The American Joint Replacement Registry's The Register
Connecting with Old and New Faces at AAOS
The AJRR booth at the AAOS Annual Meeting in the San Diego Convention Center
The American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, as always, was a  great opportunity to interact with the dedicated physicians and hospital staff that make our Registry a reality. Our booth at the March 14-18 meeting in San Diego connected us with old associates while also introducing us to some new faces. 

Among the old was past AJRR Bo ard of Directors Chair  William J. Maloney, MD, 
who assumed  his role as Pre sident of AAOS at  the meeting  and delivered an address about what  he will focus  on  throughout his term. 
AAOS President William J, Maloney, delivering his presidential address
During  his  speech, Dr. Maloney mentioned that he was asked to  explore the  development of  an  AAOS-spo nsored joint replacement registry 14 years ago. And although it took time to  come to fruition, he said that AJRR is  flourishing under its current leadership Dr. Maloney went on  to say that by talking with colleagues in other fields,  AJRR and its participants will be able to learn new way s for how the Registry can be used in the surgeon's office for quality improvement, and perhaps for Maintenance of Certification (MOC) one day.

IRB Discussions and a Case Study at the Unet Meeting 

We held our annual in-person User Group Network (Unet) meeting on March 15 at the Marriott Marquis San Diego Marina hotel. Over 80 users registered to attend the event either in-person or via webinar.  This year's Unet Meeting helped identify multiple aspects of the Registry that the AJRR can enhance to make the platform as efficient and user-friendly as possible. 

A couple of the major presentations that the meeting featured included a Registry technology update from AJRR Chief Technology Officer Paul Haisman and a quality initiative discussion with AJRR Director of Analytics Dr. Caryn Etkin.  Reagan Bayer, a member of AJRR IT staff, proposed the creation of a Technology User Group Network (TechNet) to provide a network of resources to aid in the continuous improvement of data extraction and submission to the Registry, and to provide a forum to obtain feedback and communicate Registry technology changes. The users in attendance at the meeting agreed that TechNet should be formed. More information on the group will be forthcoming. 

Mr. Mike B. Anderson of University of Utah Health gave a presentation on AJRR regulatory concerns.
Some of AJRR's most active users spoke in front of the User Group as well. Chris Neighorn  of Providence Health & Services  presented a case study on his institution's experience collecting patient-reported outcomes with external collaborators for non-employed physicians, while  Mike B. Anderson from the University of Utah Health concluded the meeting with a slideshow about how AJRR is not considered medical research and how that should affect institutional review board (IRB) decisions. 

We would like to thank everyone who participated in the meeting for their insight, and hope to see everyone again next year.  Slides and a recording from the Unet Meeting can be found in the Unet Forum .

Congratulations to our One Millionth Submitter

We're happy to announce that the Registry reached 1,000,000 hip and knee replacement procedures in late March. The lucky submitter of the one millionth procedure was Concord Hospital in Concord, NH. Concord Hospital has been an AJRR participant since 2013 as one of the Registry's earliest members.

Concord Hospital currently submits Level I data, and plans to expand to Level II and Level III once they've fully migrated to a comprehensive electronic health record (EHR) system with Cerner. They've mapped and merged data from their ICD-coded data and surgical documentation system to submit an average of 105 cases each month. Concord Hospital achieved 97% data validation in the 2016 third-party validity and completeness audit that we undergo each year to ensure our data and reporting is as accurate as possible.

"Although we are still becoming familiar with the AJRR's Data Mart, national reports are distributed to Concord Hospital's senior leadership team and our prestigious orthopaedic surgeon Dr. Stephen Fox," said Concord Hospital Director of Orthopaedic/Surgical Specialties/Trauma Pamela Paris, RN, MSN. "It's exciting to see AJRR participation gaining ground nationally, and we look forward to improving our analytics to effectively serve our patients here at Concord Hospital's Center for Orthopaedic Excellence."

We would like to thank Concord Hospital for their commitment to the Registry cause. Although this is an impressive achievement for the Registry, one million procedures is only the beginning, and we will continue working towards our goal of collecting 90% of all hip and knee replacement procedures in the United States. 
Secretary Position Created and Filled for AJRR Board
AJRR Board of Directors Secretary Bryan D. Springer, MD
At the November 3, 2016 AJRR Board of Directors Meeting, action was taken to expand the membership on the Executive Committee. The Bylaws were amended to create the position of Secretary. Previously, the position was held by a single representative designated as Secretary-Treasurer. The expansion of the Executive Committee will allow for an extra voice and individual to handle the growing responsibilities. 

AJRR Board Members nominated current Board Member and Data Management Committee Chair Bryan D. Springer, MD, for the role. He was elected at the March 13, 2017 Board Meeting with a unanimous vote. We look forward to working with Dr. Springer in his new role and know that he will help the Executive Committee run smoothly while providing additional viewpoints on the Registry's activities.
J oin our Focus Group to Influence the Annual Report

We would like to make the AJRR 2017 Annual Report as relevant to our stakeholders as possible. That's why we're sending out a call for our participants to join in a half hour phone focus group later this month. 

Are you interested in making an impact on the content presented in this year's report?  Let Erik Michalesko know at . We will schedule the call for a time that works best for everyone involved.
AJRR Welcomes the New AAHKS Board Members
The new American Association of Hip and Knee Surgeons (AAHKS) Board Members took office at the AAHKS Board of Directors Meeting on March 15 during the AAOS Annual Meeting in San Diego. Mark I. Froimson, MD, MBA was installed as the President of AAHKS. Current AJRR Board Members Craig J. Della Valle, MD and Scott M. Sporer, MD are serving as First Vice President and Member-At-Large, respectively. AJRR Board Member Brian S. Parsley, MD completed his AAHKS Board service on March 15.

AJRR and AAHKS are forging a strong relationship by having members on each others' Boards. These surgeons bring a unique perspective that adds to each organization's decision-making processes. As the official Registry of AAHKS, AJRR looks forward to Dr. Froimson's leadership throughout the coming year.
Getting Exposure Across the US at Annual Meetings

Our Executive Director Jeff Knezovich spoke at two Annual Meetings in March that AJRR had not attended before. Our Authorized Vendor AmkaiSolutions held meeting for their users called GO!2017 in Atlanta, GA, from March 19-21. Wellbe, also an Authorized Vendor, held their 2017 Spring Musculoskeletal Leadership Summit from March 30 - March 31 in Orlando, FL. Mr. Knezovich discussed the benefits of Registry participation at both meetings. We see these meetings as great opportunities to reach out to institutions that could make use of our services, but may not have been exposed to our organization. We will continue to have speakers at similar meetings.

Are you attending an annual meeting or conference later in the year? Check our "Additional Upcoming Events" section below and see if we'll be there as well.
Additional Upcoming Events
We will be attending many more events in 2017 than in past years. The "Additional Upcoming Events" section is an on-going list of annual meetings and trade shows that AJRR will participate in. If you have any questions about a particular event, contact us at or visit the Events & Webinars section of our website.

Ambulatory Surgery Center Association (ASCA) 2017 Annual Meeting

The ASCA 2017 Annual Meeting will take place May 3-6 in Washnington, DC. The meeting will include several educational sessions with expert speakers and expansive networking opportunities. AJRR will be in the meeting exhibit hall at booth 133.

For more information, click here.

California Orthopaedic Association (COA) Annual Meeting

The  California Orthopaedic Association (COA)  will hold its 2017 Annual Meeting/QMECourse from May 18-21, 2017 at the Omni La Costa Resort in Carlsbad, CA. Hundreds of orthopaedic surgeons, residents, and practice managers are expected to attend. The California Bones Society (C-Bones) Annual Meeting will be taking place at the resort at the same time too.

Several organizations including the AJRR will be exhibiting with booths during the meeting. Be sure to stop by the symposium "Data Collection and Reporting: How to Earn 70 QPP Points or More and be Rewarded" on Friday, May 19. AJRR Executive Director Jeffrey P. Knezovich will be speaking at 11:20 a.m. about qualified clinical data registries (QCDRs) and the additional benefits of registry reporting. You'll also receive CME hours in the double digits by attending the meeting.

Register for the COA Annual Meeting 
here .
International Society of Arthroplasty Registries (ISAR) Annual Meeting

The 6th Annual International Society of Arthroplasty Registers Congress, the Annual Meeting of the
International Society of Arthroplasty Registries (ISAR) , will be held from May 20-22, 2017, in San Francisco, CA. The conference will be held at the Parc 55 San Francisco, a Hilton Hotel. 
Each year, the AJRR and the California State Registry Committee send representatives to present research and display posters. The California State Registry Committee Annual Meeting will be held in San Francisco during this time as well.
Visit the ISAR website  for more information. You can register for the ISAR Annual Meeting  here . Visit the AJRR website  for links to posters from past ISAR meetings. Registration for the California State Registry Committee Annual Meeting will be forthcoming.

Authorized Vendor Profile

Company Name: OM1

Company Website:

AJRR Vendor Since: February 2017

General Description: With predictive analytics and patient-reported and clinical outcomes management tools that leverage the largest clinical administrative database, OM1 is empowering evidence-based care with data driven precision. OM1's solutions help hospitals meet rapidly emerging requirements, measure outcomes, and avoid high cost events.

Features Offered:
  • Predictive analytics targeting high-cost post-total hip arthroplasty (THA)/total knee arthroplasty (TKA) events including complications and readmission
  • Condition-specific scoring to enable comparison of performance by physician facility, device, care pathway, and more at the local, regional, and national level
  • Multi-modal, multi-lingual, fully-automated patient-reported outcome (PRO) collection meeting AJRR and the International Consortium for Health Outcomes Measurement (ICHOM) requirements
Integration with AJRR: OM1 integrates with the AJRR registry platform to automatically abstract, collect, and submit data on behalf of their clients for Level I, II, and III data submission.

Fun Fact: OM1's founder and CEO, Dr. Richard Gliklich, is the Principal Investigator (PI) for the Agency for Healthcare Research and Quality's (AHRQ) Outcome Measure Framework, which is an initiative focusing on the standardization of outcomes measurement.
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, data were collected on 17,180 revision hip arthroplasties between 2012 and 2015. Of the 17,180 revision procedures, the predominant cause for revision by diagnosis code was aseptic mechanical, with the four codes for mechanical loosening, other mechanical, wear, and osteolysis (the last two which often co-exist and are interrelated) accounting together for about 40% of revisions recorded. Dislocation was the next most common diagnosis, accounting for about 15%, with infection and periprosthetic fracture less common. The large percentage in "other codes" includes ICD-9 code 998 for "other complications not otherwise classified" and those revisions that were either not coded or miscoded. The figure above provides a visual representation of this data.

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
AJRR Data Specifications Webinar
AJRR staff will be hosting webinars about the new 2017 Data Specifications. Some of the topics that will be covered during the webinars include the changes to the file layout, Level I, II, and III data element updates, and an overview of the Data Specification Toolkit. There will be time for Q & A session at the end.

This is a great webinar to attend for both current participants and institutions interested in joining, as all existing AJRR participants will have until December 31, 2017 to comply with the revised data specifications.

The next session will be held on Thursday, April 20, 2017 at 12:00 p.m. Central Time. Click here to register.

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.

Previous Webinars
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:

#890 - Allied Physicians Surgery Center in South Bend, IN
#891 - Franciscan Health Carmel in Carmel, IN
#892 - Franciscan Health Indianapolis in Indianapolis, IN
#893 - Washington Hospital in Fremont, CA 
#894 - MaineGeneral Medical Center in Augusta, ME
#895 - Thibodaux Regional Medical Center in Thibodaux, LA
#896 - Genesys Regional Medical Center in Grand Blanc, MI
#897 - Hill Country Memorial in Fredericksburg, TX
#898 - Aurora Medical Center - Kenosha in Kenosha, WI
#899 - Aurora Sinai Medical Center of Aurora Health Care Metro, Inc. in Milwaukee, WI
#900 - Aurora West Allis Medical Center in West Allis, WI
#901 - Aurora Medical Center - Summit in Summit, WI
#902 - Aurora Medical Center - Manitowoc in Two Rivers, WI
#903 - Aurora Sheboygan Memorial Medical Center in Sheboygan, WI
#904 - Aurora Medical Center - Oshkosh in Oshkosh, WI
#905 - Aurora Lakeland Medical Center in Elkhorn, WI
#906 - Aurora Memorial Hospital - Burlington in Burlington, WI
#907 - Saint Agnes Healthcare in Baltimore, MD
AJRR currently has 907 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

Becker's ASC Review and Becker's Spine Review covered the news reported in our recent press releases:

Healio/Orthopedics Today also covered the release of our new data specifications and collaboration with ASCA:

AAOS Now published a few articles in their Daily Editions during the Annual Meeting that mentioned AJRR or encouraged attendees to visit our booth:

AJRR Authorized User CODE Technology published a blog post about the Registry reaching one million procedures:

CODE Technology - AJRR Hits 1 Million Procedures

MedPage Today released an article about the AAOS Annual Meeting, and noted that outgoing AAOS President Gerald Williams, MD, mentioned AJRR:

MedPage Today - Orthopedic Surgeons Should Advocate More, Come Together

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.