American Joint Replacement Registry (AJRR): First Annual Report and Subsequent Progress
Wednesday, November 4, 2015
: 8:30 a.m. - 8:50 a.m.
With nearly 50% of adults at risk of developing knee osteoarthritis by age 85 and 25% of adults at risk of developing hip osteoarthritis, successful treatment options are critical. Total joint arthroplasty (TJA) offers improvement in quality of life for individuals with severe osteoarthritis. Maintaining quality care for TJA patients, and understanding implant performance is imperative given the recent recall of a hip implant system which affected nearly 100,000 patients globally. AJRR is the first national, multi-stakeholder clinical data registry designed to improve the quality of TJA care. Hospitals submit data via secure electronic file transfer of procedural metrics extracted from their electronic health record. Imported procedures are subject to additional verification and in 2013 a statistically powered sample (N=12 hospitals) was audited for accuracy (agreement rate = 92.3%). Data on N=43,823 procedures from N=123 hospitals (n= 16,665 hips; n=27,158 knees) were collected in 2013. Results pertaining to ICD-9 procedure and diagnosis codes were consistent with other registries’ findings as was the frequency of revision procedures (n=2,877; 6.6%). Of the revisions with an index procedure occurring within 2 years, (n=222), n=151 (68.0%) occurred less than 3 months after the index procedure. Revisions were primarily due to preventable issues such as complications (hip=69.6%; knee=84.8%) including infection and peri-prosthetic fracture. Understanding reasons for earlier than expected revisions will assist with improvements in TJA. As of today, AJRR has enrolled over 430 hospitals representing 50 states. Acquiring more procedures will enhance our ability to generalize data and conduct longitudinal analyses including implant survivorship.
Clinical medicine applied in public health
Provision of health care to the public
Describe the development of a national arthroplasty registry.
Discuss preliminary findings from the AJRR.
Explain future directions for a national arthroplasty registry.
Keyword(s): Surveillance, Quality of Care
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have served as the Director of Analytics for the American Joint Replacement Registry since it's inception as a national clinical data registry. In my role, I have overseen a variety of tasks including hospital enrollment, data analysis, collaboration with federal entities, and report writing. I have been directly involved in all content presented in this abstract.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.