Published 11/3/2023

American Joint Replacement Registry Releases 10th Annual Report

Report offers a snapshot of the current state of hip and knee arthroplasty practice in the United States

ROSEMONT, Ill. (November 3, 2023)—The American Joint Replacement Registry (AJRR), the cornerstone of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program, published its 2023 Annual Report on hip and knee arthroplasty procedural trends and patient outcomes today. Marking the 10th anniversary edition of the report, the data represents over 3.1 million primary and revision hip and knee arthroplasty procedures performed between 2012 and 2022. This is a 23% growth in procedural cases from the prior report.

To view the full AJRR Annual Report, click here.

“This year’s AJRR Annual Report presents a glimpse into the data over the last decade through 2022 and provides clinical insights, national trends and risk-stratified outcome analyses related to Medicare patients who undergo hip and knee arthroplasty procedures,” said James I. Huddleston, III, MD, FAAOS, chair of the AJRR Steering Committee. “This linkage provides a more complete picture of our patient population and their associated comorbidities and outcomes, including longitudinal outcomes of patients who receive care at non-AJRR participating sites. The information in this year’s Annual Report gives the most comprehensive picture to date of patterns of hip and knee arthroplasty practice and outcomes in the U.S.”

Leveraging the Power of Registry Data to Improve Patient Care
With the collection and reporting of U.S. hip and knee arthroplasty data, the report aims to provide valuable information to orthopaedic surgeons, hospitals, ambulatory surgery centers (ASCs), private practices, device manufacturers, payers and most importantly patients. Its analyses can help clinicians change practice and improve patient outcomes.

The AJRR is the largest orthopaedic Registry by annual procedure count. Some notable findings in the 2023 Annual Report include:

  • Patient-Reported Outcome Measures (PROMs) are increasingly being utilized to evaluate the success of a hip or knee arthroplasty procedure. Through continued support of the RegistryInsights® PROM platform and partnerships with third-party vendors, AJRR has experienced substantial growth in PROMs capture. By the end of 2022, 496 participating sites submitted PROMs, which is a 24% increase compared to the previous year. Collection of PROMs data through the KOOS, JR. score revealed that 86% of patients achieved a meaningful improvement after total knee arthroplasty (TKA).
  • Ambulatory surgery centers (ASCs) continue to play an increasingly important role in the delivery of total joint arthroplasty care in the U.S. There are now 42,228 procedural cases reported by ASCs, an 84% increase since 2022.
  • Hospital discharges to home versus a skilled nursing facility trend upward – Approximately 93% of patients are now being discharged to home following elective primary total hip arthroplasty (THA) with far fewer patients (8%) being discharged to skilled nursing facilities compared to just a few years ago. The percentage of patients being discharged to skilled nursing following primary TKA also continues to decrease and now represents less than 6% of all discharges. This data demonstrates surgeons’ ongoing commitment to transitioning patients safely back to their home environment as well as their interest in patient preoperative optimization and care coordination.
  • Rate of technology use for assistance in elective primary total hip arthroplasty has increased substantially – Over the past 6 years, the utilization of robotics in TKA has increased over 6-fold and is now reported in over 13% of procedures, whereas computer navigation use has remained relatively stable. According to Dr. Huddleston, the continued collection and analysis of robotic data will eventually allow surgeons to assess the value proposition of these technologies.
  • New analyses offer new perspectives on patient outcomes – Additional analyses provided for the first time in the 2023 AJRR Annual Report including hip and knee survivorship comparisons between pre- and post-COVID-19 emergency declaration, revision outcome following revision THA between dual mobility and standard designs, and survivorship among fracture patients treated with THA vs. hemiarthroplasty. These new analyses offer critical insights into the impact of COVID-19 on patients and shed light on the performance of new technologies and treatment paradigms.
  • Peer-reviewed publications and presentations based on Registry data continue to be an important focus of AJRR.

"The publication of the 10th edition of the AJRR Annual Report further validates the commitment of healthcare institutions, clinicians and patients to improving the quality of musculoskeletal care," says James A. Browne, MD, FAAOS, chair of the AJRR Publications Subcommittee and editor of the AJRR Annual Report. “The ever-growing submission and compilation of data is driving new insights and fueling our desire to improve the value of care for our patients.”

For slides with figures and data tables as featured in the report, email

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AAOS Registry Program
The AAOS Registry Program’s mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data. The American Joint Replacement Registry (AJRR), the Academy’s hip and knee replacement registry, is the cornerstone of the AAOS’s Registry Program, and the world’s largest national registry of hip and knee joint replacement data by annual procedural count, with more than 3 million procedures contained within its database. Additional registries include the Fracture & Trauma Registry (FTR), the Musculoskeletal Tumor Registry (MsTR), the Shoulder & Elbow Registry (SER), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS. 

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues; and it leads the health care discussion on advancing quality.

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Contact AAOS Media Relations 

Deanna Killackey 


Lauren Riley