Registries: What Happens When Orthopaedic Surgeons Own the Data?

In this episode of the AAOS Now Podcast, host Stuart J. Fischer, MD, FAAOS, speaks with two leaders in orthopaedic data science about how physician-controlled registries are transforming outcomes measurement, implant evaluation, and clinical decision-making. From the early vision of a national joint replacement registry to a new real-time data partnership with Epic, the conversation traces how far the registries have come and where they are headed.

Drs. James Huddleston and Steven Glassman share concrete examples of how registry data is driving practice change. They also address how the data supports Clinical Practice Guidelines and research, why surgeon and patient information is protected from outside access, and what the integration of AI and patient-reported outcomes means for the next generation of orthopaedic registries.

Key Topics Covered in This Episode:

• Origins and goals of the AAOS registry portfolio: How orthopaedic surgeons built a physician-controlled data infrastructure to protect procedures and drive evidence-based care

• Data sources and infrastructure: AJRR's use of hospital and ASC submissions, Medicare claims for complete follow-up on Medicare patients, and a new Epic Community Registries partnership for real-time data capture

• Registry scale and participation gaps: Why AJRR has surpassed five million procedures while spine, shoulder and elbow, and musculoskeletal oncology registries are still building volume

• Real-world clinical impact: How AJRR data has influenced cementless knee adoption, robotics use in unicompartmental arthroplasty, and the growth of triple-tapered femoral stems in hip replacement

• Research and CPG applications: How the Registry Analytics Institute supports physician-led and industry-sponsored research, with strict controls on data dissemination

• Patient-reported outcomes: The longstanding role of PROMs in spine and the challenges of scaling PROM collection for hip and knee under new government mandates

• Data privacy: Why registry data remains de-identified and inaccessible to insurers and government agencies, and what individual surgeon dashboards can offer

• International comparisons and ISAR: How AJRR benchmarks against registries in England, Wales, and beyond, and why U.S.-specific data remains essential

• AI and the future of registries: How AJRR is piloting AI-powered EHR extraction to improve data completeness without human intervention

About Our Guests:

James Huddleston III, MD, FAAOS, is Professor of Orthopaedic Surgery at Stanford Hospital; Co-Chair of the AAOS Registry Oversight Committee; and Chair of the American Joint Replacement Registry Steering Committee

Steven D. Glassman, MD, FAAOS, is Professor of Orthopaedic Surgery at the University of Louisville School of Medicine; Medical Director at the Norton Leatherman Spine Center; Chair of the AAOS Registry Oversight Committee; and past Chair of the American Spine Registry Executive Committee