Lessons of a hip failure

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7149.1985a (Published 27 June 1998) Cite this as: BMJ 1998;316:1985

Registers of joint replacement operations should be set up

  1. Pat Riordan, Consultant in public health medicine,
  2. Graham Bickler, Director of public health,
  3. Cynthia Lyons, Public health specialist
  1. East Sussex, Brighton and Hove Health Authority, Lewes, East Sussex BN7 2PB
  2. Leicester Royal Infirmary, Leicester LE1 5WW
  3. Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 7RH
  4. Northern General Hospital, Sheffield S5 7AU
  5. Cameron McKenna, Solicitors, London EC1A 4DD
  6. Department of Public Health, Sunderland Health Authority, Sunderland SR3 4AF

    EDITOR—Fickleness characterises the fashion industry. The fact that the introduction and use of hip prostheses in the United Kingdom should also be characterised by such whimsy is scandalous.1 The failure of the 3M Capital hip system and the difficulties in tracing and reviewing patients as a result bear witness to this. 2 3

    While we agree with the points made by Muirhead-Allwood in her editorial, she does not take the next logical step of requiring the establishment of a national hip prosthesis register. On the introduction of new prostheses and monitoring of outcomes, a register would provide a nationally coherent database recording preoperative, perioperative, and postoperative follow up information.

    It has been estimated that around 62 different replacement hip joints are available in Britain, manufactured by 19 different companies. Part of the problem in evaluating their effectiveness is the lack of high quality, prospective, comparative studies.4 A national register would provide the basis for scientifically well designed, statistically robust studies. Registers in Sweden and Norway collect a lot of relevant patient data and use these to allow adjustments for the effects of case mix when comparisons are made.

    We were provoked by the failure …

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