The AJRR Annual Report Offers a Snapshot of Hip and Knee Arthroplasty Trends In the US

The 2023 AJRR Annual Report, published by the American Joint Replacement Registry (AJRR), now includes data on more than 3.1 million primary and revision hip and knee arthroplasty procedures performed between 2012 and 2022 – a 23% growth in procedural cases from the prior report.

“This year’s AJRR Annual Report presents a glimpse into the data over the last decade through 2022 and provides clinical insights, national trends and risk-stratified outcome analyses related to Medicare patients who undergo hip and knee arthroplasty procedures,” said James I. Huddleston III, MD, chair of the AJRR Steering Committee.

“This linkage provides a more complete picture of our patient population and their associated comorbidities and outcomes, including longitudinal outcomes of patients who receive care at non-AJRR participating sites. The information in this year’s Annual Report gives the most comprehensive picture to date of patterns of hip and knee arthroplasty practice and outcomes in the US.”

Leveraging Registry Data to Improve Care

With the collection and reporting of U.S. hip and knee arthroplasty data, the report aims to provide valuable information to orthopaedic surgeons, hospitals, ambulatory surgery centers (ASCs), private practices, device manufacturers, payers, and, most importantly, patients. Its analyses can help clinicians change practice and improve patient outcomes.

Notable findings in the 2023 Annual Report include the following:

  • Patient-Reported Outcome Measures (PROMs) are increasingly being utilized to evaluate the success of a hip or knee arthroplasty procedure. Through continued support of the RegistryInsights® PROM platform and partnerships with third-party vendors, AJRR has experienced substantial growth in PROMs capture. By the end of 2022, 496 participating sites submitted PROMs, which is a 24% increase compared with the previous year. Collection of PROMs data through the KOOS, JR. score revealed that 86% of patients achieved a meaningful improvement after total knee arthroplasty (TKA).
  • ASCs continue to play an increasingly important role in the delivery of total joint arthroplasty care in the US. There are now 42,228 procedural cases reported to AJRR by ASCs, an 84% increase since 2022.
  • Hospital discharges to home versus a skilled nursing facility are trending upward.  Approximately 93% of patients are now being discharged to home following elective primary total hip arthroplasty (THA) with far fewer patients (8%) being discharged to skilled nursing facilities compared with just a few years ago. The percentage of patients being discharged to skilled nursing facilities following primary TKA also continues to decrease and now represents less than 6% of all discharges. These data demonstrate  surgeons’ ongoing commitment to transitioning patients safely back to their home environment, as well as their interest in patient preoperative optimization and care coordination.
  • Rate of technology use for assistance in elective primary procedures has increased substantially. Over the past 6 years, the utilization of robotics in TKA has increased more than 6-fold and is now reported in over 13% of procedures; computer navigation use has remained relatively stable. According to Dr. Huddleston, the continued collection and analysis of robotic data will eventually allow surgeons to assess the value proposition of these technologies.
  • New analyses offer new perspectives on patient outcomes. Additional analyses provided for the first time in the 2023 AJRR Annual Report include hip and knee survivorship comparisons between pre- and post-COVID-19 emergency declaration, revision outcome following revision THA between dual mobility and standard designs, and survivorship among fracture patients treated with THA vs. hemiarthroplasty. These new analyses offer critical insights into the impact of COVID-19 on patients and shed light on the performance of new technologies and treatment paradigms.

“The publication of the 10th edition of the AJRR Annual Report further validates the commitment of healthcare institutions, clinicians, and patients to improving the quality of musculoskeletal care,” said James A. Browne, MD, chair of the AJRR Publications Subcommittee and editor of the AJRR Annual Report.

“The ever-growing submission and compilation of data is driving new insights and fueling our desire to improve the value of care for our patients.”

Click here to view the full 2023 AJRR Annual Report.

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