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 the States of Guernsey. As the largest data collection of its kind in the world, the NJR has been described in UK Parliament as a global exemplar of an implantable medical devices registry.
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. The report illustrates how the number of elective joint procedures has been heavily impacted throughout this past year by COVID-19; many joint procedures have had to be cancelled or postponed. There has been a major impact on people awaiting surgery for all joint types in a climate of continued uncertainty for their future surgical dates, with increasingly extended waiting lists. We have covered this impact, both on the orthopaedic sector and with a patient perspective on those who are facing long waiting times, in a special feature in this year’s report, you can find this on page 341.
Registry data for the surgery that has taken place this past year have again been analysed by expert statisticians and the results published with the continued aim of enhancing safety and improving clinical outcomes for the benefit of patients and the whole orthopaedic healthcare sector - 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, illustrating the value of the use of this collected data.
The work of the NJR and the contribution of patients
The registry has shown that orthopaedic surgery, as one of the main uses 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. With well over three 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 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 NJR over the years, which has enabled us to collect and develop such a rich and valuable data source. The registry 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.