The first 3-years of the national joint registry for ankles: patterns of uptake and compliance, and a comparison with that of hips, knees and shoulders
W. Rudge, M. Welck, B. Rudge, A. Goldberg
Introduction: The National Joint Registry (NJR) was established in 2003, and was extended to include ankle arthroplasty on 1st April 2010, and shoulder and elbow arthroplasty in April 2012.
Methods: The aim of this study was to evaluate the uptake of the NJR for ankle arthroplasty over its first 3 years. This is compared to the first 3 years of hip and knee data, and the first year of shoulder and elbow data. The methods of measuring compliance are also evaluated. NJR compliance is measured by comparing the number of procedures submitted to the NJR, against the number of levies raised through implant sales. This applies to all of the UK, and both independent and NHS providers. However, compliance can also be measured by comparing NJR submissions with data submitted to the Hospital Episode Statistics (HES) database. This only relates to NHS institutions in England. The NJR ankle data was compared to implant data, and adjusted to compare to HES data, to evaluate the different methods of measuring compliance. We also compared these figures with the first 3 years for hip and knee arthroplasties and the first year for shoulder and elbow arthroplasties.
Results: In 2011 there were 493 arthroplasties and the compliance was 64% against industry data. In 2012 there were 590 procedures with compliance improved to 77% against industry data. When adjusting NJR to compare with HES data, the compliance was 87% in 2012, with 507 ankle arthroplasties registered with the NJR and 582 on HES data. The reasons for this discrepancy are discussed. The specific difficulties of capturing ankle revisions are discussed, as some get revised to arthrodeses.
Conclusion: The uptake is significantly higher than the first year for all other joints (shoulders 52%, hips 57%, knees 57%, and elbows 60%).
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