International Journal of Technology Assessment in Health Care

General Essays

Arthroplasty registers: A review of international experiences

Victoria Serra-Suttona1, Alejandro Allepuza1, Mireia Espallarguesa1, Gerold Labeka2 and Joan M. V. Ponsa3

a1 Catalan Agency for Health Technology Assessment and Research

a2 European Arthroplasty Register Office and EFORT

a3 Catalan Agency for Health Technology Assessment and Research


Objectives: Registers have proven to be a valuable instrument in the evaluation of arthroplasty procedures and the performance of implants. The aim of this study was to describe the structure, functioning, and content of arthroplasty registers in Europe and other parts of the world.

Methods: A search of technical reports was carried out through the Internet and in Medline/PubMed. The exhaustiveness of the information was confirmed using the links to Web pages of other registers and contacts with key people. Aims, methods in data collection and evaluation, internal structure and organization, participants, validity of the data, and other variables were assessed for each arthroplasty register using a qualitative content analysis of the texts.

Results: Fifteen arthroplasty registers were identified which published sufficient information to conduct a comparative analysis. Eight additional registers were identified but no information was available on the Internet or in English. Most registers were initiatives of an orthopaedic society receiving governmental funding. Data were collected using standardized clinical forms and additional information from clinical-administrative datasets or other registers (mortality, implant costs, hip fractures). The main outcome measure of these registers is survival of the prostheses. Registers use the Internet and their annual reports as the main strategy for the dissemination and feed-back of their results.

Conclusions: Scientific or professional societies and the public health administration should collaborate in the development of arthroplasty registers. To adequately assess the results of observational data information on the structure, the process of arthroplasty interventions and patients characteristics should be collected.


This study has been financed through the support of the Plan de Calidad para el Sistema Nacional de Salud (Health Quality Plan for the Spanish National Health System, 2007/820) in a collaboration framework and agreement between the Instituto de Salud Carlos III, autonomous body of the Spanish Ministry of Health, and the Agencia d'Avaluació de Tecnologia i Recerca Mèdica (Catalan Agency for Health Technology and Research) of the Catalan Ministry of Health. This Project has been developed by members of the Research Group in Assessment of Health Services and Health Outcomes (Grup de Recerca en Avaluació de serveis i Resultats en salut, RAR) recognised by the Catalan Government (2005SGR 00171). The content of a preliminary version of the manuscript has been approved by Enrique Cáceres on behalf of the Catalan Society of Orthopaedic Surgery and Traumatology, by Fermin Aramburo member of the Executive Committee of the Catalan Arthroplasty Register and by Henrik Malchau on behalf of the International Society of Joint Registers. The content of the article is only responsibility of the authors, and no part of it can be interpreted as representative of any governmental body or institution.