According to the National Joint Registry (NJR) 6th Annual Report, a record amount of data on hip and knee joint replacement procedures has been requested by orthopaedic surgeons, suppliers and manufacturers of joint replacement implants and patients.
This dramatic rise in data requests demonstrates the importance to health professionals and patients of the information held on the register for the purpose of quality monitoring and improvement. Further improving the accessibility and value of the data has been a priority for NJR this year with the launch in November 2008 of NJR Clinician Feedback. A secure online service, it enables surgeons to assess their clinical practice and compare it to that of their colleagues at hospital, regional (strategic health authority), sector (NHS or independent) and national levels; and through this, to identify practice that could be improved. A total of 160,0273 hip and knee joint replacement operations were reported to the NJR during the year under review, which represents 92.5% of all such operations carried out in England and Wales in the NHS and independent healthcare sectors. Among the trends identified through the registry is the reduction in the average age of patients undergoing primary hip replacement surgery from 68.1 years in 2004 to 66.7 years. During the same period, the average body mass index (BMI) of patients having hip replacement surgery rose from 27.8 to 28.3. The average BMI of knee replacement patients has also risen in the last five years from 29.7 to 30.3. This is equivalent to a weight gain of 1.85kg (four pounds) for a person of average height and means that the average knee replacement patient, by BMI measurement, is now clinically obese. Bill Darling, chair of the NJR Steering Committee, said: “The quality of the data held on the Register is such that we can now quickly inform hospitals of potential problems with implants and so greatly reduce the time between identification of an issue and a patient review. “For the first time this year, an implant was withdrawn from sale by its supplier using information provided by the Register’s analysis following a device alert issued by the Medicines and Healthcare products Regulatory Agency (MHRA). “The NJR was able quickly to identify patients who had received the implant and inform the relevant hospitals. Our ability to track patients is greatly enhanced by staff in hospitals and units obtaining patient consent, which, I am pleased to report, is happening on an increasingly frequent basis”, he added. Looking ahead, Bill Darling said that a significant development for NJR would be its participation in the national Patient Reported Outcome Measures (PROMs) study, commissioned by the Department of Health. “Agreement has been reached with the DH for PROMs data to be linked with the NJR data, enabling the registry to provide outcomes information for the first time from the perspective of patients rather than clinicians,” he explained.
