The National Joint Registry (NJR) of England and Wales was established in 2002 with the aim of ensuring that joint replacement patients received the best possible clinical care during and after their operation.
The registry covers both the NHS and the independent sector and collects data on hip, knee and ankle replacements.
One of the prime reasons for keeping the registry is to identify implants that show a high failure rate and it was the NJR of England and Wales and its Australian counterpart that were responsible for providing the data that eventually led to the DePuy recall.
At first DePuy tried to place the responsibility for the high rate of revision work on the type of patient selected and the skill of the surgeon but the NJR provided the evidence that clearly demonstrated that the fault lay with the product not with the surgeon or the patient! It is estimated that 93,000 patients will be involved in this recall.
Apart from identifying where things go wrong the NJR is also able to show which implants and techniques perform best. Data from the Registry can be used to show the rate of revision work for a particular implant or a particular technique. Drilling down further into the data can take in variables such as choice of anaesthetic, body mass index of the patient, experience of the surgeon and the type of approach used. It will also show the reason why most revision work was needed for a particular implant and how long the implant lasted.
With that sort of data it becomes possible to make more refined choices for individual patients.
Data is collected for both primary surgery and for revision work. The list for primary surgery includes: -
Janey had a total hip replacement in early 2010 she had this to say.
The morning of my operation my surgeon came to see me to make sure I understood what was going to happen. He also asked me if I'd consent to allowing data about my operation to be sent to the National Joint Registry. He explained a bit about what it does and I readily agreed.
It just seemed such an obviously sensible thing to do. Without a central register how would anyone know what was going on. There could be all sorts of problems happening up and down the country but no one would know how widespread they were.
With a central Register it should be a lot quicker to identify when things are going wrong.
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