The vast array of implantable devices and the wide-ranging needs of patients make joint replacement treatment choices complex. Furthermore, lack of a comprehensive, scientific assessment of devices, treatment protocols, surgical approaches, and patient factors influencing results prevents more informed surgical decisions, often leading to suboptimal care, poor outcomes, and high costs.

The California Joint Replacement Registry (CJRR) was created to address the absence of comparative effectiveness information by pooling and analyzing data from surgeons and hospitals in California. CJRR focuses on hip and knee replacements, and collects patient demographics, device information, and clinical data including patient comorbidities and patient‐reported outcomes. CJRR aims to promote the use of performance information regarding hip and knee replacements to enable better decisionmaking by patients, physicians, other providers, and purchasers, and to improve the quality of care.

CJRR was founded in 2009 as a collaboration of the California HealthCare Foundation, the Pacific Business Group on Health, and the California Orthopaedic Association. Health plans Blue Shield of California, Cigna, and Anthem Blue Cross also have supported this effort. Three successful early pilots in 2011 led to eventual expansion to 45 hospitals and their affiliated surgeons by 2015. In March 2015, CJRR transitioned to operate as a project of the American Joint Replacement Registry. For details, see the press release. Learn more at the AJRR website and see their 2014 annual report that discusses CJRR.

Also in March 2015, CJRR released patient-reported outcomes (PRO) data by hospital, marking the first time a US orthopedics registry has publicly reported such data. See the results report and a subsequent journal article.

In the video below, Dr. James Caillouette, founding surgeon in chief at the Hoag Orthopedic Institute, describes how CJRR can improve care by identifying techniques and devices that are associated with better patient outcomes.

 
In a second video, knee replacement patient John Koos of Penngrove, California, shares his concerns about undergoing surgery and why he chose to participate in the California Joint Replacement Registry.