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Brief Communication  简短沟通

Highlights of the 2024 American Joint Replacement Registry Annual Report
2024 年美国关节置换登记处年度报告重点

Christopher N. Carender, MD a a  ^("a "){ }^{\text {a }}, Vishal Hegde, MD b b  ^("b "){ }^{\text {b }}, Brett R. Levine, MD c c  ^("c "){ }^{\text {c }}, James I. Huddleston III, MD d d  ^("d "){ }^{\text {d }}, Anna Cohen-Rosenblum, MD e, * e, *  ^("e, * "){ }^{\text {e, * }}
Christopher N. Carender 医学博士 a a  ^("a "){ }^{\text {a }} 、Vishal Hegde 医学博士 b b  ^("b "){ }^{\text {b }} 、Brett R. Levine 医学博士 c c  ^("c "){ }^{\text {c }} 、James I. Huddleston III 医学博士 d d  ^("d "){ }^{\text {d }} 、Anna Cohen-Rosenblum 医学博士 e, * e, *  ^("e, * "){ }^{\text {e, * }} a a  ^("a "){ }^{\text {a }} Department of Orthopedic Surgery, University of Michigan-Michigan Medicine, Ann Arbor, MI, USA
a a  ^("a "){ }^{\text {a }} 美国密歇根州安娜堡密歇根大学密歇根医学院骨科 b b ^(b){ }^{\mathrm{b}} Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
b b ^(b){ }^{\mathrm{b}} 美国马里兰州巴尔的摩市约翰霍普金斯大学骨科系 c c ^(c){ }^{\mathrm{c}} MedStar Orthopedic Institute, Georgetown University School of Medicine, Washington, DC, USA
c c ^(c){ }^{\mathrm{c}} 美国华盛顿特区乔治城大学医学院 MedStar 骨科研究所 d d ^(d){ }^{\mathrm{d}} Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA
d d ^(d){ }^{\mathrm{d}} 美国加利福尼亚州斯坦福市斯坦福大学骨科系 e e ^(e){ }^{\mathrm{e}} Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
e e ^(e){ }^{\mathrm{e}} 美国纽约州纽约市纽约大学格罗斯曼医学院骨科系

A R T I C L E I N F O
文章信息

Article history:  文章历史：

Available online xxx  可在线获取 xxx

Keywords:  关键词：

American Joint Replacement Registry
美国关节置换登记处
Highlights  亮点
Total hip arthroplasty  全髋关节置换术
Total knee arthroplasty  全膝关节置换术

Abstract  抽象的

The American Joint Replacement Registry continues to grow, as represented by the 4.3 million hip and knee arthroplasties analyzed in the 2024 American Joint Replacement Registry Annual report. Highlights of this report are found in the following article. We encourage readers to access the full report at https:// www.aaos.org/registries/publications/ajrr-annual-report/.
美国关节置换登记处 (AJRM) 的规模持续增长，2024 年 AJRM 年度报告中分析了 430 万例髋关节和膝关节置换手术。本报告的亮点内容可参见以下文章。我们鼓励读者访问 https://www.aaos.org/registries/publications/ajrr-annual-report/ 阅读完整报告。

© 2025 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
© 2025 爱思唯尔公司代表美国髋膝外科医师协会出版。本文为一篇根据知识共享署名-非商业性使用-非商业性使用许可协议 ( http://creativecommons.org/licenses/by-nc-nd/ 4.0/) 开放获取的文章。

American joint Replacement registry 2024 executive summary
美国关节置换登记处2024年执行摘要

The 2024 American Joint Replacement Registry (AJRR) Annual Report is the 11th iteration of the report, capturing 4.3 million hip and knee arthroplasties performed by nearly 5000 surgeons across 1447 member sites from all 50 states and the District of Columbia. The AJRR remains the largest orthopaedic and joint arthroplasty registry in the world by annual procedure volume; as a result, the 2024 Annual Report contains some of the most powerful analyses of recent practice trends, implant utilization, and implant survivorship currently available.
2024 年美国关节置换登记处 (AJRR) 年度报告是该报告的第 11 版，涵盖了来自全美 50 个州和哥伦比亚特区的 1447 个会员中心近 5000 名外科医生实施的 430 万例髋关节和膝关节置换术。AJRR 仍然是全球年度手术量最大的骨科和关节置换登记处；因此，2024 年年度报告包含一些目前对近期实践趋势、植入物利用率和植入物存活率最有力的分析。
With recent mandates in the collection of patient-reported outcome measures (PROMs) via the Centers for Medicare and Medicaid Services (CMS) Hospital Inpatient Quality Reporting Patient-Reported Outcome Performance Measure (PRO-PM), there has been a significant focus on reporting PROMs data. By the end of 2023, 44% of AJRR member sites had submitted PROMs data, representative of a 27 % 27 % 27%27 \% increase relative to the 2023 Annual Report. To support member sites in reporting PROMs data to CMS, AJRR updated its PROMs data collection portal and file upload specifications; subsequently, AJRR successfully reported data from
由于近期通过医疗保险和医疗补助服务中心 (CMS) 住院质量报告患者报告结果绩效指标 (PRO-PM) 收集患者报告结果指标 (PROM) 的规定，报告 PROM 数据受到了高度重视。截至 2023 年底，44% 的 AJRR 成员机构已提交 PROM 数据，较 2023 年年度报告增长了 27 % 27 % 27%27 \% 。为了支持成员机构向 CMS 报告 PROM 数据，AJRR 更新了其 PROM 数据收集门户和文件上传规范；随后，AJRR 成功报告了来自
member sites to CMS during the second voluntary Inpatient Quality Reporting PRO-PM reporting window in September 2024.
在 2024 年 9 月第二次自愿住院质量报告 PRO-PM 报告窗口期间，向 CMS 提供成员站点的信息。
As an increasing volume of primary total hip (THA) and total knee arthroplasty (TKA) procedures are performed in ambulatory surgery centers (ASCs), the AJRR has dedicated resources to increasing ASC participation and data capture. Subsequently, cases reported by ASCs to the AJRR increased by 70% over the past year and have increased by nearly 300 % 300 % 300%300 \% since the 2021 Annual Report [1,2]. Further increases in ASC procedure volume captured in AJRR over the next few years appear likely, as CMS PRO-PM mandatory reporting periods for outpatient hip and knee arthroplasty are scheduled to begin in the year 2028 [3].
随着日间手术中心 (ASC) 开展的全髋关节 (THA) 和全膝关节置换 (TKA) 初次手术量不断增加，AJRR 已投入资源，以提升 ASC 的参与度和数据采集能力。因此，ASC 向 AJRR 报告的病例在过去一年中增加了 70%，自 2021 年年度报告发布以来已增长近 300 % 300 % 300%300 \% [1,2]。由于 CMS PRO-PM 门诊髋关节和膝关节置换术的强制报告期计划于 2028 年开始，AJRR 记录的 ASC 手术量在未来几年内可能会进一步增加 [3]。
An important focus of the American Academy of Orthopaedic Surgeons Registry Program remains the tracking and monitoring of outcomes for participating institutions and surgeons. To maximize the utilization of registry data for this purpose, RegistryInsights ® ® ^(®){ }^{\circledR} has added a scorecard dashboard view available at both the site and individual surgeon level with key outcomes metrics displaying trends over time against national registry benchmarks.
美国骨科医师学会注册项目的一个重要重点仍然是跟踪和监测参与机构和外科医生的治疗结果。为了最大限度地利用注册数据，RegistryInsights ® ® ^(®){ }^{\circledR} 新增了一个记分卡信息中心视图，可在站点和单个外科医生层面使用，其中的关键结果指标可显示相对于国家注册基准的长期趋势。
Analyses of AJRR data for the purpose of specific clinical research projects are available via the American Academy of Orthopaedic Surgeons Registry Analytics Institute. Over the past year, AJRR data were utilized in 18 unique peer-reviewed manuscripts and over 35 abstract presentations. Research topics included periprosthetic joint infection [4,5], periprosthetic femur fracture following THA [6], uncemented TKA [7], and patellar resurfacing [8,9].
特定临床研究项目的 AJRR 数据分析可通过美国骨科医师学会注册分析研究所获取。过去一年，AJRR 数据被用于 18 篇独特的同行评审论文和超过 35 篇摘要报告。研究主题包括假体周围关节感染[4,5]、全髋关节置换术后股骨假体周围骨折[6]、非骨水泥型全膝关节置换术[7]以及髌骨表面置换术[8,9]。

2024 AJRR Annual Report highlights
2024 年 AJRR 年度报告重点

The 2024 AJRR Annual Report contains 3 , 715 , 320 3 , 715 , 320 3,715,3203,715,320 validated primary and revision THA and TKA procedures performed during years 2012 to 2023. Primary TKA (51.1%) and primary THA (32.4%) comprised the majority of procedures captured. Regarding patient demographics, 58.6 % 58.6 % 58.6%58.6 \% of patients were female, 76.6 % 76.6 % 76.6%76.6 \% identified as non-Hispanic White (race was unreported in 14.0 % 14.0 % 14.0%14.0 \% of patients), and the mean age of primary TKA and THA patients was 67.6 years and 65.6 years, respectively. The average annual elective surgical volume of submitting arthroplasty surgeons was 44.3 primary THAs (increased from 39.2 in 2022) and 65.4 primary TKAs (increased from 56.0 in 2022) [10].
2024 年 AJRR 年度报告包含 2012 年至 2023 年间实施的 3 , 715 , 320 3 , 715 , 320 3,715,3203,715,320 例已验证的初次全髋关节置换 (THA) 和翻修全髋关节置换 (TKA) 手术。初次全髋关节置换 (TKA) (51.1%) 和初次全髋关节置换 (THA) (32.4%) 占报告病例的大多数。患者人口统计数据显示， 58.6 % 58.6 % 58.6%58.6 \% 的患者为女性， 76.6 % 76.6 % 76.6%76.6 \% 的患者被认定为非西班牙裔白人（ 14.0 % 14.0 % 14.0%14.0 \% 的患者种族信息未报告），初次全髋关节置换 (TKA) 和全髋关节置换 (THA) 患者的平均年龄分别为 67.6 岁和 65.6 岁。提交报告的关节置换外科医生平均每年择期手术量分别为 44.3 例初次全髋关节置换 (THA)（高于 2022 年的 39.2 例）和 65.4 例初次全髋关节置换 (TKA)（高于 2022 年的 56.0 例）[10]。
Trends identified in prior iterations of the AJRR annual report that continued in 2023
AJRR 年度报告中前几版中确定的趋势在 2023 年继续延续
  • Postoperative length of stay (LOS) continued to decline. For primary THA, mean LOS was 1.1 days in 2023, decreased from 1.2 days in 2022 and 3.0 days in 2012. For primary TKA, mean LOS was 1.1 days in 2022 and 2023, decreased from 2.9 days in 2012.
    术后住院时间（LOS）持续下降。初次全髋关节置换（THA）患者，2023 年平均住院时间为 1.1 天，较 2022 年的 1.2 天和 2012 年的 3.0 天有所下降。初次全膝关节置换（TKA）患者，2022 年和 2023 年平均住院时间为 1.1 天，较 2012 年的 2.9 天有所下降。
  • Utilization of general anesthesia (GA) without a peripheral nerve block for elective primary THA and TKA decreased further; GA in isolation was used in 36.4 % 36.4 % 36.4%36.4 \% of elective primary THA in 2023 (48.8% in 2017) and 22.7 % 22.7 % 22.7%22.7 \% of primary TKA (40.6% in 2017). However, use of GA in tandem with a peripheral nerve block continues to increase, used in 3.7% of primary THA in 2023 (1.0% in 2017) and 13.0 % 13.0 % 13.0%13.0 \% of primary TKA in 2023 (3.5% in 2017).
    择期初次全髋关节置换术 (THA) 和全膝关节置换术 (TKA) 中，未联合外周神经阻滞的全身麻醉 (GA) 使用率进一步下降；2023 年择期初次全髋关节置换术中单独使用全身麻醉的比例为 36.4 % 36.4 % 36.4%36.4 \% （2017 年为 48.8%），初次全膝关节置换术中单独使用全身麻醉的比例为 22.7 % 22.7 % 22.7%22.7 \% （2017 年为 40.6%）。然而，联合使用全身麻醉和外周神经阻滞的比例持续上升，2023 年择期初次全髋关节置换术中单独使用全身麻醉的比例为 3.7%（2017 年为 1.0%），2023 年择期初次全膝关节置换术中单独使用全身麻醉的比例为 13.0 % 13.0 % 13.0%13.0 \% （2017 年为 3.5%）。
  • Use of ceramic femoral heads in elective primary THA increased in popularity, accounting for 81.9 % 81.9 % 81.9%81.9 \% of all implants in 2023. This represents an increase from 81.4% utilization in 2022 and 38.1% in 2012.
    在选择性初次全髋关节置换术 (THA) 中，陶瓷股骨头的使用越来越普及，到 2023 年占所有植入物的 81.9 % 81.9 % 81.9%81.9 \% 。这比 2022 年的 81.4% 和 2012 年的 38.1% 有所增长。
Trends identified in prior iterations of the AJRR Annual Report that changed in 2023
AJRR 年度报告中前几版中确定的趋势在 2023 年发生了变化
  • Primary THA was increasingly utilized for the treatment of femoral neck fractures from 2012 to 2022; however, since 2022, the rate of primary THA utilization for the treatment of femoral neck fractures has remained stable at 27.7 % 27.7 % 27.7%27.7 \%.
    2012 年至 2022 年，用于治疗股骨颈骨折的初次 THA 应用越来越多；然而，自 2022 年以来，用于治疗股骨颈骨折的初次 THA 应用率保持稳定在 27.7 % 27.7 % 27.7%27.7 \% 。
  • Use of dual-mobility (DM) constructs in elective primary THA increased from 2012 to 2020, reaching a peak utilization rate of 10.7 % 10.7 % 10.7%10.7 \% in 2020. Utilization of DM constructs subsequently decreased to 9.3 % 9.3 % 9.3%9.3 \% in 2021 and 7.5 % 7.5 % 7.5%7.5 \% in 2022. In 2023, utilization rates of DM constructs in elective primary THA remained steady at 7.5 % 7.5 % 7.5%7.5 \%.
    2012 年至 2020 年，选择性初级全髋关节置换 (THA) 中双移动性 (DM) 结构的使用率有所增加，并在 2020 年达到峰值 10.7 % 10.7 % 10.7%10.7 \% 。随后，DM 结构的使用率在 2021 年下降到 9.3 % 9.3 % 9.3%9.3 \% ，在 2022 年下降到 7.5 % 7.5 % 7.5%7.5 \% 。2023 年，选择性初级全髋关节置换 (THA) 中 DM 结构的使用率保持稳定在 7.5 % 7.5 % 7.5%7.5 \% 。
  • Utilization rates of cemented femoral stem fixation in elective primary THA increased in 2023 to 5.1 % 5.1 % 5.1%5.1 \%; this comes after a decrease in the rate of cemented femoral stem fixation from 2021 to 2022. Overall, use of cemented femoral stem fixation in elective primary THA has increased from a utilization rate of 3.0 % 3.0 % 3.0%3.0 \% in 2012. The 2023 cemented femoral stem fixation rate of 5.1 % 5.1 % 5.1%5.1 \% represents the highest rate of cemented femoral component utilization in elective primary THA since the inception of the AJRR. Considering female Medicare patients aged 65 years and older that underwent an elective primary THA for primary osteoarthritis (OA), cemented femoral stems had a significantly
    2023 年择期初次全髋关节置换术中骨水泥型股骨柄固定的使用率上升至 5.1 % 5.1 % 5.1%5.1 \% ；此前，骨水泥型股骨柄固定的使用率在 2021 年至 2022 年有所下降。总体而言，择期初次全髋关节置换术中骨水泥型股骨柄固定的使用率较 2012 年的 3.0 % 3.0 % 3.0%3.0 \% 有所上升。2023 年骨水泥型股骨柄固定率为 5.1 % 5.1 % 5.1%5.1 \% ，这是自 AJRR 成立以来择期初次全髋关节置换术中骨水泥型股骨部件使用率的最高值。考虑到 65 岁及以上因原发性骨关节炎 (OA) 而接受择期初次全髋关节置换术的女性医保患者，骨水泥型股骨柄的使用率显著
    lower cumulative rate of all-cause revision relative to uncemented femoral stems (adjusted hazard ratio [HR] 0.81, 95% confidence interval [95% CI] 0.72-0.90; P = .002 P = .002 P=.002P=.002 ).
    与非骨水泥型股骨柄相比，全原因翻修的累积发生率较低（调整风险比 [HR] 0.81，95% 置信区间 [95% CI] 0.72-0.90； P = .002 P = .002 P=.002P=.002 ）。
  • When a primary THA or hemiarthroplasty was performed for the treatment of a femoral neck fracture in 2023, cemented femoral stem fixation was used in 56.7 % 56.7 % 56.7%56.7 \% of cases (increased from 51.7 % 51.7 % 51.7%51.7 \% in 2022). Cemented femoral stem fixation was more common in hemiarthroplasties performed in elderly patients relative to hemiarthroplasties performed in younger patients, with utilization rates of 27.3 % 27.3 % 27.3%27.3 \% in patients aged < 50 < 50 < 50<50 years, 28.5 % 28.5 % 28.5%28.5 \% in patients aged 50 − 59 50 − 59 50-5950-59 years, 35.2 % 35.2 % 35.2%35.2 \% in patients aged 60 − 69 60 − 69 60-6960-69 years, 42.2 % 42.2 % 42.2%42.2 \% in patients aged 70-79 years, 48.0% in patients aged 80-89 years, and 54.3 % 54.3 % 54.3%54.3 \% of patients aged ≥ 90 ≥ 90 >= 90\geq 90 years.
    2023年，因股骨颈骨折行初次全髋关节置换术或半髋关节置换术时，应用骨水泥型股骨柄固定的病例为 56.7 % 56.7 % 56.7%56.7 \% 例（较2022年的 51.7 % 51.7 % 51.7%51.7 \% 例有所增加）。老年患者半髋关节置换术中，骨水泥型股骨柄固定的使用率高于年轻患者半髋关节置换术， < 50 < 50 < 50<50 岁患者使用率为 27.3 % 27.3 % 27.3%27.3 \% 例， 50 − 59 50 − 59 50-5950-59 岁患者使用率为 28.5 % 28.5 % 28.5%28.5 \% 例， 60 − 69 60 − 69 60-6960-69 岁患者使用率为 35.2 % 35.2 % 35.2%35.2 \% 例，70-79岁患者使用率为 42.2 % 42.2 % 42.2%42.2 \% 例，80-89岁患者使用率为48.0%， ≥ 90 ≥ 90 >= 90\geq 90 岁患者使用率为 54.3 % 54.3 % 54.3%54.3 \% 例。
  • Large femoral heads ( ≥ 36 mm ≥ 36 mm >= 36mm\geq 36 \mathrm{~mm} in diameter) were more popular than ever, with 36 − mm 36 − mm 36-mm36-\mathrm{mm} heads implanted in 63.8 % 63.8 % 63.8%63.8 \% of elective primary THA in 2023 (increased from 62.3 % 62.3 % 62.3%62.3 \% in 2022 and 48.0 % 48.0 % 48.0%48.0 \% in 2012). Femoral heads ≥ 40 mm ≥ 40 mm >= 40mm\geq 40 \mathrm{~mm} were used in 9.9 % 9.9 % 9.9%9.9 \% of elective primary THA in 2023, increased from 8.8% in 2022 and 8.1% in 2012.
    大股骨头（直径 ≥ 36 mm ≥ 36 mm >= 36mm\geq 36 \mathrm{~mm} ）比以往任何时候都更受欢迎，2023 年择期初次全髋关节置换术 (THA) 中 63.8 % 63.8 % 63.8%63.8 \% 例植入了 36 − mm 36 − mm 36-mm36-\mathrm{mm} 个股骨头（较 2022 年的 62.3 % 62.3 % 62.3%62.3 \% 例和 2012 年的 48.0 % 48.0 % 48.0%48.0 \% 例有所增加）。2023 年择期初次全髋关节置换术 (THA) 中 9.9 % 9.9 % 9.9%9.9 \% 例使用了股骨头 ≥ 40 mm ≥ 40 mm >= 40mm\geq 40 \mathrm{~mm} ，较 2022 年的 8.8% 和 2012 年的 8.1% 有所增加。
  • Ceramic on highly cross-linked polyethylene remains the most common bearing surface in elective primary THA, accounting for 73.5 % 73.5 % 73.5%73.5 \% of cases in 2023. Conversely, utilization rates of metal heads on highly cross-linked polyethylene reached an all-time low of 3.7 % 3.7 % 3.7%3.7 \% in 2023 (decreased from 48.8% in 2012). Ceramic on polyethylene articulations had a significantly lower rate of cumulative all-cause revision relative to metal on polyethylene articulations in Medicare patients aged 65 years and older (adjusted HR 1.14, 95% CI 1.08, 1.19; P < .001 P < .001 P < .001P<.001 ).
    高交联聚乙烯陶瓷假体仍然是择期初次全髋关节置换术中最常见的承重面，2023 年占 73.5 % 73.5 % 73.5%73.5 \% 例。相反，高交联聚乙烯金属头的使用率在 2023 年降至 3.7 % 3.7 % 3.7%3.7 \% 的历史最低点（低于 2012 年的 48.8%）。在 65 岁及以上的医保患者中，陶瓷聚乙烯关节的累积全因翻修率显著低于金属聚乙烯关节（调整后 HR 1.14，95% CI 1.08, 1.19； P < .001 P < .001 P < .001P<.001 ）。
  • Robotics were used in 6.6 % 6.6 % 6.6%6.6 \% of elective primary THA in 2023, stable from 6.6 % 6.6 % 6.6%6.6 \% in 2022 and increased from 2.0 % 2.0 % 2.0%2.0 \% in 2017. Use of navigation in elective primary THA decreased from 5.1% in 2022 to 2.8 % 2.8 % 2.8%2.8 \% in 2023.
    2023 年，选修初级全髋关节置换术 (THA) 中使用了机器人的占比为 6.6 % 6.6 % 6.6%6.6 \% ，与 2022 年的 6.6 % 6.6 % 6.6%6.6 \% 保持稳定，较 2017 年的 2.0 % 2.0 % 2.0%2.0 \% 有所增加。选修初级全髋关节置换术 (THA) 中使用导航的比例从 2022 年的 5.1% 下降到 2023 年的 2.8 % 2.8 % 2.8%2.8 \% 。
  • The most common reason for revision THA in 2023 was infection (26.3%) followed by instability (20.6%). This continues the overall trend of infection as the most common diagnosis associated with THA revision from 2012 to 2023 (21.4%).
    2023 年全髋关节置换术（THA）最常见的原因是感染（26.3%），其次是关节不稳定（20.6%）。这延续了 2012 年至 2023 年全髋关节置换术（THA）最常见的诊断（21.4%）的总体趋势。
  • DM bearings were used in 34.0% of revision THA for instability in 2023, while constrained liners were used in 34.3 % 34.3 % 34.3%34.3 \% of such cases. The use of constrained liners for revision THA for instability has been steadily increasing since a low of 23.2 % 23.2 % 23.2%23.2 \% in 2020, while DM usage has remained stable and standard bearings have steadily decreased (43.4% in 2020, to 31.7 % 31.7 % 31.7%31.7 \% in 2023).
    2023 年，34.0%的失稳性全髋关节置换术（THA）使用了 DM 轴承，而 34.3 % 34.3 % 34.3%34.3 \% 例失稳性全髋关节置换术（THA）使用了限制性衬套。自 2020 年 23.2 % 23.2 % 23.2%23.2 \% 的低点以来，限制性衬套在失稳性全髋关节置换术（THA）中的使用率一直在稳步上升，而 DM 轴承的使用率保持稳定，标准轴承的使用率则稳步下降（2020 年为 43.4%，2023 年为 31.7 % 31.7 % 31.7%31.7 \% ）。
  • For the first time, more granular TKA constraint and insert design categories were analyzed in the 2024 AJRR Annual Report. Medial congruent primary TKA designs have seen a rapid increase in popularity, accounting for 32.1% of cases in 2023 (24.1% in 2022 and 2.3 % 2.3 % 2.3%2.3 \% in 2017). While posterior stabilized designs decreased in popularity in 2023 (40.8% of cases, down from 44.5 % 44.5 % 44.5%44.5 \% of cases in 2022), they remain the most used primary TKA implant design. Cruciate retaining designs were used in 9.0 % 9.0 % 9.0%9.0 \% of cases in 2023, down from 35.6 % 35.6 % 35.6%35.6 \% in 2012.
    2024 年 AJRR 年度报告首次对全膝关节置换 (TKA) 约束和插入物设计类别进行了更细致的分析。内侧一致型全膝关节置换 (TKA) 主设计应用迅速增长，2023 年占比 32.1%（2022 年为 24.1%，2017 年为 2.3 % 2.3 % 2.3%2.3 \% ）。虽然后稳定型设计在 2023 年的应用率有所下降（占比 40.8%，低于 2022 年的 44.5 % 44.5 % 44.5%44.5 \% ），但它仍然是最常用的全膝关节置换 (TKA) 主植入物设计。2023 年，十字韧带保留型设计在 9.0 % 9.0 % 9.0%9.0 \% 例病例中的应用率低于 2012 年的 35.6 % 35.6 % 35.6%35.6 \% 例。
  • Utilization of highly cross-linked polyethylene and antioxidant polyethylene inserts increased from 2022 to 2023. Highly crosslinked polyethylene remains the most used insert material
    2022 年至 2023 年，高交联聚乙烯和抗氧化聚乙烯内衬的使用率有所增加。高交联聚乙烯仍然是最常用的内衬材料
    accounting for 45.9 % 45.9 % 45.9%45.9 \% of primary TKA. Conventional polyethylene was used in 14.6 % 14.6 % 14.6%14.6 \% of primary TKA in 2023, a decrease from 17.1 % 17.1 % 17.1%17.1 \% in 2022 and 42.5 % 42.5 % 42.5%42.5 \% in 2012. Notably, there were no significant differences in rates of cumulative all-cause revision between highly cross-linked polyethylene, antioxidant polyethylene, or conventional polyethylene inserts in primary TKAs performed for primary OA in Medicare patients aged 65 years and older ( P > .05 P > .05 P > .05P>.05 for all).
    占初次全膝关节置换术 (TKA) 的 45.9 % 45.9 % 45.9%45.9 \% 。2023 年，常规聚乙烯在初次全膝关节置换术中的应用占 14.6 % 14.6 % 14.6%14.6 \% ，较 2022 年的 17.1 % 17.1 % 17.1%17.1 \% 和 2012 年的 42.5 % 42.5 % 42.5%42.5 \% 有所下降。值得注意的是，在 65 岁及以上享受医疗保险的原发性骨关节炎 (OA) 患者中，在初次全膝关节置换术中，使用高交联聚乙烯、抗氧化聚乙烯或常规聚乙烯插入物的患者，其累积全因翻修率并无显著差异（所有患者均为 P > .05 P > .05 P > .05P>.05 ）。
  • Patellar resurfacing remains commonplace in primary TKA, performed in 87.0 % 87.0 % 87.0%87.0 \% of cases in 2023. However, rates of patellar resurfacing have decreased over time ( 87.0 % 87.0 % 87.0%87.0 \% of cases in 2023, decreased from 88.8 % 88.8 % 88.8%88.8 \% in 2022 and 95.9 % 95.9 % 95.9%95.9 \% in 2012).
    髌骨表面置换在初次全膝关节置换术中仍然很常见，2023 年有 87.0 % 87.0 % 87.0%87.0 \% 例实施了髌骨表面置换术。然而，髌骨表面置换术的实施率随着时间的推移有所下降（2023 年为 87.0 % 87.0 % 87.0%87.0 \% 例，低于 2022 年的 88.8 % 88.8 % 88.8%88.8 \% 例和 2012 年的 95.9 % 95.9 % 95.9%95.9 \% 例）。
  • Cementless fixation in primary TKA continues to rise in popularity, accounting for 21.8 % 21.8 % 21.8%21.8 \% of primary TKA in 2023. Considering primary TKA in male Medicare patients aged 65 years and older, there was no statistically significant difference in the rate of cumulative all-cause revision between cementless and cemented fixation (adjusted HR 1.035, 95% CI 0.94-1.14; P = .05 P = .05 P=.05P=.05 ). When considering male patients less than age 65 undergoing primary TKA for primary OA, there remained no statistically significant difference in the rate of cumulative all-cause revision between cementless and cemented TKA (adjusted HR 0.93, 95% CI 0.85-1.02; P = .103 P = .103 P=.103P=.103 ); however, hybrid fixation had a significantly lower rate of cumulative all-cause revision relative to cemented fixation (adjusted HR 0.84, 95% CI 0.72-0.99; P = .04 P = .04 P=.04P=.04 ). Cementless fixation had an increased rate of cumulative all-cause revision relative to cemented fixation in primary TKA in female Medicare patients aged 65 years and older (adjusted HR 1.17, 95 % 95 % 95%95 \% CI 1.05-1.29; P = .003 P = .003 P=.003P=.003 ).
    非骨水泥固定在初次 TKA 中的应用持续上升，占 2023 年初次 TKA 的 21.8 % 21.8 % 21.8%21.8 \% 。对于 65 岁及以上的男性医疗保险患者，非骨水泥固定与骨水泥固定的累积全因翻修率没有统计学上的显著差异（调整后 HR 1.035，95% CI 0.94-1.14； P = .05 P = .05 P=.05P=.05 ）。对于 65 岁以下因原发性骨关节炎接受初次 TKA 的男性患者，非骨水泥固定与骨水泥固定的累积全因翻修率仍然没有统计学上的显著差异（调整后 HR 0.93，95% CI 0.85-1.02； P = .103 P = .103 P=.103P=.103 ）；然而，混合固定的累积全因翻修率明显低于骨水泥固定（调整后 HR 0.84，95% CI 0.72-0.99； P = .04 P = .04 P=.04P=.04 ）。对于 65 岁及以上的女性医疗保险患者，初次 TKA 中非骨水泥固定的累积全因翻修率高于骨水泥固定（调整后 HR 1.17， 95 % 95 % 95%95 \% CI 1.05-1.29； P = .003 P = .003 P=.003P=.003 ）。
  • Robotics were used in 15.9 % 15.9 % 15.9%15.9 \% of primary TKA in 2023, increased from 12.5 % 12.5 % 12.5%12.5 \% in 2022, and an 8-fold increase from 2017 (1.8%). Similar to primary THA, use of computer navigation declined from 5.2 % 5.2 % 5.2%5.2 \% in 2022 to 4.0 % 4.0 % 4.0%4.0 \% in 2023.
    2023 年，机器人技术在初次全膝关节置换术 (TKA) 中的应用率 ( 15.9 % 15.9 % 15.9%15.9 \% ) 高于 2022 年的 12.5 % 12.5 % 12.5%12.5 \% ，是 2017 年的 8 倍（1.8%）。与初次全髋关节置换术 (THA) 类似，计算机导航的使用率从 2022 年的 5.2 % 5.2 % 5.2%5.2 \% 下降到 2023 年的 4.0 % 4.0 % 4.0%4.0 \% 。
  • The most common reason for revision TKA in 2023 was infection (32.5%). This continues the overall trend of infection as the most common diagnosis associated with THA revision from 2012 to 2023 (33.1%), followed by mechanical loosening (24.4%).
    2023 年全膝关节置换术(TKA)翻修的最常见原因是感染(32.5%)。这延续了 2012 年至 2023 年全膝关节置换术(THA)翻修中感染(33.1%)成为最常见诊断的总体趋势，其次是机械松动(24.4%)。
  • Infection was also the most common diagnosis associated with TKA re-revisions from 2012 to 2023 (37.3%).
    感染也是 2012 年至 2023 年间与 TKA 再修订相关的最常见诊断（37.3%）。
As the AJRR Annual Report enters into its second decade of existence, it remains the pre-eminent source of data and analyses on hip and knee arthroplasty practice trends and rates of implant utilization and survivorship in the United States. Increasing rates of participation through the addition of new member sites and improving rates of data capture and submission from existing sites will further improve the quality, completeness, and power of the data contained with the AJRR. To learn more about specific AJRR initiatives and to review the full 2024 AJRR Annual Report, visit https://connect.registryapps.net/2024-ajrr-annual-report.
随着 AJRR 年度报告迈入第二个十年，它仍然是美国髋关节和膝关节置换实践趋势以及植入物使用率和存活率的首要数据和分析来源。通过增加新成员中心来提高参与率，并提高现有中心的数据采集和提交率，将进一步提升 AJRR 数据的质量、完整性和权威性。如需了解更多关于 AJRR 具体举措的信息并查看完整的 2024 年 AJRR 年度报告，请访问 https://connect.registryapps.net/2024-ajrr-annual-report 。

Conflicts of interest  利益冲突

Vishal Hegde receives speakers’ bureau/paid presentations for Ortho Development; is a Paid consultant for Globus Medical; receives research support from Ortho Development and Zimmer Biomet; receives fellowship support from Smith & Nephew; and is a board member/committee appointments for AAHKS Research Committee. AAOS AJRR Research Projects Subcommittee, and AAOS Adult Reconstruction Knee Program Committee. Brett Levine is a paid consultant for Link, Enovis, and Zimmer Biomet; receives royalties, financial or material support from Human Kinetics, Slack INC., Wolters Kluwer, and Elsevier; is a member of the Medical/ Orthopaedic publications editorial/governing board at Orthopedics, JOA, AT (Editor-in-chief); and is a board member/committee appointments for AAOS EQBV Committee, AAHKS Member at Large, and HS/KS Digital Media Committee. Anna CohenRosenblum is a paid consultant for Zimmer Biomet; receives royalties, financial or material support from Elsevier and JBJS; is a memver of the Medical/Orthopaedic publications editorial/governing board at Arthroplasty Today, Journal of Arthroplasty; is a board member/committee appointments for AAOS, AAHKS, SICOT, and RJOS. The other authors declare there are no conflicts of interest.
Vishal Hegde 是 Ortho Development 的演讲者/付费演讲者；是 Globus Medical 的付费顾问；获得 Ortho Development 和 Zimmer Biomet 的研究支持；获得 Smith & Nephew 的奖学金支持；并且是 AAHKS 研究委员会的董事会成员/委员会成员。AAOS AJRR 研究项目小组委员会和 AAOS 成人重建膝关节计划委员会。Brett Levine 是 Link、Enovis 和 Zimmer Biomet 的付费顾问；从 Human Kinetics、Slack INC.、Wolters Kluwer 和 Elsevier 获得版税、财务或物质支持；是 Orthopedics、JOA、AT（主编）的医学/骨科出版物编辑/管理委员会成员；并且是 AAOS EQBV 委员会、AAHKS 一般会员和 HS/KS 数字媒体委员会的董事会成员/委员会成员。 Anna CohenRosenblum 是 Zimmer Biomet 的付费顾问；获得爱思唯尔 (Elsevier) 和 JBJS 的版税、财务或物质支持；是《Arthroplasty Today》、《Journal of Arthroplasty》杂志医学/骨科出版物编辑/管理委员会成员；同时担任 AAOS、AAHKS、SICOT 和 RJOS 的董事会成员/委员会成员。其他作者声明不存在利益冲突。
For full disclosure statements refer to https://doi.org/10.1016/j. artd.2025.101727.
完整披露声明请参阅 https://doi.org/10.1016/j . artd.2025.101727。

References  参考

[1] Hegde V, Stambough JB, Levine BR, Springer BD. Highlights of the 2022 American joint replacement registry annual report. Arthroplast Today 2023;21:101137.
[1] Hegde V, Stambough JB, Levine BR, Springer BD. 2022 年美国关节置换登记年度报告亮点。《Arthroplast Today》2023;21:101-137。
[2] Siddiqi A, Levine BR, Springer BD. Highlights of the 2021 American joint replacement registry annual report. Arthroplast Today 2022;13:205.
[2] Siddiqi A, Levine BR, Springer BD. 2021 年美国关节置换登记年度报告重点推荐。《今日关节成形术》2022;13:205。
[3] 42 CFR Parts 406, 407, 410, 411, 416, 419, 435, 440, 457, 482, and 485. Department of health and human Services, centers for Medicare and Medicaid Servicesvol 89. Baltimore, MD: Centers for Medicare and Medicaid Services; 2024. p. 93912-4594. No. 229. Federal Register.
[3] 42 CFR 第 406、407、410、411、416、419、435、440、457、482 和 485 部分。美国卫生与公众服务部，医疗保险和医疗补助服务中心，第 89 卷。马里兰州巴尔的摩：医疗保险和医疗补助服务中心；2024 年，第 93912-4594 页。第 229 期。《联邦公报》。
[4] Nourie BO, Cozzarelli NF, Krueger CA, Donnelly PC, Fillingham YA. Antibiotic laden bone cement does not reduce acute periprosthetic joint infection risk in primary total knee arthroplasty. J Arthroplasty 2024;39:S229.
[4] Nourie BO, Cozzarelli NF, Krueger CA, Donnelly PC, Fillingham YA. 抗生素骨水泥并不能降低初次全膝关节置换术中假体周围关节急性感染风险。《关节成形术杂志》2024;39:S229。
[5] De A, Chalmers BP, Springer BD, Browne JA, Lewallen DG, Stambough JB. What is the incidence of and outcomes after debridement, antibiotics, and implant retention (DAIR) for the treatment of periprosthetic joint infections in the AJRR population? Clin Orthop Relat Res 2024;482:2042.
[5] De A, Chalmers BP, Springer BD, Browne JA, Lewallen DG, Stambough JB. 在 AJRR 人群中，清创、抗生素和植入物保留(DAIR)治疗假体周围关节感染的发生率和疗效如何？Clin Orthop Relat Res，2024;482:2042。
[6] Sassoon AA, Taylor JM, Jimenez E, Stancil R, Cannady D, De A. Periprosthetic fractures: a rising tide of hip arthroplasty failure noted in the American joint replacement registry and the preventative role of cemented stems. J Arthroplasty 2024;39:S454.
[6] Sassoon AA, Taylor JM, Jimenez E, Stancil R, Cannady D, De A.假体周围骨折：美国关节置换登记处记录的髋关节置换术失败率上升及骨水泥柄的预防作用。《关节成形术杂志》2024;39:S454。
[7] Kagan R, Pelt CE, Khanuja HS, Oni JK, Zaniletti I, De A, et al. Selective use of modern cementless total knee arthroplasty is not associated with increased risk of revision in patients aged 65 or greater: an analysis from the American joint replacement registry. J Knee Surg 2024;38:130-5.
[7] Kagan R, Pelt CE, Khanuja HS, Oni JK, Zaniletti I, De A 等。选择性使用现代非骨水泥型全膝关节置换术与 65 岁及以上患者翻修风险增加无关：一项来自美国关节置换登记处的分析。《膝关节外科杂志》2024;38:130-135。
[8] Eiel ES, Donnelly P, Chen AF, Sloan M. Outcomes and survivorships of total knee arthroplasty comparing resurfaced and unresurfaced patellae. J Arthroplasty 2023;38(7 Suppl 2):S227.
[8] Eiel ES, Donnelly P, Chen AF, Sloan M. 全膝关节置换术疗效及生存率比较，比较修复表面髌骨与未修复表面髌骨。《关节成形术杂志》2023;38(7 Suppl 2):S227。
[9] DeMik DE, Lizcano JD, Jimenez E, Mullen KJ, Lonner JH, Krueger CA. Does resurfacing the patella increase the risk of extensor mechanism injury within the first 2 Years after total knee arthroplasty? J Knee Surg 2024;38: 110-4.
[9] DeMik DE, Lizcano JD, Jimenez E, Mullen KJ, Lonner JH, Krueger CA. 髌骨表面置换是否会增加全膝关节置换术后 2 年内伸肌装置损伤的风险？ J Knee Surg 2024;38: 110-4.
[10] Ryan SP, Stambough JB, Huddleston 3rd JI, Levine BR. Highlights of the 2023 American joint replacement registry annual report. Arthroplast Today 2024;26:101325.
[10] Ryan SP, Stambough JB, Huddleston 3rd JI, Levine BR. 2023 年美国关节置换登记年度报告亮点。《Arthroplast Today》2024;26:101325。
    • Corresponding author. Department of Orthopedic Surgery, New York University Grossman School of Medicine, 301 E. 17th Street, Ste 1402, New York, NY 10003, USA
      通讯作者。纽约大学格罗斯曼医学院骨科，301 E. 17th Street, Ste 1402, New York, NY 10003, USA