AAOS Registry Program Blog

How Impending Knee Replacement Surgery Took One Arthroplasty Surgeon by Surprise

Fig. 1 Three preoperative radiographic views from Kevin J. Bozic, MD, MBA, of the right knee showing severe medical joint space narrowing and patellofemoral osteoarthritis.

COURTESY OF KEVIN J. BOZIC, MD, MBA

This blog is the first of a two-part series that originally appeared in AAOS Now (July 2019). It shares an interview with Dr. Kevin J. Bozic, MBA, about his own experience with total knee arthroplasty (TKA) and how his decision process and treatment affected him as a patient. In August, our blog will share the second part of the interview which explores, not only his own post-operative patient journey, but how the role reversal from physician-to-patient influenced his interaction with the surgical patients he treats today. The interviews were conducted by Meredith L. Grogan Moore, BS*.

Kevin J. Bozic, MD, MBA, is a renowned joint replacement surgeon in Austin, Texas. After graduating from the Harvard Combined Orthopaedic Residency Program, he trained in adult reconstructive surgery at Rush University Medical Center in Chicago. Widely published across orthopaedic and health services journals, he is a pioneer in value-based health care. He is also chair of the Steering Committee for the American Joint Replacement Registry. A few years ago, Dr. Bozic found himself on a path to reconstructive surgery of his own knee. From the outset, unique considerations emerged. His preoperative physician-turned-patient experience is illuminating.

AAOS Musculoskeletal Tumor Registry Pilot Shares Vision

In February 2019, the American Academy of Orthopaedic Surgeons (AAOS) and the Musculoskeletal Tumor Society (MSTS), announced the launch of a Musculoskeletal Tumor Registry (MsTR) feasibility pilot. The pilot, part of the AAOS Registry Program, captures data on orthopaedic oncology bone tumor procedures in a structured and scalable way. As part of Sarcoma Awareness Month (July), sponsored by the Sarcoma Foundation of America (SFA), this week’s blog provides an update on MsTR pilot progress.

Presidio Surgery Center Earns Joint Commission Advanced Certification for Total Hip and Total Knee Replacement

The American Joint Replacement Registry (AJRR), part of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program, is the largest hip and knee registry in the world based on annual procedures submitted. With total joint procedures increasingly migrating to the outpatient space, collecting ambulatory surgery center (ASC) procedure data, via registries like AJRR, informs outpatient practice. The data helps demonstrate that ASCs are viable sites for orthopaedic surgical services. Presidio Surgery Center in San Francisco, a California Pacific Medical Center affiliate, discovered the benefits of AJRR participation early. They submitted their first procedures to the Registry in 2015 and by March 2019, the number of hip and knee arthroplasty procedures had grown to 366.

Presidio Registry Participation Supports Joint Commission Certification

While Presidio’s initial Registry data collection helped with the analysis of their quality performance, additional continuous quality improvement initiatives were supported by The Joint Commission. Already accredited by The Joint Commission, Presidio received their Advanced Total Hip and Total Knee Replacement Certification in 2016, and was re-certified in 2018. Rob Mayle, MD, Medical Director of the Joint Replacement Program at Presidio Surgery Center, said, “Presidio Surgery Center has been able to demonstrate high-quality performance through registry participation, Joint Commission best practices, and patient-reported outcomes. Our evidence-based approach to patient care is valued by our clinical team, contracting entities, and patients. We chose AJRR as our registry because of the flexibility of the RegistryInsights^® platform and the size of the database allowing for meaningful benchmark analysis.”

This article was originally published in the June 2019 issue of AAOS Now, the American Academy of Orthopaedic Surgeons (AAOS) monthly news magazine. 

The University of Maryland Shore Regional Health (UMSRH), part of the University of Maryland Medical System (UMMS), recently shared its patient-reported outcomes (PROs) journey at the National Association of Orthopaedic Nurses 39th Annual Congress (NAON), which took place May 18–21 in Atlanta. The UMSRH story demonstrates how physician and nurse leadership can successfully collaborate to implement a PRO program both locally and in conjunction with a national arthroplasty registry.

In October 2018, the American Academy of Orthopaedic Surgeons (AAOS) Registry Program launched the Shoulder & Elbow Registry (SER). The first module focused on shoulder arthroplasty procedures, with additional modules supporting elbow arthroplasty and rotator cuff repair anticipated. We are pleased to announce that all three areas of focus are now available within SER. They represent high-volume procedures that are performed across the specialty and often in outpatient settings.

Gerald R. Williams Jr., MD, chair of the SER Steering Committee said, “SER, the first of a number of planned offerings emerging from the experience of the highly successful American Joint Replacement Registry (AJRR), demonstrates the Academy’s commitment to providing an infrastructure for our members to study outcomes of their procedures.”

Surgeons Can Now Compare Their Own Procedure Data Against National Registry Benchmarks

The mission of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program is to improve orthopaedic care through the collection, analysis, and reporting of actionable data contributed by hospitals, ambulatory surgical centers, and orthopaedic practices across the United States. With the recent introduction of Surgeon Dashboards, the Registry Program has added a new quality improvement resource available to individual AAOS surgeon members.

This new member benefit allows surgeons, whose sites participate in an AAOS Registry, to compare their individual data against national de-identified information and benchmarks. The Surgeon Dashboards, enabled by an enhancement to the AAOS RegistryInsights^® platform, can display procedural, post-operative, and patient-reported outcomes (PRO) data. Surgeon Dashboards are available at no additional cost to participating sites’ surgeons who are AAOS members.

A Guest Blog by Richard Seiden

As a patient who has undergone multiple joint replacement surgeries (hip, knee, shoulder), I have learned a few things from my experience. Sharing what I’ve learned and making a difference in patient outcomes is important to me, but how? I’m a patient, not a doctor.

I have come to realize that I can play a meaningful role in improving care for future surgery patients, including myself, by doing what my doctor asks of me, and that includes participating in the patient-reported outcome (PRO) surveys. The surveys are offered by health care provider sites participating in a clinical data registry. Sites can include hospitals, ambulatory surgery centers (ASCs), or physician offices. I simply answer a few questions prior to and after my surgery. This enables my surgeon and clinical team to monitor my self-reported recovery, my pain levels, and my return to daily activities. Through my participation, I am also providing direct personal input into a larger quality improvement effort. The aggregated data from those efforts can, over time, improve the processes, protocols, device selection, and recovery techniques available to other patients in the future. Sharing my recovery and related levels of satisfaction, also educates surgeons and clinicians regarding best practices in patient care. Here is how we, as patients, can assist.

This blog is the final installment in a three-part series reporting on orthopaedic studies presented at the 2019 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting and utilizing American Joint Replacement Registry (AJRR) registry data. All presentations are reported by Terry Stanton, senior science writer for AAOS Now.

Paper 878, “Correlation of Perioperative Periprosthetic Femur Fractures with Fixation Method” was presented by Bryan D. Springer, MD, vice chair of AJRR, on Friday, March 15, 2019 at the AAOS Annual Meeting in Las Vegas, Nevada. The study evaluated data from the AJRR over a five-year period and analyzed the relationship between femoral stem fixation and perioperative periprosthetic femur fracture (PPFx) requiring early revision total hip arthroplasty (THA) surgery. Analyses determined that cementless femoral fixation accounted for 93 percent of stems with early PPF. Dr. Springer said that patients with cementless stems were 2.6 times more likely to undergo early revision for PPF than those with cemented fixation, although the number of cemented stems in the analyzed population was small, making that finding not statistically significant.

This blog is the second in a three-part series reporting on orthopaedic studies presented at the 2019 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting and utilizing American Joint Replacement Registry (AJRR) registry data. All presentations are reported by Terry Stanton, senior science writer for AAOS Now.

Paper 877, “An Early Look at Patient-Reported Outcome (PRO) Data” was presented by Kevin J. Bozic, MD, MBA, chair of the AJRR, on Thursday, March 14, 2019 at the AAOS Annual Meeting in Las Vegas, Nevada. The study offers an “early look” at patient-reported outcome (PRO) data from the AJRR, a part of the AAOS Registry Program. Dr. Bozic explained that the study covered differences between patient-reported outcome measures (PROMs) from submitters and nonsubmitters and the response rates tallied so far for PROMs.

This blog is the first in a three-part series reporting on orthopaedic studies presented at the 2019 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting and utilizing American Joint Replacement Registry (AJRR) registry data. All presentations are reported by Terry Stanton, senior science writer for AAOS Now.

Paper 145, “National Trends in Treatment of Femoral Neck Fracture” was presented by Bryan D. Springer, MD, vice chair of AJRR, on Tuesday, March 12, 2019 at the AAOS Annual Meeting in Las Vegas, Nevada. The study tracked trends in the treatment of femoral neck fractures (FNFs) based on data from the AJRR and found that although hemiarthroplasty remained the predominant mode of treatment over the five-year study period, use of total hip arthroplasty (THA) increased significantly during that time.