AAOS releases new trends from the hip and knee replacement registry

MedTech News: The American Academy of Orthopaedic Surgeons (AAOS) Registry Program announced the availability of the American Joint Replacement Registry Program (AJRR) 2020 Annual Report Supplement which was released during the AAOS 2021 Annual Meeting recently, offering actionable information to guide surgeons and patient decision making to improve care.

“There’s great momentum across the AAOS family of registries,” said William J. Maloney, MD, FAAOS, chair of the AAOS Registry Oversight Committee. “The number of anatomical areas and procedures covered continues to grow and the data being submitted by participating sites is paving the way for improved orthopaedic outcomes. We are pleased to publish these clinical insights from the AJRR and the SER and look forward to seeing continued growth and increasingly impactful analyses in the years ahead.”

Data presented in the 2020 AJRR Annual Report Supplement were submitted to the AJRR by 1,110 institutions through June 2020, covering procedures from 2012 to 2019. For the second consecutive year, the supplement includes reporting of device-specific cumulative percent revision estimates. In addition, analyses in the 2020 supplement were expanded to include many more devices than the 2019.

The majority of the variation in the hip device-specific survivorship curves appeared to occur within one year of the primary procedure. Early failure is typically a result of infection, dislocation, or periprosthetic fracture, which may or may not be related to the implant itself. Results showed all device constructs included in analysis have a cumulative percent revision of less than 2.8% at one year and less than 4.7% at final follow-up for each respective device. Metal-on-metal hip constructs were excluded from all analyses. Cemented acetabular components did not have sufficient procedure volume to be included in this supplement but will be included in future publications when numbers permit.

Johnson & Johnson Medical Devices performed well in this analysis with its Pinnacle Corail and Actis DuoFix having the lowest cumulative percent revisions at one year when compared to the top 10 most used prosthesis.

Unlike the hip device-specific survivorship curves which showed some divergence in the first year, the knee-device curves showed very little divergence for both posterior stabilised and minimally stabilised (cruciate retaining) constructs. All Total Knee Arthroplasty (TKA) device constructs included in the analysis have a cumulative percent revision of less than 2.5% at three years and less than 3.7% at final follow-up for each respective device.

In the top 10 most used devices in knee arthroplasty, J&J performed strongly again with Attune CR and Sigma CR showing the lowest cumulative percent revisions at three years.

Cementless TKA constructs did not have sufficient procedure volume to be included in this supplement but will be included in future publications when numbers permit.

The AAOS also released the the Shoulder & Elbow Registry (SER) 2020 Annual Report which collects shoulder and elbow procedural data to establish survivor curves, track revisions, and support orthopaedic care and best practices. The program’s latest annual report represents submitted shoulder and elbow procedures dating from 2015 through 2020.

“The AAOS Shoulder and Elbow Registry is one of the most important endeavors being undertaken in shoulder and elbow surgery,” said SER Steering Committee member Stephen F. Brockmeier, MD, FAAOS. “This data will drive future clinical care, answer critical questions and contribute to research in the field, and dramatically enhance our ability to provide optimal outcomes for our patients. As can be seen in the 2020 SER Annual Report, the Registry data continues to accumulate at a rapid pace, and new procedures are added for study each year.”