American Joint Replacement Registry
American Academy of Orthopaedic Surgeons (AAOS)
Creates Independent Organization
The American Academy of Orthopaedic Surgeons (AAOS)
has incorporated the American Joint Replacement Registry
(AJRR), a nonprofit organization dedicated to collecting
and reporting on hip and knee joint replacement
procedures. AAOS believes this proposed option is a
patient safety best practice.
The goal of a national joint registry is to monitor
device performance, thereby allowing early recognition
of underperforming processes or devices and supporting
continued clinical learning.
“In 2009, AAOS has made great strides in bringing the
American Joint Replacement Registry to reality. We have
now incorporated. And, we currently are in the process
of forming project work groups to tackle data,
governance and oversight issues." said John Callaghan,
MD, first vice president of the AAOS and orthopaedic
surgeon at the University of Iowa.
The AAOS has researched and determined the best
course of action for starting and administering a
national joint registry, one that would include:
- privacy safeguards for patients;
- legal protections for device makers and
- a plan to begin capturing data as early as
- infrastructure to capture at least 90
percent of all procedures.
In 2006, there were more than 1 million hip and knee
replacements performed in the U.S. Of these,
approximately 7.5 percent were revisions, resulting in
77,000 procedures at a cost of more than $32 billion. A
national joint registry will help doctors to more
quickly identify poorly performing products and match
patient procedures and devices to optimize outcomes.
Therefore, the AJRR could help patients and payers save
money and could limit the number of revision (or
secondary) surgeries necessary. Based on the projected
procedures through 2030, the potential savings could
exceed $13 billion over 20 years.
Proposed by the AAOS and related stakeholders, the
AJRR proposal calls for an independent, not-for-profit
organization, funded by the proposing stakeholders —
orthopaedic surgeons, payers, government agencies,
patient groups, hospitals and device manufacturers. The
AJRR is estimated to cost $20 to $25 million to
“We now have a chance to put best practices, already
benefiting patients in other countries, to work here in
the U.S. For instance, registries in Sweden, Great
Britain, Canada and Australia have seen up to a 10
percent reduction in revision rates. Even with a modest
2 percent decrease in the U.S. revision rate, this
proposal would yield a savings of $652 million in one
year," said David Lewallen, MD, chair of the AJRR
Project Team and orthopaedic surgeon at Mayo Clinic.
Background: 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 needs and
lifestyle as well as the device’s performance. A
device’s longevity is one of the factors that would be
monitored by a national joint registry. A joint registry
follows the artificial joint device throughout a
recipient’s lifetime in a database with information
about the patient’s demographics, as well as where and
when the surgery took place.