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12/3/2018
American Joint Replacement Registry California State Registry Supplement
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These slides are put together with the intent to be used in presentations and for discussions around the AJRR 2018 Annual Report – California State Registry Supplement.
For more information, please contact the AJRR Marketing and Communications department at
Established in CJRR collected and analyzed data from hip and knee replacement surgeries performed in California.
CJRR became part of AJRR on 2015.

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Figure 1 shows an increase in the quantity/ volume of the data submitted regarding the Hip and Knee Replacement surgeries, to CJR.
The time line presented in figure 1 is between 2011 and 2017.
More data submitted for the Knee Replacement Surgeries.
N= 596 (KRS) in 2011 went up to N=29451 (KRS) in 2017.
N=483 (HRS) in 2011 went up to N =19815.

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Figure 2 shows the CSR participants by size.
Source: American Hospital Association (AHA) Annual Survey Database Fiscal Year 2015
Small = 1-99 beds; Medium = beds; Large = 400+ beds

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Table 1 shows CSR participants and cases reported through December 31, 2017.
*With the integration of CJRR data into the AJRR database, a migration and validation process was implemented. As such, CJRR data that did not pass AJRR validation standards was excluded from import and analysis.

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Figure 3 shows the mean score distribution.
The Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC), which assess a patient’s hip and knee pain and function.
On a scale, higher score indicates better health.

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Figure 4 shows the mean score distribution.
The Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC), which assess a patient’s hip and knee pain and function
On a scale, higher score indicates better health.

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Table 2 shows the change in WOMAC Hip Function Scores Pre-Surgery and One Year Post-Surgery by Hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Table 3 shows the change in WOMAC hip pain scores re-surgery and one year post-surgery, by hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Table 4 shows the change in WOMAC hip stiffness scores pre-surgery and one year post-surgery, by hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Table 5 shows the change in WOMAC knee function scores pre-surgery and one year post-surgery, by hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Table 6 shows the change in WOMAC knee pain scores pre-surgery and one year post surgery, by hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

12. 12/3/2018 .
Table7 shows the change in WOMAC knee stiffness scores pre-surgery and one year post surgery, by hospital.
Upon comparison to the previous year’s report, most institutions had no to small changes in the number of completed pre- and 1-year post-surgery WOMAC- survey.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Figure 5 shows the VR-12 hip and knee scores for physical component, pre-surgery and one year post surgery.
The Veterans’ Rand 12-Item Health Survey (VR-12) to assess a patient’s overall perspective of their health- physical health.
On a scale, higher score indicates better health.

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Figure 6 shows the VR-12 hip and knee scores for mental component, pre-surgery and one year post surgery.
The Veterans’ Rand 12-Item Health Survey (VR-12) to assess a patient’s overall perspective of their health- mental health.
On a scale, higher score indicates better health.

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Table 8 shows the change in VR-12 Physical Score.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Table 9 shows the change in VR-12 mental component score.
*For hospitals with > 30 eligible patients who completed both pre-surgical and 1-year post-surgical PROMs.
¥Meaningful improvement was calculated by minimal clinically-important difference (MCID) and adjusted for age, gender and race. MCID was determined to be a positive change score of half the posted standard deviation.

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Figure 7 shows the age distribution of primary and revision hip procedures in US and California.
*Source: Healthcare Cost and Utilization Project [HCUP], 2014 (US). California State Registry data January 2011 to June 15, 2017.

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Figure 8 shows the age distribution of primary and revision knee procedures in US and California.
*Source: Healthcare Cost and Utilization Project [HCUP], 2014 (US). California State Registry data January 2011 to June 15, 2017.

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Figure 9 shows the Mean Body Mass Index (BMI) by procedure and sex.

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Figure 10 shows the principal diagnosis based on Revision Procedure.
Osteoarthritis was the diagnosis at the time of surgery for approximately 90.7% of patients undergoing a primary hip arthroplasty and 97.1% for primary knee arthroplasty.

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Figure 11 shows the mean length of stay.

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Figure 12 shows observed comorbidities by percentage.