The National Joint Registry (NJR) collects information about hip, knee, ankle, elbow and shoulder joint replacement operations (arthroplasty) from all participating hospitals in England, Wales, Northern Ireland, the Isle of Man and Guernsey. Described as a global exemplar of an implantable medical device registry, the NJR continues to be the largest orthopaedic registry in the world, with an international reputation.
The registry’s purpose is to record patient information and provide data on: the performance and longevity of replacement joint implants: the surgical outcomes for the hospitals where these operations are carried out; and on the performance outcomes of the surgeons who conduct the procedures. We produce this Annual Report, summarising our work and sharing the analysis of data for the past year, visually in tables and graphs, for procedures across each of the joints, as well as implant and hospital outcomes.
PROMs questionnaires completed by patients themselves are a valuable tool in giving insight as to how a patient feels and functions, both before and after surgery, therefore being an important measurement of the success of their joint replacement. Our report this year has a section on how PROMs data might best be handled to integrate with NJR routine reporting and thus add an additional dimension in the reporting of the performance of joint replacements.
This year’s report also illustrates the continued impact of COVID on the number of procedures undertaken, which is having a resulting negative impact on the quality of life for patients being left in pain and with issues around reduced mobility. You can see the figures regarding current procedure volume compared to pre-COVID years here.
Registry data for the reduced volume of surgery that has taken place this past year, have again been analysed by expert statisticians and the results published - device outcome results are also shared with implant manufacturers. The report also includes some short excerpts which showcase the NJR’s contribution to orthopaedic research activity, demonstrating the value of the use of these collected data. A key message from the report is that safety and clinical outcomes continue to improve, as identified through the reduction of revision surgery.
The work of the NJR and the contribution of patients
The registry has shown that orthopaedic surgery, as one of the main users of implant devices in the UK, is demonstrating the highest standards of patient safety with regard to their use. Patient representatives are actively involved in our workstreams and committees and with over 3.5 million records, registry data are also made available under strict security conditions to medical and academic researchers, to further progress the pool of work in measuring and understanding which practices provide better outcomes.
Our data collection and analysis work provides the evidence to drive the continuous development and implementation of measures, to ensure implant safety and the enhancement of patient outcomes is always top of the agenda alongside a focus on reduced revision rates year-on-year, as well as improvements in standards in quality of care whilst also addressing overall cost-effectiveness in joint replacement surgery.
We are very grateful to all patients, who having undergone a joint replacement, have provided their data to the registry over the years, which has enabled us to collect and develop such a rich and valuable data source. The NJR is also appreciative of the work of data entry staff in all participating hospitals, who willingly engage in our stringent data quality award programmes to ensure our information is of high quality, accurate and as complete as is possible.