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General Orthopaedics

REVISING THE REVISION RATE: IS DR FOSTER'S DATA ACCURATE?

The South West Orthopaedic Club (SWOC) Spring Meeting



Abstract

There is increasing focus on publishing comparable data for individual hospitals and surgeons. The Dr Foster website is one portal for accessing such information, and uses hospital episode statistics sent to the Department of Health. For 2008–2011 our Trust was labelled as a statistical outlier with high one year revision rates for total knee replacement; relative risk was 2.53. We examined the accuracy of this information.

According to Dr Foster's data, out of 1517 primary total knee replacements performed between April 2008 and March 2011, fifty-five were revised within one year (29 female: 26 male). This gave a revision rate of 3.6% compared to a 1.4% national average. We reviewed patient records for those labelled as revisions.

Of these cases, only one was a revision total knee replacement within one year. Forty-four had a manipulation under anaesthesia for stiffness and the remaining cases had alternative operations such as arthroscopic washout.

For our Trust, therefore, the data is inaccurate, and a patient relying on such data would be misled. Either Trusts should work with Dr Foster to improve accurate coding of data, or they should keep ownership of their data, and publish accurate figures of their own.