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| Australasian Joint Replacement Registry | |
|---|---|
| Name | Australasian Joint Replacement Registry |
| Formation | 1999 |
| Type | Non-profit registry |
| Headquarters | Melbourne, Victoria |
| Region served | Australia, New Zealand |
Australasian Joint Replacement Registry is a clinical registry that collects, analyses and reports data on joint replacement procedures performed in Australia and New Zealand. It provides benchmarking and surveillance for arthroplasty interventions, implants and surgical outcomes to inform clinicians, hospitals, regulators and industry. The registry interfaces with professional bodies, hospitals and health departments to improve safety and quality in joint replacement care.
The registry was established in 1999 following discussions among orthopaedic surgeons associated with institutions such as Royal Melbourne Hospital, St Vincent's Hospital, Melbourne, University of Melbourne and specialist societies including the Australian Orthopaedic Association and the New Zealand Orthopaedic Association. Early collaborators included registries and surveillance programs like the Swedish Hip Arthroplasty Register, the National Joint Registry (United Kingdom), and the Kaiser Permanente orthopaedic monitoring activities associated with academic centres such as Stanford University and Harvard Medical School. Founding clinicians and administrators drew on models from organizations such as the Australian Commission on Safety and Quality in Health Care and consulted with regulatory authorities including the Therapeutic Goods Administration and New Zealand's Medsafe. Over time the registry expanded governance links with tertiary hospitals like Royal Hobart Hospital, Auckland City Hospital and universities such as University of Auckland and Monash University.
The registry's remit covers hip, knee, shoulder and other large joint arthroplasty procedures performed across public and private hospitals in Australia and New Zealand. Objectives include device surveillance similar to programmes run by the European Medicines Agency and reporting to specialty groups such as the International Society of Arthroplasty Registries and the American Academy of Orthopaedic Surgeons. It aims to produce annual reports used by surgeons affiliated with institutions like Royal Prince Alfred Hospital and Wellington Regional Hospital, to support commissioners in state and territorial health departments including Victorian Department of Health, NSW Ministry of Health and New Zealand's Ministry of Health (New Zealand). The registry supports device recall processes coordinated with agencies such as the Therapeutic Goods Administration and international partners like the United States Food and Drug Administration.
Case ascertainment relies on hospital submission pathways used by large networks such as Ramsay Health Care and Healthscope, with data elements designed by clinician working groups including academics from University of Sydney, University of Otago and University of Queensland. Data items include patient identifiers linked to provincial systems like the Victorian Admitted Episodes Dataset, procedural codes analogous to Australian Classification of Health Interventions and implant catalogues cross-referenced to manufacturers such as Stryker Corporation, Zimmer Biomet and DePuy Synthes. Methodology includes probabilistic linkage with administrative data sets from agencies including the Australian Institute of Health and Welfare and the New Zealand Health Information Service; statistical analyses employ survival methods familiar to users in centres like Johns Hopkins Hospital and Mayo Clinic. Quality assurance draws on standards endorsed by organisations such as the International Society for Quality in Health Care and benchmarking approaches used by the National Joint Registry (United Kingdom).
The registry is governed by a board comprising representatives from professional societies such as the Australian Orthopaedic Association, consumer advocates and academic leads from universities including Flinders University and Griffith University. Funding sources include contributions from state health departments, hospital networks like Eastern Health (Victoria), philanthropic grants from foundations similar to the National Health and Medical Research Council and project funding from research bodies such as the Marsden Fund. Industry contributions from implant manufacturers are managed under conflict-of-interest policies aligned with guidelines from bodies like the Australian Medical Research Ethics Committee and international best practice from the World Health Organization registry guidance documents.
Annual reports provide device-specific revision rates, survival curves and aggregate outcomes with stratification by age, sex and indication used by clinicians at centres like Royal Adelaide Hospital and Christchurch Hospital. Key findings have included identification of higher-than-expected revision rates for particular implant designs, prompting regulatory review by agencies such as the Therapeutic Goods Administration and resulting in action parallels to recalls issued by the United States Food and Drug Administration. Reports have been cited in academic journals produced by publishers like Elsevier and Springer Nature and discussed at meetings including the American Association of Hip and Knee Surgeons congress and the Australian Orthopaedic Association National Conference.
Registry outputs have influenced implant selection at hospitals including Prince of Wales Hospital (Sydney) and Royal Brisbane and Women's Hospital and informed clinical guidelines developed by specialty groups like the Australian and New Zealand Hip Fracture Registry collaborators and professional colleges such as the Royal Australasian College of Surgeons. Policy impacts include changes in procurement practices by health services in Queensland Health and adoption of surveillance protocols consistent with recommendations from the International Society of Arthroplasty Registries and the Organisation for Economic Co-operation and Development health indicators. The registry has supported research partnerships with academic centres such as University of Oxford and University College London for comparative effectiveness studies.
Criticisms mirror those faced by other registries such as completeness of capture in private sector networks like Healthscope, variation in data quality between facilities including smaller rural hospitals, and challenges linking outcomes to patient-reported measures used in studies from institutions like Ghent University and Karolinska Institutet. Some stakeholders have highlighted delays in real-time surveillance compared with active device monitoring programmes run by organisations such as Medtronic and regulatory agencies like the European Medicines Agency. There are ongoing debates about governance transparency, data access rules compared with models used by the National Joint Registry (United Kingdom) and the balance of industry funding versus academic independence seen in collaborations with manufacturers like Smith & Nephew.
Category:Medical registries