Patient Reported Outcomes Measures (PROMs) are commonly used in total joint arthroplasty (TJA) to assess surgical outcomes. However certain patient populations may be underrepresented due to lower survey completion rates. The purpose of this study is to evaluate factors that influence PROM completion rates for 1997 TJA patients between 7/1/2007 and 12/31/2010. Completion rates were lower among patients who were over 75, Hispanic or Black, had Medicare or Medicaid, TKA patients and revision TJA patients (P < 0.05 for all comparisons). Having multiple risk factors further reduced completion rates (P < 0.001). Overall participation increased significantly during the study period, after electronic data capture methods were introduced. Awareness of these factors may help physicians and researchers improve participation of all patient populations so they are well represented in TJA outcomes research.