American Joint Replacement Registry reaches 5.2 million procedures, reveals shifts in care

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American Joint Replacement Registry reaches 5.2 million procedures, reveals shifts in care

2026 Annual Report highlights growth in outpatient joint replacement and new insights into patient outcomes

ROSEMONT, Ill. (Nov. 5, 2026)-The American Joint Replacement Registry (AJRR), the cornerstone of the American Academy of Orthopaedic Surgeons' (AAOS) Registry Program, released its 2026 Annual Report, offering new insight into the changing landscape of hip and knee replacement.

The 2026 report includes 5.2 million procedures performed from 2012 through 2025, with contributions from 1,598 institutions and 12,663 surgeons. With 615,330 procedures submitted in 2025, the AJRR continues to grow as a leading source of real-world evidence, providing a clearer picture of joint replacement care across the country.

To view the full AJRR Annual Report, click here.

"Every procedure submitted to the AJRR adds to our understanding of what works in joint replacement care," said James I. Huddleston, III, MD, FAAOS, chair of the AJRR Steering Committee. "Together, those experiences give surgeons evidence they can use to make informed decisions and help patients achieve the best possible outcomes."

Advancing joint replacement care through data
The 2026 report offers new insights into how joint replacement care is evolving, including:

• Outpatient care: Ambulatory surgery center submissions reached 35,495 procedures in 2025, more than three times the volume submitted in 2021.
• Hospital stays and discharge: In 2025, mean length of stay was approximately one day after elective primary hip replacement and 0.9 day after primary knee replacement. Approximately 92% of hip replacement patients and 93.3% of knee replacement patients were discharged home.
• Implant selection: Cementless fixation in primary knee replacement increased from 1.8% in 2012 to 23.9% in 2025. Ceramic femoral heads accounted for 82.4% of elective primary hip replacements with material information in 2025.

"The AJRR's growth is a testament to the institutions and surgeons committed to advancing joint replacement care," said Dr. Huddleston. "Every contribution helps build a more robust picture of how patients recover following surgery and where opportunities remain to improve. That shared knowledge has the potential to shape the future of care for patients across the country."

Understanding outcomes to inform future care
The report provides insight into patients' experiences following joint replacement. Among patients with linked preoperative and approximately one-year scores, 76.9% after hip replacement and 65.0% after knee replacement reached the Centers for Medicare & Medicaid Services (CMS)-defined threshold for substantial clinical benefit, with baseline scores strongly related to the likelihood of reaching that threshold. The report also highlights infection as an ongoing challenge, recorded in 52.9% of linked knee revisions in 2025 and 41.2% of knee re-revisions from 2012 through 2025.

Together, these findings help surgeons better understand what recovery looks like for patients and identify challenges that warrant continued attention, supporting ongoing efforts to improve joint replacement care.

View slides featuring figures and data tables from the report.

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About the 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 5.2 million procedures contained within its database. Additional registries include 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 AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. 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 daily. AAOS is the source of information on bone and joint conditions, treatments, and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality. 

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