Joint responsibility: the need for a national arthroplasty register

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7049.66 (Published 13 July 1996) Cite this as: BMJ 1996;313:66
  1. David H Sochart,
  2. J Alison Long,
  3. L Porter Martyn
  1. Senior orthopaedic research fellow Regional orthopaedic audit coordinator Consultant orthopaedic surgeon Centre for Hip Surgery, Wrightington Hospital for Joint Disease, Wigan WN6 9EP

    A register could collect comparative data on implants and outcomes

    Sixty two different replacement hip joints manufactured by 19 companies are currently available in Britain, half of which have been introduced in the past five years.1 A minimum follow up of 10 years is normally required to judge a joint replacement successful, but for only eight of these prostheses are there published follow ups of over five years. Only the Charnley low friction arthroplasty, widely regarded as the gold standard, has 20 year follow up results published in a peer reviewed journal.2 Since there is no requirement for new implants to be clinically tested before being introduced,3 the power of advertising, rather than a scientific report, may lead a surgeon to select one prosthesis in favour of another.”4 How then can we find out whether any implant is better than any other?

    It is impossible to compare hip and knee implants and their outcomes because different methods are used to collect and analyse data. A sound study would require standardisation of these, together with a large number of patients, requiring a multicentre study. Pilot arthroplasty registers have …

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