The Australian Orthopaedic Association National Joint Replacement Registry

Professor Stephen E. Graves
AOA National Joint Replacement Registry

The Australian Joint Replacement Registry is owned and managed by the Australian Orthopaedic Association and is fully funded by the Australian Federal Government. The Registry commenced data collection from a small number of hospitals in September 1999. It then underwent a staged implementation to all remaining hospitals nationally. This was completed in mid 2002. All hospitals, both government and private, undertaking joint replacement surgery, contribute data to the registry. This totals almost 300 hospitals nationwide. There is 100% surgeon participation.

Initially, the Registry collected information only on hip and knee replacements however; since November 2007, it has also commenced collecting data on shoulder, elbow, wrist, ankle and spinal disc replacement. As of January 2008 it has information on over 400,000 hip and knee replacement procedures and over 2000 procedures involving other joints - mostly shoulder replacement.

Data is provided by each hospital independently of their usual reporting requirements to government. Most hospitals use a paper-based reporting system providing the information on Registry specific forms for each procedure. The Registry purposely focuses on collecting a minimum data set but uses extensive internal and external validation systems to ensure that that data set is correct. The data set includes patient hospital and surgeon details, reasons for surgery, and information on the procedure. All components used are identified by catalogue and lot number.

The Registry produces an Annual Report which is mailed in hard copy to all Australian orthopaedic surgeons and is also publicly available on the web The principal outcome measures are death and revision. The report details demographic and outcome information. Outcomes are reported specific to patient features such as age gender and diagnosis, categories of prostheses and individual prostheses within those categories. There is also increasing analysis being undertaken related to generic features of prostheses. The Registry also provides upon request, additional specific reports to Australian surgeons, hospitals, universities and other research organizations and government at no charge. It also provides reports to industry for a nominal fee.

Although the Australian Registry is relatively young, since its establishment there have been significant changes in surgical practice - many of which can be attributed to the information provided by the Registry. These changes have been associated with a major reduction in the proportion of revision procedures being undertaken. Revision hip replacement, as a proportion of all hip replacement procedures, has declined from 14.6% in 2001 to 12.1% in 2006 and revision knees from 10.0% to 8.1% during the same period.

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