International Registry Symposium During AAOS Annual Meeting Provides Concrete Examples of the Benefits of Registries

The American Academy of Orthopaedic Surgeons (AAOS) 2018 Annual Meeting was a huge success for AJRR and the Academy as a whole. One of the highlights was the symposium held by the International Society of Arthroplasty Registries (ISAR) on the rationale for registries.

The symposium, “What Can a Registry Do for Me?” was moderated by the Adviser of ISAR, Henrik Malchau, MD. A dozen other panelists representing the U.S. registry movement and international registries offered their perspectives. A few of the U.S. registry representatives included AJRR Medical Director David G. Lewallen, MD; AJRR Steering Committee Chair Kevin J. Bozic, MD, MBA; Director of Kaiser Permanente’s national implant registry program Liz Paxton; and Brian R. Hallstrom, MD, from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI).

The benefits of surgeons participating in a registry were discussed. These include improved patient safety and outcomes, better informed implant selection, equitable reimbursement policies, and other desirable ends. The AAOS plan to create a family of registries was also mentioned. AAOS will build on the AJRR’s success when establishing registries for different orthopaedic specialties.

The AJRR has made significant progress since 2009; the registry has more than 1.2 million procedures, 1,047 participating institutions, and over 10,000 surgeons. Although the AJRR’s size eclipsed every other hip and knee registry in 2016, its experienced international counterparts collect more data elements. AJRR is working towards expanding its data collection in order to reach its goal of 90 percent of procedures performed in the US.

The more experienced state and international registries offered insights into the positive outcomes their data impacted:

  • MARCQI reduced the use of blood transfusions in Michigan to a transfusion rate of 0.9 percent for total knee arthroplasty vs. a national rate of 4.4 percent. They also nearly eliminated unnecessary transfusions in patients with hemoglobin greater than 8 g/dL.
  • Kaiser Permanente reduced the use of opioids 90 days post-surgery from 39 percent of total knee replacement and 35 percent of total hip replacement patients to 12 percent and 9.1 percent, respectively.
  • In Sweden in 2003, registry reporting alerted practitioners to a heightened risk of dislocation with a commonly used FAL cup for hip arthroplasty, leading to sharply curtailed use of the cup.

For more information about the “What Can a Registry Do for Me” symposium, read the summary in AAOS Now. A recording of the symposium will be made available to AJRR participants.

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