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INTERNATIONAL OVERVIEW OF JOINT REPLACEMENT REGISTRIES



Abstract

Introduction and Aims: Nine countries have established national joint replacement registries. The first population-based national registry, the Swedish Knee Registry, was established in 1975 with the most recent, the UK National Joint Registry (UK NJR), beginning in 2003. We identify commonalities and differences in the structure, function and methods of reporting among these national registries.

Method: Data was collected from the annual reports of the various registries, published literature and personal contact with registry coordinators and directors.

Results: Commonalities include registry ownership, source of funding, procedure types collected, method of data collection and validation of data. Most registries are owned by the national Orthopaedic Association or a government agency. The most common source of funding is government; membership fees and a mandated implant levy are also used. Most national registries collect total hip and knee replacements, primaries and revisions. Hemiarthroplasties are not commonly collected, though some registries collect additional joints (including shoulder, elbow, wrist, finger, ankle and toe). The most common method of data collection is paper-based, usually from theatre, with subsequent data entry at the registry. Electronic data collection is used to supplement the paper-based system in some countries, while the Swedish Hip Registry and the UK NJR utilise a web application for the submission of data. Most registries attempt to validate their data against hospital inpatient data held by government. Differences include reporting of rates, cost per registration and definitions. Failures of primary implants may be reported as cumulative proportions, true incidence rates or survival probabilities. This leads to difficulties in comparison of data among the national registries. The cost of registering a procedure varies up to five-fold across countries.

Conclusion: There are obvious opportunities for collaboration between national joint replacement registries, however some issues need to be addressed. These include definitions of what is collected, for example hemiarthroplasties, and methods of analysis and reporting, especially revision rates.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.