PL01

Establishing A National Arthroplasty Registry

Ed Marel

Australian Orthopaedic Association National Joint Replacement Registry

Registries are continuous quality assurance programs that are integrated into healthcare systems. They are appropriately designed and governed to ensure that they bring about significant improvement in health outcomes. Registries collect quality clinical evidence that can be used to identify outcome differences (best and worse practice) within the relevant healthcare setting and subsequently provide that information to appropriate stakeholders to enable action and beneficial change.Registries play a critical role in improving the outcome of joint replacement surgery by enabling clinicians to identify best practice that is relevant to their own approach to arthroplasty using community based comparative data which simultaneously compares the effect of multiple factors on outcome.The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) commenced collection of Hip and Knee Arthroplasty data in 1999 and by 2002 had full national coverage with 100% of arthroplasty surgeons and hospitals participating. Collection of data on Shoulder, Elbow, Wrist, Ankle and Spinal Disc commenced in 2007. The Registry now has data on 905,666 hip and knee procedures and 28,381 other joint replacements.The AOANJRR provides data which enables beneficial changes in practice by individual surgeons as well as beneficial changes at both national and international levels.The essential features of a quality Registry include scrupulously maintained quality of data and clinician involvement at all levels. A quality Registry provides useful information to all stakeholders, enabling clinicians to better select suitable patients procedures and implants and also benefitting regulators and government agencies.Increasingly there is international collaboration between registries which can learn more by pooling large data resources when definitions and data are shared.Help for establishing a joint replacement registry is available from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) and the International Society of Arthroplasty Registries (ISAR).