DiagnosticsAmerican Academy Of Orthopaedic Surgeons Creates Independent Organization: American Joint Replacement Registry
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 physicians;
* a plan to begin capturing data as early as 2010; and
* 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 initiate.
"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. To find more information, visit http://www.aaos.org/registry
Kristina Findlay
American Academy of Orthopaedic Surgeons