BERLIN — England and Wales performed the most knee arthroplasties compared to other countries and Australia performed the most knee arthroplasties per 100,000 patients, according to a British researcher who studied the procedures in national registries. However, she found that other arthroplasty registry results could not fairly be compared on an international level due to compliance, funding and other biases that likely affected them.
“There is a vast amount of data available,” Philippa M. Bennett, MB, ChB, RN, said in a presentation at the 13th EFORT Congress 2012, here. “Unfortunately, it is not directly comparable. And we believe that on certain levels, it should be, and the fundamentals should be standardized across countries not only so that we can improve outcomes for our patients and prevent industry damaging scandals, but so that we can learn from other countries and learn which implants are performing well and which are not performing well.”
Philippa M. Bennett
Bennett studied whether data from national registers were comparable on an international level. If they were, she hoped that might help detect earlier those knee or hip prostheses that were associated with higher complication rates.
She searched the current worldwide joint arthroplasty registers, identifying 10 registers that met the study’s inclusion criteria. Bennett eliminated registries without national coverage, those not at least 3 years old, and any registers not published in English.
Overall, based on the most recent results per register, England and Wales performed the most knee and hip replacements and Slovakia performed the lowest number of these procedures. But New Zealand performed the most hip arthroplasty procedures per 100,000 citizens and Australia performed the most knee replacements per 100,000 citizens after adjusting for compliance, according to Bennett.
“The method of data collection is a huge source of bias, as well,” she said.
Therefore, the 10 national registries that Bennett analyzed could not be compared on an international level due to funding and compliance biases, she said. Furthermore, the definitions of primary knee and hip replacement and revision procedures used differed across the registries and the various countries collected their data differently — either in real time or retrospectively — which “negates the quality of information,” Bennett said.
Bennett PM. A global review of national arthroplasty registers. Paper #12-1378. Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
Disclosure: Bennett has no relevant financial disclosures.