as the device’s performance. The device longevity is one of the factors that would be able to be monitored by a national joint registry.

A joint registry monitors the artificial joint throughout a recipient’s lifetime in a database with information about the patient, surgeon and facility where the procedure took place. The registry costs are unknown at this point, but could range from $10 to $20 million to operate. The data collected will help doctors to more quickly identify poorly performing products and match patients procedures and devices to optimize outcomes.

There are many ongoing efforts to establish local and regional joint registries, however, the AAOS proposes a national, independent, not-for-profit organization outlined below.

American Joint Replacement Registry Fact Sheet (PDF format)

The Independent Registry Proposal:

Created by the AAOS and related stakeholders, such as surgical societies, hospital associates and device makers, this proposal calls for an independent, nonprofit, funded and governed by the stakeholders. The AJRR would gather data on all replacement and revision surgeries, including younger patients who are not recipients of Medicare – with a goal of 90% participation – starting as early as 2010. The funding does not have an end date, and it is anticipated that it would continue as an essential patient-safety practice.

• Details on AAOS Independent Registry

• Press Release

Podcasts

What is AJRR and why is it important? (1:30)
David Lewallen, MD, Chair, AJRR Project Team
What are the benefits of AJRR? (2:30)
David Lewallen, MD, Chair, AJRR Project Team

Background:

The AJRR is the AAOS’ most recent patient safety initiative designed to provide surgeons with timely feedback on their performance, as well as the long-term function of the devices they implant. The AAOS has researched existing models for starting and administering a national joint registry, to develop one that secures patient privacy, while providing legal protections for device makers and physicians, assuring that all parties will participate in the long-term monitoring of each procedure. Through this process, the AAOS has learned much about the capabilities of registries and the importance of matching stakeholder needs with data collection and reporting to optimize patient outcomes.

Past Media Coverage: