Patient-reported outcome measures (PROMs) will be an important component of real-world evidence, but best practices for capture and integration are not yet defined. While digital tools support patients, clinicians, and researchers to collect PROMs, PROM capture in clinical care remains challenging. We synthesized PROM implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. This information can guide health systems that are preparing to implement PROMs to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. Specific information is included to guide each step in the implementation process, including selecting PROMs, redesigning office procedures, programming of information technology, and informing interpretation and clinical use. While no one solution exists for successful PROM implementation in total hip and total knee replacement, referred to as total joint replacement, these guidelines can inform optimal PROM deployment and the capture of complete PROM data. In addition, we outline future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.