Dear Sir,
These are exciting times in the orthopaedic world with the profession taking the lead in collecting data to define the natural history of disease processes and the success of our surgical interventions. Initiatives include the National Joint Registry (NJR), National Hip Fracture Database (NHFD), the collection of national Patient Reported Outcome Measures (PROMS) data, a national register for spinal surgery through the British Association of Spinal Surgery (BASS), and a planned soft-tissue knee surgery register (Knee Ligament Registry). With the formation of all these national registers the UK may indeed be entering a golden era of orthopaedic data collection whereby all clinicians routinely enter data onto a national register as part of the accepted culture of working.
May I draw your attention to the Non Arthroplasty Hip Register (NAHR), which was launched in March 2012.1 The NAHR has been set up to collect longitudinal outcome data for any type of hip condition and/or surgery other than arthroplasty and the treatment of acute fracture. It has been constructed so that paediatric conditions can also be studied for the lifetime of the patient on a unique pathway passing between treating clinicians.
Who benefits from the creation of the NAHR?
The patients
Patients will only undergo surgery if it is likely to reduce their pain, improve their function (ability to undertake activity and work) and/or prevent the progress of arthritis of the hip and ultimately a hip replacement. Patients who will not benefit are spared the risk of surgery and the potential for the procedure to exacerbate their symptoms and accelerate the progression of arthritis.
The purchasers of healthcare
Funding will be targeted at patients who will benefit from a surgical procedure. Funds will not be used where the outcome clearly does not justify the resource.
Surgeons
Clinicians are able to use the Register to collect and display comprehensive outcome and audit data for all of their own patients, using scores and outcome measures of their own choice. Surgeons will be able to determine which patients will benefit from surgery and what details of the operative procedure will define a good result.
Getting started
Which patients should I enter?
The NAHR has been set up to allow data collection for any patient with a hip condition other than arthroplasty or fracture (e.g. trochanteric bursitis, femoroacetabular impingement (FAI), slipped upper femoral epiphysis, Perthes’, etc.).
The NAHR can track the outcome of conservative or surgical treatment for any hip condition.
The National Institute for Health and Clinical Excellence (NICE) requires that data are entered onto the Register for patients undergoing surgery for FAI whether the surgery is open or arthroscopic.
If you work in the UK and treat patients with hip disorders please r egister and organise the protocol for data collection for patients under your care.
Full information and instruction are available on the website: http://britishhipsociety.com/NAHSR/Index.htm.
John Timperley, FRCS (Ed) D. Phil (Oxon), President-Elect British Hip Society, Chairman NAHR Subcommittee, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK
1 No authors listed. The Non Arthroplasty Hip Register. http://britishhipsociety.com/NAHSR/Index.htm (date last accessed 20 June 2012). Google Scholar
