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The AJRR Annual Report 2025: a digest of the main takeaways

The AMERICAN JOINT REPLACEMENT REGISTRY, NFP (AJRR) has collected data on over 1.8 million joint arthroplasty procedures between 2012 and 2024, providing an overview of meaningful trends and outcomes in hip and knee replacement surgery as reported in the US.

Infographic showing key data from the AJRR Annual Report 2025, including 82.5% ceramic femoral head use, 73.5% ceramic‑on‑polyethylene bearings, distribution of femoral head sizes (36 mm at 64%), and 93.3% reported improvement one year after total hip arthroplasty, over a U.S. flag background.
Infographic from the AJRR Annual Report 2025 showing an overall revision burden of 9.6%, with leading causes listed: infection/inflammatory reaction (20.8%), mechanical complications (16.9%), instability (16.8%), fracture (15.4%), aseptic loosening (13.3%), and pain (9.4%), displayed over a U.S. flag background.

Procedure: 

77.7% of cases were elective primary total hip arthroplasties (THA).

Femoral head material:

  • Ceramic rose in use to 82.5% – more than double what the AJRR first found in 2012 (38.1%).
  • CoCr declined from 55.8% to 6.8%.
  • Ceramicized metal increased to 10.7%.

Bearing type:

  • CoP (ceramic-on-polyethylene) increased to 73.5%.
  • MoP (metal-on-polyethylene) dropped to 2.9%.
  • Ceramicized metal-on-polyethylene increased to 10.7%
  • Dual mobility bearings reached 7.7% in 2024, most often in revisions related to dislocation/instability (65.6%).
  • 44 hip resurfacing procedures were reported in 2024, the majority in younger patients (mean age 53.4 since 2012).

Femoral head size:

  • 36mm heads are now most common at 64% (up from 48.8% in 2012).
  • 32mm heads decreased to 12.8% (from 33.6%).
  • ≥40mm heads increased to 12.5%.
  • Small heads (≤28mm) remain stable at ~3.5%.
  • Among patients ≥65 years, 36mm heads have lower revision rates than 40mm heads between two and 10 years (as reported by AJRR).

Implant fixation: Cementless femoral stems remain the standard in the US, with only 4.6% of stems cemented in 2024.

Revision rates:

  • Overall revision burden fell from 19.9% (2012) to 9.6% (2024).
  • 10-year revision rates: CoP (2.90%), ceramicized MoP (3.07%), dual mobility (3.74%), MoP (3.49%).
  • MoP showed higher revision rates compared to CoP in Medicare patients ≥65 with primary osteoarthritis (per AJRR).

Revision causes: 

Leading causes included infection/inflammatory reaction (20.8%), mechanical complications (16.9%), instability (16.8%), periprosthetic fracture (15.4%), aseptic loosening (13.3%), and pain (9.4%).

Patient outcomes: 

93.3% reported meaningful improvement one year after THA (HOOS JR), with significant gains in physical health on PROMIS-10 and VR-12 metrics (per AJRR).

 

For even more of the AJRR’s findings reflecting the evolution of arthroplasty practices and patient outcomes, visit the AAOS website: The AJRR Annual Report

This text was created with the support of AI.

Reference: 
American Joint Replacement Registry (AJRR): 2025 Annual Report: The 12th Annual Report of the AJRR on Hip and Knee Arthroplasty. Rosemont, IL: American Academy of Orthopaedic Surgeons (AAOS), 2025. Accessed 13 November 2025. 

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