Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)

Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)

Joint replacement is a commonly performed major surgical procedure that has considerable success in alleviating pain and disability. In 1993, the Australian Orthopaedic Association (AOA) recognised the need to establish a national joint replacement registry. At that time, the outcome of joint replacement in Australia was unknown. Patient demographics were not available and the outcomes of the types of prostheses and techniques used to implant them were not tracked.

The purpose of the AOANJRR is to continually improve the quality of care for patients experiencing musculoskeletal diseases and in particular joint replacement. This is achieved by collecting a defined minimum data set that enables outcomes to be determined based on patient characteristics, prosthesis type and features, method of prosthesis fixation and surgical technique used. The principal outcome measure is time to first revision surgery. This is an unambiguous measure of the need for further intervention. Combined with a careful analysis of potential confounding factors, this can be used as an accurate measure of the success, or otherwise, of a procedure. The Registry also monitors mortality of patients, which is critical when determining the rate of revision.

Under the guidance of the AOA, and in order to meet the growing needs of stakeholders and increased requirements for Registry data, the AOANJRR is gradually expanding its capability and has broadened the focus of its work to more broadly encompass musculoskeletal health. This has included the provision of more automated reporting systems, automated data collection, the collection of Patient Reported Outcome Measures, the provision of Registry Nested Clinical Trials, both industry initiated and surgeon initiated, data linkage studies and an expanded breadth of research projects.

The AOANJRR encourages and supports research using data collected by the Registry. Research projects using Registry data vary in complexity from an individual ad hoc request, to large and complex grant-funded projects.

Research projects using Registry data include Registry Nested Clinical Trials (RNCTs), Patient Reported Outcome Measures (PROMs) collected via the electronic trial platform RAPID (Real-time Automated Platform for Integrated Data collection) and other projects, such as data linkage studies which combine external datasets with Registry data.

The AOANJRR leverages established infrastructure, experience and expertise to undertake research activities that efficiently and effectively investigate additional aspects of joint replacement surgery. The aim of these activities is to facilitate further improvements in outcomes for patients undergoing joint replacement. With the support of hospitals, surgeons and patients, the Registry conducts these studies and projects using a cost-recovery/not-for-profit model, reinvesting income into further research and development activities within the Registry.

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