The American Joint Replacement Registry (AJRR) has released its 12th Annual Report, reflecting continued growth in procedure count, advanced data methodologies, and strengthened national and international collaborations.

The 2025 report includes an analysis of more than 4.4 million hip and knee arthroplasty procedures collected from 2012 through 2024 from all 50 states, the District of Columbia, and Puerto Rico. The total represents an 8.8% increase compared to 2024. To date, the AJRR database encompasses more than 4.6 million cumulative procedures, reinforcing its position as the largest orthopedic registry in the world by annual procedural count.

“Each year, the AJRR builds on its momentum as a premier national and global resource,” said James I. Huddleston III, M.D., AJRR Steering Committee chair. “By collecting and analyzing real-world patient data from millions of procedures, the Registry is driving evidence-based decisions that advance quality initiatives and expand the knowledge base that guides orthopedic care worldwide.”

The 2025 report shows major advancements in data methodology, analytics, and research productivity, including:

• 4.6+ million procedures captured, 751 institutions submitted patient-reported outcome measures (PROMs), a 19% increase from 2024, with expanded reporting on:
  • Minimal Clinically Important Difference (MCID)
  • Substantial Clinical Benefit (SCB)
  • Patient Acceptable Symptomatic State (PASS)
  • CMS Inpatient Quality Reporting (IQR) THA/TKA PRO-PM
• New survival analysis methodology: AJRR adopted the Kaplan-Meier method, replacing the Cox model to more accurately describe revision risk over time.
• Expanded robotics analysis, including manufacturer-specific utilization trends, reflecting technology’s increasing role in arthroplasty.
• Industry and academic collaboration: More than 80 custom analyses completed for industry sponsors and expanded partnerships with The Hip Society, The Knee Society, and American Association of Hip and Knee Surgeons (AAHKS).

“The AJRR’s continued growth reflects the commitment of our participating sites, surgeons, and data partners. By strengthening our analytic framework and expanding collaboration, we’re harnessing the power of data to turn information into insights that improve patient outcomes and help define best practices for the future of joint replacement care,” Dr. Huddleston stated.

This year’s report also highlights AJRR’s expanding role in international registry collaboration. Working with the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) and the International Society of Arthroplasty Registries (ISAR), AJRR is contributing to global data-sharing initiatives and the development of the International Prosthesis Library (IPL), a worldwide effort to standardize implant performance evaluation and accelerate clinical innovation.

The AAOS Registry Program’s mission is to improve orthopedic care by collecting, analyzing, and reporting actionable data. The American Joint Replacement Registry, 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 4.6 million procedures contained within its database. Additional registries include the Musculoskeletal Tumor Registry, the Shoulder & Elbow Registry, and the American Spine Registry, a collaborative effort between the American Association of Neurological Surgeons and the AAOS. 

With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. AAOS advances musculoskeletal health, providing comprehensive education to help orthopedic surgeons and allied health professionals best treat patients in their daily practices. AAOS is the authoritative source for information on bone and joint conditions, treatments, and related musculoskeletal health care issues; and it leads the healthcare discussion on advancing quality.