The American Joint Replacement Registry

Smith, Mary Atkinson; Smith, William Todd

doi:10.1097/nor.0b013e31826649b6

Cited by 18 publications

(10 citation statements)

References 1 publication

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“…Understanding the implications of the tourniquet timing and pressure, preoperative identification of patients at risk due to history of lumbar spine disease/surgery, evaluation of the role of sex in perioperative outcome, as well as planning of anesthetic duration should be considered in efforts to reduce postoperative morbidity. Existing TKA registries, such as the American Joint Replacement Registry, should capture these data elements and include nerve injury among the reported complications . This would allow for efficient, high‐quality data capture to help answer these remaining questions.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for acute nerve injury after total knee arthroplasty

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Risk factors for acute nerve injury after total knee arthroplasty

et al. 2018

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“…Over the past few decades, total hip replacement (THR) has been reported as clinically effective in treating pain and disability resulting from late stage arthritis of the hip [1]. THR is indicated for patients who failed to respond to non-surgical management options such as pharmaceutical treatments (e.g., analgesics, anti-inflammatory agents, steroid injections, topical treatments), self-management, patient education, acupuncture, exercise, physical therapy, or manual therapy [2]–[3].…”

Section: Introductionmentioning

confidence: 99%

Total Hip Replacement for the Treatment of End Stage Arthritis of the Hip: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundEvolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR) have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.MethodsA comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs) and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.ResultsFourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78) or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89). Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture) was inconclusive.ConclusionsThe majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition), methodological limitations (small sample size, low event counts, short follow-up), and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s) as well CONSORT, PRISMA and STROBE guidelines to ensure better reporting and more reliable production and assessment of evidence.

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“…As of 2014, the registry had collected data from 44 hospitals for more than 51,000 cases Kaiser Permanente National Total Joint Replacement Registry (TJRR) 44 The Kaiser Permanente TJRR was founded in 2001 and began collection in multiple regions of the United States, including California, Hawaii, Washington, Oregon, and Colorado. The results of its data collection include the identification of a hip implant requiring recall, a 10% reduction in revision total knee replacement rates, and reduced volume of minimally invasive procedures leading to improved reduction of pain and better subjective patient outcomes American Joint Replacement Registry (AJRR) 45 The AJRR began as a joint effort by the American Academy of Orthopaedic 46 In 2010, the Agency for Healthcare Research and Quality funded the FORCE-TJR, a 4-year research initiative to establish a national network of total joint surgeons. By organizing and collecting data from over 130 orthopaedic surgeons across the United States, the research consortium aims to assess longitudinal outcomes representative of all regions of the country, in order to guide surgical practice and optimize patient function and clinical outcomes formed through a collaboration between the Canadian Orthopaedic Association and the Canadian Institute for Health Information in 2001 to provide patient and procedure-related information beyond that available in provincial administrative databases 21 .…”

Section: Value-based Advancements In Canadamentioning

confidence: 99%

Improving Value in Musculoskeletal Care Delivery

Wei

Hawker

Jevsevar

et al. 2015

The Journal of Bone and Joint Surgery-American Volume

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Improving value in musculoskeletal health care has emerged as an important objective in both the United States and Canada. In order to achieve this objective, providers need to have a clear definition of value and an infrastructure for measuring outcomes of interest to patients and costs over the episode of care. Although national patient registries have been established in the United States and Canada, they nevertheless lag behind other registries worldwide in terms of collecting patient-reported outcomes and capturing data from a wide cross-section of hospitals and physicians. With the help of professional medical societies and the creation of national initiatives, patient-reported outcomes data collection on a large scale may be possible, but many challenges remain regarding implementation. Alternatives to the fee-for-service payment model, including pay-for-reporting and pay-for-performance, may help incentivize physicians and health-care providers to obtain and improve on patient-reported outcomes data collection. Other payment reforms, such as bundled payments, have been piloted in certain regions, but their sustainability and long-term success are unclear at this time. Novel health-care delivery strategies aimed at improving quality, coordinating multispecialty care, and enhancing patient participation in shared decision-making have shown promise in improving patient-centered outcomes, but delivery models continue to vary greatly throughout the United States and Canada. The current status of musculoskeletal health-care delivery requires substantial change before the goal of improving patient outcomes and lowering health-care costs can be achieved.

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The American Joint Replacement Registry

Cited by 18 publications

References 1 publication

Risk factors for acute nerve injury after total knee arthroplasty

Risk factors for acute nerve injury after total knee arthroplasty

Total Hip Replacement for the Treatment of End Stage Arthritis of the Hip: A Systematic Review and Meta-Analysis

Improving Value in Musculoskeletal Care Delivery

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