Joint replacement registries have been in place in Europe and Australia for decades. This registry data have given researchers robust information to evaluate joint replacement volume, utilization patterns, and outcomes. In many instances, registries can also serve as a mechanism for implant surveillance and an early warning system for underperforming implants. As the US health care system evolves from a volume-based system to a value-based system, the role of registry data will become increasingly more important. The true value of a registry in this type of health care environment will allow for an evaluation of value, cost, comparative effectiveness, and patient reported outcomes. The American Joint Replacement Registry (AJRR) is a multistakeholder, independent nonprofit organization established by the American Academy of Orthopaedic Surgeons in 2009. AJRR has experiencedwide support across the orthopaedic community andas such as seen a rapid expansion in the number of participating hospitals and procedural volume reported. On concluding a pilot study in 2011, AJRR had 8 hospitals enrolled and approximately 13,000 procedures. In the latest annual report for 2014, these numbers had increased dramatically to 417 enrolled hospitals and over 225, 000 procedures in the registry. In addition, AJRR has been recognized for