Have you ever heard of the National Joint Registry (NJR)?
If you’re considering knee replacement, you may have come across it online. A google search for national joint registry knee turns up no less than 7.6 million hits.
It may, off the bat, sound a bit dry. Or technical. But in fact the NJR is a really useful resource for anyone looking into knee replacement surgery. It just takes a little unpacking.
What is the National Joint Registry?
The NJR is an organisation that collects data about replacement joints and the surgeons who implant them. Not just for knees, but for hips, ankles, elbows and shoulders too. The Registry was set up by the Department of Health in 2002. It covers most of the UK (Scotland has its own version, the Scottish Arthroplasty Project). And it’s now the biggest orthopaedic registry in the world, with 3.7m procedure records in its database. That’s where its real power lies.
Why does it exist?
Knee replacements have been around for several decades now. But they’re not the same as they were 30 years ago. The technology has changed. And so have the techniques used to implant them. So how effective are they in patients? And how safe are the newer devices and surgeons? These are the questions that the database can help to answer. If a new implant isn’t performing well, it quickly becomes obvious. Across the board, it helps to drive up standards.
What can the NJR tell you about knee replacements?
You can use the database to get all kinds of facts about knee replacement operations. The National Joint Registry Annual Report is open to everybody, and lets you drill down into the type of replacement you’re considering and how common (or rare) it is, and so on. It’s data-dense, but there’s a handy one-page summary too: the average age of patients in 2021 (67 for men, 69 for women), the number due to osteoarthritis damage (90%), and more. You can also view the performance of your intended hospital or the implant your surgeon might be considering for you.
What can the NJR tell you about a knee surgeon?
You can also use the Registry to research individual surgeons. Click here for the Surgeon Profile finder; enter the consultant’s name to bring up their statistics (this is the link for my own page). In the Knee section you can see the types of patients they treated and even the mortality rate after surgery against the national average (fortunately very rare). Under the Practice Profiles, you can see which, and how many, ops they perform versus the national average. You can also see their revision rate – in other words, how many times they have had to remove and replace one or more of the parts, usually because of pain or loss of function.
Are there any caveats?
It’s worth bearing in mind that, as with any data set, you’re not getting all the context. For example, a higher-than-average revision rate – on the face of it – is a negative, because it suggests there were a higher number of issues with the original operations. But some surgeons specialise in revision surgery, so their figures will naturally reflect that.
Also, the figures can’t indicate why the revision took place. Did the patient damage their implant through injury? Did the whole implant fail or simply a smaller component, such as a polyethylene bearing? What was the age, BMI and fitness of the patient involved? And so on. So it’s worth balancing the data with other facts and findings. As with so many things in life, that often comes down to word of mouth. A recommendation from friends. Or the post-surgery reviews on sites like Doctify or IWantGreatCare.
Interested in reading more about NJR and knee replacements?
This article from January 2023 – National Joint Registry: My 10-Year Results – looks into the detail of my NJR performance over the past decade, and shows you where I stand against the national averages.