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100,000th joint replacement at Bupa Hospital Cardiff 25 August 2004 According to the National Joint Registry (NJR), the milestone 100,000th joint replacement operation has taken place at a Bupa Hospital, in Cardiff. Since its inauguration in April 2003, the body set up by the Department of Health has been harvesting data on hip and knee replacements from NHS and independent hospitals across England and Wales. Looking to identify which types of replacement joints last the longest, and which ones give patients best quality of life, the NJR was set up by the Department of Health to audit hip and knee replacements in England and Wales in order to help improve the success of this relatively common type of surgery. According to the NJR, 95% of eligible hospitals that perform hip and knee replacements operations submit information, including all of Bupa’s 35 hospitals. The NJR database was set up following the failure of a hip implant made by 3M. In 1998, the Department of Health advised surgeons to stop using the replacement hip because it was not performing as well as expected, and asked hospitals to contact patients who had received the implant to see if they were experiencing any problems. Bupa ran a helpline for patients and hospitals to answer their concerns and arranged for approximately 3,500 people to be tested and treated if appropriate. Bupa Hospitals clinical director, Dr Chris Dark is the independent sector representative on the steering committee which has developed the registry. He explains the real benefit to patients that comes from such a study: “Every year Bupa performs thousands of joint replacements and in the vast majority of cases these give patients long-lasting benefits. But along with the NHS, and the rest of the independent sector, we want to know which implants work best.” He continues: “Patients can be even more confident that surgery will achieve long-term benefits, as the NJR database will help to pinpoint types of surgery and replacement joints that produce the best results. It will, however, take another couple of years before the raw data can be used to reveal any significant trends or learnings.” Similar registers in Sweden, Norway and Australia, and in localised regions in the UK, which were set up several years ago, have shown the potential for this project as they have brought about significant advances in the quality of joint replacement both locally and globally. Dr Dark adds: “In Sweden, there was a two-thirds reduction over 13 years in hip replacement patients having to receive further implants, which has largely been attributed to feedback from the Swedish register.” NJR Chairman, Bill Darling sent a note of recognition to all members: “At 16h01 on Tuesday 11th August 2004, the NJR received the 100,000th completed electronic record… This is a fantastic achievement and is set against a context of significant efforts from a large number of interested individuals and organisations.” “Having been involved with the NJR from its conception, we are delighted that one of our hospitals was the venue for this important milestone,” says Dr Dark. The first annual report for the NJR will be presented at the British Orthopaedic Association Congress on 15 September 2004.
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