Orthopaedic registries - the UK view (National Joint Registry) : impact on practice

• The National Joint Registry (NJR) was established in 2002 as the result of an unexpectedly high failure rate of a cemented total hip replacement.

• Initial compliance with the Registry was low until data entry was mandated. Current case ascertainment is approximately 95% for primary procedures and 90% for revision procedures.

• The NJR links to other data sources to enrich the reporting processes. The NJR provides several web-based and open-access reports to the public and detailed confidential performance reports to individual surgeons, hospitals and industry bodies.

• A transparency and accountability process ensures that device and surgical performance are actively monitored on a six-monthly basis, and adverse variation is dealt with in an appropriate way that underpins patient safety.

• The NJR also manages a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit.

• Moving forwards, the NJR intends to look at factors that lead to better outcomes so that good practice can be embedded into routine care.