The Department of Orthopaedic Surgery at NYU Langone Medical Center has been chosen as one of only 16 centers across the country to participate in the American Joint Replacement Registry (AJRR). The AJRR is a national, independent, not-for-profit organization created to collect key joint replacement and revision data in order to better to monitor device performance and identify underperforming processes while providing information supporting best practices in safety, cost control and advances in technology.
Existing registries outside of the U.S. have shown to result in up to a 10 percent reduction in revision rates. With the American Association of Orthopaedic Surgeons estimating more than 800,000 hip and knee replacements performed in the US annually, even a modest 2 percent decrease in the U.S. revision rate would yield a savings of $65.2 million in one year – with potential projected savings of more than $1.3 billion over 20 years.
The AJRR will collect data from both younger joint replacement patients (40-60) as well as from Medicare patients. The data will provide long-term information about the progression of joint replacements and the impact of wear and tear over time from a younger, more active population. The result will be better cost management, improved device longevity and improved outcomes. In addition, the data will also help patients make more informed choices, in consultation with their surgeon, about the timing of their total joint replacement procedures, the device they will receive and the best course of rehabilitation.
"Similar registries in other countries have proven very successful and, with the aging baby boomer population, we need to engage and educate our patients to develop the best care for their joints in the future," said James D. Slover, MD, assistant professor, Department of Orthopaedic Surgery at NYU Langone Medical Center and the institutions designated registry champion. "We are proud to participate in the AJRR and quickly created the infrastructure across key surgical, nursing, administrative and information technology staff at NYU Langone Medical Center and the Hospital for Joint Diseases to provide appropriate data to the AJRR in a timely, secure and confidential manner."
Replacement joints have a relative lifespan before a device may become loose and potentially require an additional surgery, called revision arthroplasty, in which a previously implanted artificial joint is removed and replaced with a new one. According to the AJRR, registries can act as an early warning system for early implant failure; provide evidence that can positively influence physician behavior to the benefit of patients and society; decrease the burden of disease and cost associated with surgical morbidity and mortality; and reduce the volume of premature revision procedures.
"Joint replacement registries have been very effective in England, Australia, Sweden and other countries," said Joseph D. Zuckerman, the Walter A.L. Thompson Professor of Orthopaedic Surgery and chairman, Department of Orthopaedic Surgery at NYU Langone Medical Center. "Based on the high volume of joint replacements done in the U.S., the AJRR is necessary for the development of future devices as well as for the advancement of orthopaedic patient care, and we are committed to its development."
The initial 16 hospitals selected by AJRR's Hospital Surgeon Participation Workgroup range from academic centers to smaller community hospitals and private orthopaedic practices – reflecting the diversity of hospitals across the country in terms of geographic location, size, and practice type. The pilot will conclude once it generates three months of data from each institution, allowing a better understanding of the burden of reporting data and identify best practices for hospitals and a larger-scale U.S. joint registry roll out later this year. The long-term goal of the registry is to capture data from 90 percent of U.S. hospitals where hip and knee arthroplasty procedures are performed over the next 5 years.
Orthopaedic Surgery at NYU Langone Medical Center, and the Hospital for Joint Diseases (HJD), one of the nation's leading orthopaedic and rheumatologic specialty hospitals dedicated to the prevention and treatment of neuromusculoskeletal disease, are consistently ranked among the leading orthopaedic centers nationwide by U.S. News and World Report. You can learn more about the AJRR at www.ajrr.net, or NYU Langone Medical Center's Department of Orthopaedic Surgery at http://www.med.nyu.edu/department/hospital-joint-diseases.