The kaiser permanente national total joint replacement registry

Area of Science:

• Orthopedic Surgery
• Medical Device Surveillance
• Arthroplasty Registries

Background:

• The Kaiser Permanente National Total Joint Replacement Registry (TJRR) is a national database for postmarket surveillance of hip and knee replacements.
• As of March 31, 2007, the registry contained data on 16,945 primary total hip arthroplasties (THA) and 30,815 total knee arthroplasties (TKA).

Purpose of the Study:

• To analyze data from the TJRR to identify trends and risk factors in total joint replacement.
• To evaluate the effectiveness of the TJRR as a surveillance system for orthopedic implants.

Main Methods:

• The TJRR database was queried for primary and revision THA and TKA procedures up to March 31, 2007.
• Statistical analysis was performed to identify significant findings related to patient demographics, diagnoses, and revision reasons.

Main Results:

• Revision rates were 11.2% for THA and 5.5% for TKA.
• Older age and higher American Society of Anesthesiology risk scores were associated with revision THAs.
• Osteoarthritis was the most common diagnosis for both THA and TKA; aseptic loosening and instability were the most frequent reasons for revision.

Conclusions:

• The TJRR serves as an effective mechanism for postmarket surveillance, enabling recalls and patient identification for early revisions.
• Registry data has influenced physician practice by providing valuable feedback on total joint replacement outcomes.