The American Joint Replacement Registry's The Register
AJRR Awarded "Best Poster Presentation"
ISAR Annual Meeting attendees stopping to read AJRR's research posters
Last month, AJRR staff and Board Members attended the the 6th International  Congress  of Arthroplasty Registries, the annual meeting of the International Society of Arthroplasty Registries (ISAR). The meeting was very educational, and allowed our staff to see the different challenges and successes that hip and knee registries experience around the world. We presented two posters and were awarded "Best Poster Presentation" by a voting panel of judges. The winning poster was titled, "Infection burden in total hip and knee arth ropla sty: an international registry based perspective." Based off a research article in Arthroplasty Today, the official journal of the AJRR, the poster explored infection-related revision across six national arthroplasty registries. 

The research article authors were made up of of mostly AJRR staff and Board members: Bryan D. Springer, MD, September R. Cahue, MPH, Caryn D. Etkin, PhD, MPH, David G.
Lewallen, MD, and Brian J. McGrory, MD, MS. They hypothesized that infection burden
AJRR Director of Analytics Caryn D. Etkin, PhD, MPH, with the "Best Poster Presentation" award on behalf of AJRR
would be the similar across multiple national  arthroplasty registr ies. The results showed that for both hip and knee arthroplasty, each  registry with six-year data showed an increased  infection burden over the period of the survey. The study supports the idea that joint  infection is one of the most frequent modes of  failure in total joint arthroplasty worldwide. 

In addition to the research article, Arthroplasty Today published a story about AJRR's history and where the organization will be headed in the future. Arthroplasty Today features AJRR articles twice a year, so the publication is a  good resource to learn more about the AJRR's progress and what the Registry offers. Visit the Arthroplasty Today website here . To view the two posters that AJRR presented at the ISAR Annual Meeting, click here.
Platform Improvements Coming July 1
As part of our ongoing technology transformation efforts, we are working to continuously improve our Registry platform to make it more efficient and practical for our users. The next significant update will take place on July 1, 2017. Luckily, the bulk of the changes will happen behind the scenes, and the few differences that users will notice will enhance their Registry experience.

The URL for accessing the Registry will not change. However, users will be asked to create a new two-factor identification password in order to keep up with modern security standards. Users will also have more insight into the data that they submit. This increased transparency will be accompanied by enhanced search capabilities. The "Tools" and "Resources" tabs will also be consolidated to offer training materials and documentation that supports participation in the Registry.

Our patient-reported outcome measures (PROMs) platform will be streamlined, and may look a little different as well. Since there will be some noticeable changes to the Registry, a training session will be held in July. The training session date and registration link will be posted soon.
AJRR's Annual Conference Involvement
An NOLC opportunity for AJRR Executive Director Jeffrey P. Knezovich, CAE, with members of the IL delegation visiting Congressman Danny Davis
We've appeared at several conferences this past month. AJRR Executive Director Jeffrey P. Knezovich attended the  American Academy of Orthopaedic Surgeons (AAOS) 2017 National Orthopaedic Leadership Conference from April 26 - April 29 in Washington, D.C. The meeting consisted of several symposiums that were relevant to members of the orthopaedic community with topics like health policy and health care cost. 

The AJRR California State Registry Committee Annual Meeting was held in conjunction with the ISAR Annual Meeting in San Francisco. California AJRR participants discussed a range of topics, including the transition of AJRR technology to California hospitals, California State Registry Committee 2016 Annual Report, the upcoming 2017 Annual Report, and the submission of abstracts using California data. AJRR Executive Director Jeffrey P. Knezovich, CAE, recently presented at the California Orthopaedic Association (COA) Annual Meeting as well. Mr. Knezovich's presenation about registries, in addition to AJRR's booth at the meeting, gained the Registry a great deal of exposure. Our next Annual Meeting appearance will be at the American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting in November. Click here for a preliminary program of the meeting.
Authorized Vendor Profile

Company Name: Kermit 

Company Website: 

AJRR Vendor Since: April 2015

General Description: Kermit is a technology-enabled service that provides hospitals and health systems visibility to utilization and pricing of implants (knee, hip, shoulder, and 23 other high-spend categories). The platform is also used internally by senior analysts to surface savings opportunities for Kermit's hospital customers who can take action or request assistance. Kermit's thesis is that orthopaedic service line spend management should be a collaboration between surgeon, supply chain, and hospital executives informed by pristine data collected at the point of use and properly categorized.

Features Offered: As a cloud-based service, Kermit performs automated price audit and contract compliance on each bill-only invoice being produced in an orthopaedic, spine, or cardio surgery where implants are used. Because their system holds the hospital's negotiated prices and vendor contracts (whose terms and conditions are distilled into business rules within the system), Kermit can quickly identify cases with issues and ensure they are not paid until the issues are corrected. They also leverage Kermit to perform real-time analysis of U.S. Food & Drug Administration (FDA) implant recalls to quickly identify patients affected by recalled implants; usually well ahead of any notification by the manufacturer.

Integration with AJRR: Kermit collects the data needed for Level I data submission (implant catalog number, description, lot number), as well as patient demographic and clinical demographic (surgical approach, surgical assists, laterality, surgery type/subtype), and can automate the daily or scheduled export of data to the AJRR file format.

Fun Fact: Kermit's founders were tenured orthopaedic representatives who completed thousands of hip and knee surgeries with a significant appreciation for the rigors of the operating room. Kermit values the surgeon as a stakeholder in the spend management of this category. They also buy lunch every Friday for their entire staff in a ritual they call "French Dip Friday."
A full list of AJRR's technology partners can be found here.
Data Corner
Our  2016 Annual Report   contains a wealth of information on procedural and component data. According to the report, a total of 1,276 knee replacement revisions were "linked" procedures, meaning that they had data in the Registry relating to the original primary procedure as well. Of these linked revision procedures, 34% were performed in the first three months post-surgery and 28% were performed more than a year after the primary procedure. In keeping with this bias toward early revision procedures, aseptic problems of wear, or mechanical failure, were less frequent than infection. This accounted for more than one in four of these relatively early revision procedures (Figure 43, above).

Slides with all the tables and figures from the AJRR 2016 Annual Report can be found on our website. Feel free to use them in any talks, presentations, or lectures that you may have.
Upcoming Webinars and Calls
Introductory Webinars
AJRR staff hosts monthly introductory webinars for those who are interested in joining the Registry and would like a basic overview of what we offer. If your institution resides in one of the CJR metropolitan statistical areas, this webinar should be of special interest to you! A demonstration of the new dashboards will be provided. Introductory webinars will be held at the following times this year:
To register for a session, click here.

AJRR User Group Network Conference Call
The AJRR User Group Network (Unet) hosts quarterly conference calls. The next call will be held on Thursday, June 15, 2017 from 12:00 p.m. - 1:00 p.m. Central Time. A finalized agenda will be released soon.

Register here.

Previous Webinars
From Data to Innovative Models: Reducing Risk & Improving Joint Replacement Outcomes
If you were unable to attend From Data to Innovative Models: Reducing Risk & Improving Joint Replacement Outcomes, a webinar we hosted with OM1, we have a recording that you can view. Click here to view the recording.

AJRR 2017 Data Specifications Webinar
If you were unable to attend the AJRR 2017 Data Specifications Webinar, we have a recording and slides that you can view. Click here to access the Unet Forum and view the recording and slides.

AJRR Introductory Webinar for Ambulatory Surgery Centers
If you were unable to attend the AJRR Introductory Webinar for Ambulatory Surgery Centers, a webinar hosted by AJRR in partnership with the Ambulatory Surgery Center Association (ASCA), we have a recording that you can view. Click here to view the recording.

AJRR Orthopaedic Quality Resource Center: What You Need to Know  
If you were unable to attend AJRR Orthopaedic Quality Resource Center: What You Need to Know, a webinar we hosted with CECity, a Premier Inc. Company, we have a recording that you can view. Click  here to view the recording.

Registry Participation 101: A Simple Step-by-Step Guide to Understanding What You Really Need to Know from AJRR 
If you were unable to attend Registry Participation 101: A Simple Step-by-Step Guide to Understanding What You Really Need to Know from AJRR, a Wellbe, Inc. sponsored webinar, we have a recording that you can view. Click  here to view the recording.

Recordings and slides from all other previously held webinars can be found on our  website .
Our Newest Hospitals

We've welcomed these participants into the Registry since the last volume of the The Register:

#917 - Carilion New River Valley Medical Center in Christiansburg, VA
#918 - Carilion Roanoke Memorial Hospital in Roanoke, VA
#919 - UHS Binghamton General Hospital in Binghamton, NY
#920 - Penn Highlands DuBois in DuBois, PA
#921 - Good Shepherd Medical Center - Marshall in Marshall, TX
#922 - Henderson Hospital in Henderson, NV
#923 - Navicent Health in Macon, GA
#924 - Carolina Coast Surgery Center in Murrells Inlet, SC
AJRR currently has 924 participating hospitals in all 50 states and the District of Columbia! Click here for a full list of all participating sites.

AJRR in the News

The medical device publication Orthopedic Design & Technology posted an article about our Level II patient risk factors, comorbidities and complications data capabilities, and how they can lead to the development of implant survivorship curves:

To view our press releases, click here.
Special Thanks to Each of Our Supporters

The Register is the official newsletter of the American
Joint Replacement Registry serving to connect the 
orthopaedic community. For questions, comments, 
or concerns, please contact Erik Michalesko, Marketing 
and Communications Specialist at

The Register editor: Erik Michalesko
©2017. All rights reserved.