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School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Australia
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The Australian Orthopaedic Association National Joint Replacement Registry first began data collection on 1 September 1999 and full nationwide implementation commenced in January 2003.
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The purpose of the Registry is to improve the quality of care for individuals receiving joint replacement surgery.
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The Registry enables surgeons, academic institutions, governments and industry to request specific data that are not available in published annual reports.
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There is an established system for identifying prostheses with a higher than anticipated rate of revision (HTARR) which was introduced in 2004.
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The higher rate of revision for the ASR Hip Resurfacing System was first identified by this process in 2007.
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There has been a reduction in revision hip and knee replacement over the years that the Registry has been in operation, and the addition of Patient Reported Outcome Measures (PROMs) and data linkage will enable more extensive analysis of joint replacement surgery in the future.
Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180071
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National Joint Replacement for England, Wales, Northern Ireland, Isle of Man and the States of Guernsey (NJR)
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Recent concerns surrounding joint replacements that have a higher than expected rate of revision have led to stricter controls by regulatory authorities with regards to the introduction of new devices into the marketplace.
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Implant post-market surveillance remains important, and joint replacement registries are ideally placed to perform this role. This review examined if and how joint replacement registries identified outlier prostheses, outlined problems and suggested solutions to improve post-market surveillance.
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A search was performed of all joint replacement registries that had electronic or published reports detailing the outcomes of joint replacement. These reports were examined for registry identification of outlier prostheses. Five registries publicly identified outlier prostheses in their reports and the methods by which this was performed, and three others had internal reports.
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Identification of outlier prostheses is one area that may improve overall joint replacement outcomes; however, further research is needed to determine the optimum methods for identification, including the threshold, the comparator and the numbers required for notification of devices.
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Co-operation of registries at a global level may lead to earlier identification of devices and thereby further improve the results of joint replacement.
