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Registries & Data

National orthopaedic registries for monitoring implant safety and efficacy, benchmarking performance, and identifying systemic failure patterns.

Overview

National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2]. Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4]. A community-based registry in the United States highlighted the impact of the registry on clinical practice, patient safety, cost effectiveness, and research within the integrated system [5]. National joint registry data underestimates the burden of prosthetic joint infection [10].

Registry studies use inconsistent methods to account for patients lost to follow-up [3]. Rates of patients lost to follow-up in registry studies are unacceptably high [3]. Collection of post-operative patient-reported outcome measures is problematic due to insufficient response rates, suggesting alternative outcome measures are required for a national registry [6]. Strategies for improving data accuracy in registries may include revising the registry forms to include reoperation without change of components [10]. Strategies for improving data accuracy in registries may include frequent validation of national data with other databases [10].

Orthopaedic registry studies differ from randomized controlled trials in many ways and offer certain advantages [11]. The strengths and limitations of registry cohort studies and randomized controlled trials must be understood to properly evaluate the literature [11]. Nationwide registry data show significantly higher mortality rates for one-stage revision total hip arthroplasty (RTHA) compared to two-stage, raising concerns about broader implementation outside specialized centers [13]. The rate of revision in a series of 4802 cementless total hip arthroplasties is comparable with the best performing THAs in registry data [15].

Anatomy & Pathophysiology

Kinematics and Pathology

Hip microinstability is characterized by abnormal femoral head micromotion within the acetabulum [45]. This abnormal micromotion leads to cartilage damage and osteoarthritis [45]. The condition is often associated with acetabular dysplasia [45] and femoroacetabular impingement syndrome [45].

Injury Mechanisms

Hip and groin injuries are most common in sports that involve kicking or skating [47]. These injuries are also prevalent in sports that involve sudden changes in direction and speed [47].

Experimental Modeling

A high energetic impulse induced by a custom-made drop-test bench can successfully simulate realistic proximal femur fractures in cadaveric specimens with intact soft tissue [59]. The same model can successfully simulate realistic acetabular fractures in cadaveric specimens with intact soft tissue [59].

Classification

Registry Utility & Scope: National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4]. Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2]. National and hospital registries are strong advocates for maintaining, improving, and building the American Joint Replacement Registry to facilitate evidence-based decision making [1].

Specific Registry Examples: The National Cruciate Ligament Surgery Registry will each year enroll approximately 1500 primary cruciate ligament reconstruction cases [8]. Six registries in Asia were identified, with three (Indian, Japanese, and Pakistan) having developed official websites and published annual reports [36].

Data Integrity & Validation: Strategies for improving registry data accuracy may include revising the registry forms to include reoperation without change of components and frequent validation of national data with other databases [10]. Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields [18]. Existing discrepancies within multiple institutional data sets may lead to inaccurate reporting by the AJRR and other registries that rely on ICD-10-PCS coding [17].

Operational & Collaborative Models: The National Joint Registry (NJR) provides a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit [7]. The same method of creating a registry can be applied to hospitals using similar EMR systems [34]. In its best form, a registry is a mission-driven, independent stakeholder–registry team collaboration that enables rapid, transparent and open-access knowledge generation and dissemination [14]. Co-operation of registries at a global level may lead to earlier identification of devices and thereby further improve the results of joint replacement [35]. The common dataset between the Norwegian and Swedish National Registries enables further investigations of the impact of differences on revision rates and mortality [22]. The authors call for the formation of a global hand registry network to ensure data harmonization and quality standards [37].

Other Considerations: Nationwide registry data show significantly higher mortality rates for one-stage revision total hip arthroplasty (RTHA) compared to two-stage, raising concerns about broader implementation outside specialized centers [13].

Clinical Presentation

National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. Well-validated national registry data help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2]. Nationwide databases offer large sample sizes and enable the investigation of trends over time [20]. Quality clinical outcomes research from large registries and prospective cohorts is essential to advance orthopaedic surgery, improve patient care, and minimize false turns in clinical practice, despite being expensive and time-intensive [9].

Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4]. A community-based registry in the United States highlighted the impact of the registry on clinical practice, patient safety, cost effectiveness, and research within the integrated system [5]. The National Joint Registry (NJR) provides a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit [7]. In its best form, a registry is a mission-driven, independent stakeholder–registry team collaboration that enables rapid, transparent and open-access knowledge generation and dissemination [14].

National and hospital registries are strong advocates for maintaining, improving, and building the American Joint Replacement Registry to facilitate evidence-based decision making [1]. The development of a national clinical registry for hip arthroscopy was considered successful [33]. Deep learning-based registry construction is essential for developing impactful clinical applications [32]. Diagnostic AI is likely to augment clinical decision-making in the near future [32]. Applications of deep learning to enhance data privacy will become increasingly important as the field grows [32].

Registry studies use inconsistent methods to account for patients lost to follow-up [3]. Rates of patients lost to follow-up in registry studies are unacceptably high [3]. Clinical data should not be drawn from administrative databases without validation [31]. Readers of nationwide databases must be aware of limitations including variations in data collection, imperfections in patient sampling, insufficient follow-up, and lack of orthopaedic-specific outcomes [20].

National joint registry data underestimates the burden of prosthetic joint infection [10]. Strategies for improving data accuracy in registries may include revising the registry forms to include reoperation without change of components [10]. Strategies for improving data accuracy in registries may include frequent validation of national data with other databases [10]. Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields [18]. Existing discrepancies within multiple institutional data sets may lead to inaccurate reporting by the AJRR and other registries that rely on ICD-10-PCS coding [17].

Findings from the nationwide FinSpine registry mark a need for future pragmatic RCTs as well as clinical registry-based studies to improve the evidence for decision making in real-life settings [12]. Nationwide registry data show significantly higher mortality rates for one-stage revision total hip arthroplasty (RTHA) compared to two-stage, raising concerns about broader implementation outside specialized centers [13]. Detailed demographic data were missing from the literature in studies assessing thromboprophylaxis after total joint arthroplasty, and the authors were unable to demonstrate the cause of different reported outcomes between industry-funded and nonfunded studies [19].

Investigations

Plain radiography: Radiographic results for anatomic and reverse total shoulder arthroplasty appear to deteriorate over time [44].

MRI: The North American Hip Arthroscopy Registry provides initial insights into the demographics and clinical profiles of North American patients undergoing hip arthroscopy as well as the types of procedures performed [30].

CT: Nationwide databases offer large sample sizes and enable the investigation of trends over time [20].

Bone scan: Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4].

Tomosynthesis: National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1].

Aspiration: National joint registry data underestimates the burden of prosthetic joint infection [10].

Laboratory: The British Spine Registry has entered over 27,000 patients and 12,000 Patient-Reported Outcome Measures (PROM) forms in its first two years [49].

Other Considerations: National and hospital registries are strong advocates for maintaining, improving, and building the American Joint Replacement Registry to facilitate evidence-based decision making [1]. Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2]. Community-based registries have an impact on clinical practice, patient safety, cost effectiveness, and research within the integrated system [5]. A national cruciate ligament surgery registry enrolls approximately 1500 primary cruciate ligament reconstruction cases each year [8]. A national population-based knee ligament reconstruction registry can be established and maintained, presenting population-based outcome data with subjective validated outcome score profiles and 2-year revision rates [25]. The main purpose of orthopaedic registers is to collect information on patients, implants, and procedures in order to monitor and improve the outcome of the specific procedure [29]. The British Spine Registry serves as a valuable resource for identifying best practice and facilitating improved patient care [49]. Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018 provides a well-documented basis to compare revision arthroplasties with other nationwide registries and with clinical studies [50].

Registry studies use inconsistent methods to account for patients lost to follow-up [3]. Rates of patients lost to follow-up in registry studies are unacceptably high [3]. Readers of nationwide databases must be aware of limitations including variations in data collection [20]. Readers of nationwide databases must be aware of limitations including imperfections in patient sampling [20]. Readers of nationwide databases must be aware of limitations including insufficient follow-up [20]. Readers of nationwide databases must be aware of limitations including lack of orthopaedic-specific outcomes [20]. Strategies for improving national registry data accuracy include revising registry forms to include reoperation without change of components [10]. Strategies for improving national registry data accuracy include frequent validation of national data with other databases [10]. The full value of the British Spine Registry depends on achieving mandatory data capture [49]. Explant analysis including patient, clinical, and imaging documentation is crucial to identify failure mechanisms early enough to prevent massive failures detectable in registries [51]. A system that analyses all explants from revisions attributed to implant failure is mandatory to reduce failures [51].

Orthopaedic registry studies differ from randomized controlled trials in many ways and offer certain advantages [11]. The strengths and limitations of registry cohort studies and randomized controlled trials must be understood to properly evaluate the literature [11]. Prospective multicenter studies generally provide a higher level of evidence and better-quality research than registry-based studies [27]. Both prospective multicenter studies and registry-based studies are increasingly important for improving patient care and identifying risk factors in orthopaedic surgery and sports medicine [27]. The rate of revision in a series of 4802 cementless total hip arthroplasties is comparable with the best performing total hip arthroplasties in registry data [15]. Findings on the risk of periprosthetic joint infection in multiple primary joint arthroplasties suggest a potential trend that requires confirmation with larger, prospective, multicenter, or registry-based studies [16].

Treatment

Non-Operative

There are not convincing data of the superiority of operative treatment over non-operative management in all rotator cuff tears [48].

Operative

Indications: Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2].

Surgical Approach / Technique: Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4].

Implant Selection: The rate of revision in a series of 4802 cementless total hip arthroplasties is comparable with the best performing total hip arthroplasties in registry data [15].

Alignment / Balancing Strategy: There is a large variation in recommendations for the follow-up schedule after total hip arthroplasty [38]. There is a lack of evidence-based indications for follow-up schedules after total hip arthroplasty, as all guidelines were drafted from expert consensus rather than clinical studies [38].

Pain Management: Quality clinical outcomes research from large registries and prospective cohorts is essential to advance orthopaedic surgery, improve patient care, and minimize false turns in clinical practice, despite being expensive and time-intensive [9].

Adjuncts: National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. The main purpose of orthopaedic registers is to collect information on patients, implants, and procedures in order to monitor and improve the outcome of the specific procedure [29].

Setting of Care: A community-based registry in the United States highlighted the impact of the registry on clinical practice, patient safety, cost effectiveness, and research within an integrated system [5]. The National Joint Registry (NJR) provides a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit [7].

Revision: Registry studies use inconsistent methods to account for patients lost to follow-up [3]. Rates of patients lost to follow-up in registry studies are unacceptably high [3].

Other Considerations: Orthopaedic registry studies differ from randomized controlled trials in many ways and offer certain advantages [11]. The strengths and limitations of registry cohort studies and randomized controlled trials must be understood to properly evaluate the literature [11]. Findings comparing randomized controlled trial evidence on surgery for lumbar disc herniations to the nationwide FinSpine registry mark a need for future pragmatic randomized controlled trials as well as clinical registry-based studies to improve the evidence for decision making in real-life settings [12]. Prospective multicenter studies generally provide a higher level of evidence and better-quality research than registry-based studies [27]. Both prospective multicenter studies and registry-based studies are increasingly important for improving patient care and identifying risk factors in orthopaedic surgery and sports medicine [27].

Complications

Infection (PJI): There is a potential trend regarding multiple primary joint arthroplasties and the risk of periprosthetic joint infection that requires confirmation with larger, prospective, multicenter, or registry-based studies [16].

Thromboembolism: Detailed demographic data were missing from the literature on thromboprophylaxis after total joint arthroplasty, and the cause of different reported outcomes between industry-funded and nonfunded studies could not be demonstrated [19].

Other Considerations: National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications [2]. Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes [4]. Registries highlight the impact on clinical practice, patient safety, cost effectiveness, and research within the integrated system [5]. Quality clinical outcomes research from large registries and prospective cohorts is essential to advance orthopaedic surgery, improve patient care, and minimize false turns in clinical practice, despite being expensive and time-intensive [9]. In its best form, a registry is a mission-driven, independent stakeholder–registry team collaboration that enables rapid, transparent and open-access knowledge generation and dissemination [14]. The largest registry study to date investigated the incidence and risk factors for intraoperative complications during revision shoulder arthroplasty [41].

Registry methodology presents specific challenges. Registry studies use inconsistent methods to account for patients lost to follow-up, and rates of patients lost to follow-up in registry studies are unacceptably high [3]. The German Arthroplasty Registry (EPRD) utilizes collaboration with public health insurers to minimize loss to follow-up and avoid underestimation of revision rates [21]. The German Arthroplasty Registry (EPRD) provides short-term implant survival data and an integrated, harmonized product database [21]. A common dataset between the Norwegian and Swedish National Registries enables further investigations of the impact of differences on revision rates and mortality [22]. Collection of post-operative patient-reported outcome measures is problematic due to insufficient response rates, suggesting alternative outcome measures are required for a national registry [6]. The National Joint Registry (NJR) provides a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit [7].

Analytical rigor is critical. A registry study comparing mortality rates between simultaneous and staged bilateral total knee arthroplasty was argued to be flawed because it failed to account for mortality after the first procedure in patients intended for staged TKR [23]. The flawed registry study potentially compared simultaneous TKR with a selected cohort of patients who survived a unilateral TKR [23].

Implant-specific and revision considerations include serum cobalt and chromium levels not always being constant at a medium-term to long-term follow-up period, with a subgroup showing increasing trends [24]. Prior revision history predicts subsequent failure, and early referral to centers with appropriate expertise and infrastructure may optimize outcomes [26].

Recovery

National and hospital registries provide an invaluable source of information for assessing treatment outcomes, efficacy, and safety [1]. These systems are strong advocates for maintaining, improving, and building the American Joint Replacement Registry to facilitate evidence-based decision making [1]. Registry studies have an impact on clinical practice, patient safety, cost effectiveness, and research within the integrated system [5]. Quality clinical outcomes research from large registries and prospective cohorts is essential to advance orthopaedic surgery, improve patient care, and minimize false turns in clinical practice, despite being expensive and time-intensive [9]. There is a need for future pragmatic RCTs as well as clinical registry-based studies to improve the evidence for decision making in real-life settings [12].

Light activity (weeks): Evidence does not specify a week range for light activity or desk work.

Full activity (months): Evidence does not specify a month range for full activity, manual work, or sport.

Complete recovery / outcome plateau (months): In an unselected cohort, patients experience a similar health-related quality of life as a reference group of a similar age and sex structure 7 years after total hip replacement except for general physical function where the patients score worse [66].

Rehabilitation protocol: Evidence does not specify PT phasing, immobilisation duration, weight-bearing/ROM progression, or sling/brace removal timing.

Functional milestones: The functional status of a large cohort of patients significantly improved after hip and knee replacement based on routine data collection [39]. The Danish ACL reconstruction registry presents the first population-based outcome data with subjective validated outcome score profiles and 2-year revision rates [25].

Other Considerations: Registry studies use inconsistent methods to account for patients lost to follow-up [3]. Rates of patients lost to follow-up in registry studies are unacceptably high [3]. The German Arthroplasty Registry (EPRD) utilizes collaboration with public health insurers to minimize loss to follow-up and avoid underestimation of revision rates [21]. The German Arthroplasty Registry (EPRD) provides short-term implant survival data and an integrated, harmonized product database [21]. Collection of post-operative patient-reported outcome measures is problematic due to insufficient response rates, suggesting alternative outcome measures are required for a national registry [6].

The registry will each year enroll approximately 1500 primary cruciate ligament reconstruction cases [8]. A national population-based knee ligament reconstruction registry could be established and maintained in Denmark [25]. Prior revision history predicts subsequent failure, so early referral to centers with appropriate expertise and infrastructure may optimize outcomes in revision total knee arthroplasty [26]. Findings on multiple primary joint arthroplasties and the risk of periprosthetic joint infection suggest a potential trend that requires confirmation with larger, prospective, multicenter, or registry-based studies [16]. A registry study comparing mortality rates between simultaneous and staged bilateral total knee arthroplasty is flawed because it fails to account for mortality after the first procedure in patients intended for staged TKR [23]. The flawed registry study potentially compares simultaneous TKR with a selected cohort of patients who survived a unilateral TKR [23].

Serum cobalt and chromium levels are not always constant at a medium-term to long-term follow-up period, with a subgroup showing increasing trends [24]. The fixed-bearing medial unicompartmental knee arthroplasty provides successful long-term survivorship [42]. Further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time in autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee [43]. Longitudinal studies require continued contact and evaluation of patients for many years after the administration of treatment [56]. Every reasonable effort should be made to obtain information on all patients in a study to ensure meaningful data [56]. Improved understanding of the natural history of spine deformity, combined with advances in imaging, surgical technology, radiation therapy, and chemotherapeutic regimens, has improved survival rates and decreased rates of local recurrence [28].

Key Evidence

  • [L3] Well-validated national registry data can help understand the epidemiology of revision knee arthroplasty, including changing clinical indications. (10.1302/0301-620x.104b5.bjj-2021-1219.r1)
  • [L2] Registry studies use inconsistent methods to account for patient lost to follow-up, and rates of patients lost to follow-up are unacceptably high. (10.1016/j.asmr.2021.07.016)
  • [L5] Comprehensive registries collecting information on orthopaedic injuries, treatment, complications, and outcomes are required to characterize trauma, evaluate treatment options, and improve care and outcomes. (10.1016/j.injury.2005.02.027)
  • [L4] It highlights the impact of the registry on clinical practice, patient safety, cost effectiveness, and research within the integrated system. (10.2106/jbjs.j.00807)
  • [L3] However, the collection of post-operative patient-reported outcome measures is problematic due to insufficient response rates, suggesting alternative outcome measures are required for a national registry. (10.1007/s00167-016-4398-1)
  • [L4] The National Joint Registry (NJR) provides a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit. (10.1302/2058-5241.4.180084)
  • [L1] The registry will each year enroll approximately 1500 primary cruciate ligament reconstruction cases. (10.1177/0363546507308939)
  • [L5] Quality clinical outcomes research from large registries and prospective cohorts is essential to advance orthopaedic surgery, improve patient care, and minimize false turns in clinical practice, despite being expensive and time-intensive. (10.1016/j.arthro.2018.05.019)
  • [L3] Strategies for improving data accuracy may include revising the registry forms to include reoperation without change of components and frequent validation of national data with other databases. (10.1177/2325967116s00088)
  • [L3] Orthopaedic registry studies differ from randomized controlled trials in many ways and offer certain advantages; the strengths and limitations of registry cohort studies and RCTs must be understood to properly evaluate the literature. (10.2106/jbjs.n.01332)
  • [L2] Our findings mark a need for future pragmatic RCTs as well as clinical registry-based studies to improve the evidence for decision making in real-life settings. (10.1186/s13018-025-06401-y)
  • [L3] Nationwide registry data show significantly higher mortality rates for one-stage RTHA compared to two-stage, raising concerns about broader implementation outside specialized centers. (10.1016/j.arth.2025.08.015)
  • [L5] In its best form, a registry is a mission-driven, independent stakeholder–registry team collaboration that enables rapid, transparent and open-access knowledge generation and dissemination. (10.1302/2058-5241.4.180077)
  • [L3] The rate of revision in this series is comparable with the best performing THAs in registry data. (10.1302/0301-620x.98b12.bjj-2016-0203.r1)
  • [L3] These findings suggest a potential trend that requires confirmation with larger, prospective, multicenter, or registry-based studies. (10.1016/j.arth.2025.12.016)
  • [L3] Existing discrepancies within multiple institutional data sets may lead to inaccurate reporting by the AJRR and other registries that rely on ICD-10-PCS coding. (10.2106/jbjs.23.00325)
  • [L4] Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. (10.1302/0301-620x.97b1.35279)
  • [L3] Detailed demographic data were missing from the literature, and the authors were unable to demonstrate the cause of different reported outcomes between industry-funded and nonfunded studies. (10.1016/j.arth.2018.06.025)
  • [L5] Nationwide databases offer large sample sizes and enable the investigation of trends over time, but readers must be aware of limitations including variations in data collection, imperfections in patient sampling, insufficient follow-up, and lack of orthopaedic-specific outcomes. (10.5435/jaaos-d-15-00217)
  • [L3] The German Arthroplasty Registry (EPRD) utilizes collaboration with public health insurers to minimize loss to follow-up and avoid underestimation of revision rates, while providing short-term implant survival data and an integrated, harmonized product database. (10.1302/2058-5241.4.180064)
  • [L4] The common dataset enables further investigations of the impact of these differences on revision rates and mortality. (10.5301/hipint.5000105)
  • [L5] The letter argues that the original registry study's comparison of mortality rates between simultaneous and staged bilateral TKR is flawed because it fails to account for mortality after the first procedure in patients intended for staged TKR, potentially comparing simultaneous TKR with a selected cohort of patients who survived a unilateral TKR. (10.1016/j.arth.2019.05.027)
  • [L3] At a medium-term to long-term follow-up period, serum cobalt and chromium levels are not always constant, with a subgroup showing increasing trends. (10.1016/j.arth.2018.11.023)
  • [L4] This study shows that a national population-based knee ligament reconstruction registry could be established and maintained in Denmark, presenting the first population-based outcome data with subjective validated outcome score profiles and 2-year revision rates. (10.1007/s00167-008-0654-3)
  • [L3] Because prior revision history predicts subsequent failure, early referral to centers with appropriate expertise and infrastructure may optimize outcomes. (10.1016/j.arth.2025.09.038)
  • [L4] Improved understanding of the natural history of spine deformity, combined with advances in imaging, surgical technology, radiation therapy, and chemotherapeutic regimens, has improved survival rates and decreased rates of local recurrence. (10.5435/00124635-201210000-00004)
  • [L5] The main purpose of orthopaedic registers is to collect information on patients, implants and procedures in order to monitor and improve the outcome of the specific procedure. (10.1302/2058-5241.4.180097)
  • [L3] These findings provide initial insights into the demographics and clinical profiles of North American patients undergoing hip arthroscopy as well as the types of procedures performed. (10.1177/03635465251408089)
  • [L4] Clinical data should not be drawn from administrative databases without validation. (10.1302/0301-620x.98b10.37089)
  • [L4] Deep learning-based registry construction is essential for developing impactful clinical applications, diagnostic AI is likely to augment clinical decision-making in the near future, and applications of deep learning to enhance data privacy will become increasingly important as the field grows. (10.1002/ksa.12085)
  • [L4] The development of a national clinical registry for hip arthroscopy was considered successful. (10.2106/jbjs.19.01496)
  • [L4] The same method of creating a registry can be applied to hospitals using similar EMR systems. (10.1302/0301-620x.102b7.bjj-2019-1622.r1)
  • [L4] Co-operation of registries at a global level may lead to earlier identification of devices and thereby further improve the results of joint replacement. (10.1530/eor-22-0058)
  • [L4] Six registries in Asia were identified, with three (Indian, Japanese, and Pakistan) having developed official websites and published annual reports. (10.1530/eor-2024-0085)
  • [L4] The authors call for the formation of a global hand registry network to ensure data harmonization and quality standards. (10.1177/1753193420970155)
  • [L2] The review found a large variation in recommendations for the follow-up schedule after total hip arthroplasty and a lack of evidence-based indications, as all guidelines were drafted from expert consensus rather than clinical studies. (10.1530/eor-21-0016)
  • [L4] The functional status of a large cohort of patients significantly improved after hip and knee replacement based on routine data collection. (10.1186/s12891-017-1455-y)
  • [L3] This is the largest registry study to date investigating the incidence and risk factors for intraoperative complications during revision shoulder arthroplasty. (10.1177/1758573216685706)
  • [L3] The fixed-bearing medial UKA provides successful long-term survivorship. (10.1186/s12891-024-07378-1)
  • [L4] However, further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time. (10.1007/s00167-010-1042-3)
  • [L3] Radiographic and clinical results appear to deteriorate over time. (10.5435/jaaos-d-21-01090)
  • [L4] Hip/groin injuries are most common in sports that involve kicking or skating and sudden changes in direction and speed. (10.1177/2325967118771676)
  • [L3] This progress can be questioned, since there are not convincing data of the superiority of the operative treatment over non-operative management in all rotator cuff tears. (10.1186/s12891-015-0639-6)
  • [L4] The British Spine Registry has successfully entered over 27,000 patients and 12,000 PROM forms in its first two years, serving as a valuable resource for identifying best practice and facilitating improved patient care, though its full value depends on achieving mandatory data capture. (10.1302/0301-620x.97b7.35391)
  • [L3] This study provides a well-documented basis to compare revision arthroplasties of the shoulder performed in Germany over the last decade as documented in the nationwide registry with other nationwide registries and with clinical studies. (10.1016/j.jseint.2020.12.003)
  • [L5] Explant analysis including patient, clinical and imaging documentation is crucial to identify failure mechanisms early enough to prevent massive failures detectable in the registries, and a system that analyses all explants from revisions attributed to implant failure is mandatory to reduce failures. (10.1530/eor-22-0033)
  • [L5] Longitudinal studies require continued contact and evaluation of patients for many years after the administration of treatment, and every reasonable effort should be made to obtain information on all patients in a study to ensure meaningful data. (10.2106/00004623-199803000-00018)
  • [Paper] A high energetic impulse induced by a custom-made drop-test bench can successfully simulate realistic proximal femur and acetabular fractures in cadaveric specimens with intact soft tissue. (10.1007/s00402-020-03628-8)
  • [L3] In an unselected cohort, patients experience a similar health-related quality of life as a reference group of a similar age and sex structure 7 years after THR except for general physical function where the patients score worse. (10.1186/1471-2474-11-47)

References

[1] National_and_Hospital_Registries_An_Invaluable_Source_and_Wealth_of_Information_S088354031500282X. n.d..

[2] Monitoring the lifetime risk of revision knee arthroplasty over a decade. The Bone & Joint Journal. 2022. DOI: 10.1302/0301-620x.104b5.bjj-2021-1219.r1

[3] Registry Studies Use Inconsistent Methods to Account for Patients Lost to Follow‐up, and Rates of Patients LTFU Are High. Arthroscopy, Sports Medicine, and Rehabilitation. 2021. DOI: 10.1016/j.asmr.2021.07.016

[4] Orthopaedic trauma: Establishment of an outcomes registry to evaluate and monitor treatment effectiveness. Injury. 2006. DOI: 10.1016/j.injury.2005.02.027

[5] A Prospective Study of 80,000 Total Joint and 5000 Anterior Cruciate Ligament Reconstruction Procedures in a Community-Based Registry in the United States. Journal of Bone and Joint Surgery. 2010. DOI: 10.2106/jbjs.j.00807

[6] Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Knee Surgery, Sports Traumatology, Arthroscopy. 2017. DOI: 10.1007/s00167-016-4398-1

[7] Orthopaedic registries – the UK view (National Joint Registry): impact on practice. EFORT Open Reviews. 2019. DOI: 10.1302/2058-5241.4.180084

[8] Development of a National Cruciate Ligament Surgery Registry. The American Journal of Sports Medicine. 2007. DOI: 10.1177/0363546507308939

[9] Editorial Commentary: Registries, Prospective Cohorts, and Predictors of Outcomes: Why Bother?. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2018.05.019

[10] National joint registry data underestimates the burden of prosthetic joint infection. Orthopaedic Journal of Sports Medicine. 2016. DOI: 10.1177/2325967116s00088

[11] Understanding Orthopaedic Registry Studies. The Journal of Bone and Joint Surgery. 2016. DOI: 10.2106/jbjs.n.01332

[12] Applicability of randomized controlled trial evidence on surgery for lumbar disc herniations to clinical reality: a comparison with the nationwide FinSpine registry. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06401-y

[13] One- or Two-Stage Hip Revision? High Mortality in One-Stage Challenges Its Growing Popularity: A Registry Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.08.015

[14] Registry stakeholders. EFORT Open Reviews. 2019. DOI: 10.1302/2058-5241.4.180077

[15] Impact of a learning curve on the survivorship of 4802 cementless total hip arthroplasties. The Bone & Joint Journal. 2016. DOI: 10.1302/0301-620x.98b12.bjj-2016-0203.r1

[16] Multiple Primary Joint Arthroplasties and the Risk of Periprosthetic Joint Infection: Evidence From a Large Retrospective Cohort. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.12.016

[17] Precision or Pitfall? Evaluating the Accuracy of ICD-10 Coding for Cemented Total Hip Arthroplasty. Journal of Bone and Joint Surgery. 2023. DOI: 10.2106/jbjs.23.00325

[18] Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre. The Bone & Joint Journal. 2015. DOI: 10.1302/0301-620x.97b1.35279

[19] Differences in Reported Outcomes in Industry-Funded vs Nonfunded Studies Assessing Thromboprophylaxis After Total Joint Arthroplasty. The Journal of Arthroplasty. 2018. DOI: 10.1016/j.arth.2018.06.025

[20] Nationwide Databases in Orthopaedic Surgery Research. Journal of the American Academy of Orthopaedic Surgeons. 2016. DOI: 10.5435/jaaos-d-15-00217

[21] Orthopaedic registries: the German experience. EFORT Open Reviews. 2019. DOI: 10.1302/2058-5241.4.180064

[22] Hemiarthroplasties after Hip Fractures in Norway and Sweden: A Collaboration between the Norwegian and Swedish National Registries. HIP International. 2014. DOI: 10.5301/hipint.5000105

[23] Letter to the Editor on “Mortality and Implant Survival With Simultaneous and Staged Bilateral Total Knee Arthroplasty Experience From the Australian Orthopedic Association National Joint Replacement Registry”. The Journal of Arthroplasty. 2019. DOI: 10.1016/j.arth.2019.05.027

[24] Serum Metal Ion Levels in Cementless Metal-On-Metal Total Hip Arthroplasty: Long-Term Follow-Up Trends. The Journal of Arthroplasty. 2019. DOI: 10.1016/j.arth.2018.11.023

[25] The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow‐up results from 5,818 knee ligament reconstructions. Knee Surgery, Sports Traumatology, Arthroscopy. 2008. DOI: 10.1007/s00167-008-0654-3

[26] Ensuring Access to High Quality Care in Revision Total Knee Arthroplasty: An Analysis of Referral Patterns and Clinical Outcomes at a Tertiary Care Center. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2025.09.038

[27] Chapter 37 Research Studies and Registries in Sports Medicine. 2019.

[28] Malignant Osseous Tumors of the Pediatric Spine. Journal of the American Academy of Orthopaedic Surgeons. 2012. DOI: 10.5435/00124635-201210000-00004

[29] The what, when and how of orthopaedic registers: an introduction into register-based research. EFORT Open Reviews. 2019. DOI: 10.1302/2058-5241.4.180097

[30] Hip Surgical Treatment Registry (HipSTR): The North American Hip Arthroscopy Registry—Who We Are Operating on and What We Are Doing; Findings in Its Inaugural Year 2023 With >1000 Patients. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251408089

[31] Data errors in the National Hip Fracture Database. The Bone & Joint Journal. 2016. DOI: 10.1302/0301-620x.98b10.37089

[32] A practical guide to the development and deployment of deep learning models for the orthopaedic surgeon: Part III, focus on registry creation, diagnosis, and data privacy. Knee Surgery, Sports Traumatology, Arthroscopy. 2024. DOI: 10.1002/ksa.12085

[33] An Updated Description of More Than 5,000 Procedures from the Danish Hip Arthroscopy Registry. Journal of Bone and Joint Surgery. 2020. DOI: 10.2106/jbjs.19.01496

[34] Development and early findings of a semiautomated arthroplasty registry in a multi-institutional healthcare network. The Bone & Joint Journal. 2020. DOI: 10.1302/0301-620x.102b7.bjj-2019-1622.r1

[35] Identification of implant outliers in joint replacement registries. EFORT Open Reviews. 2023. DOI: 10.1530/eor-22-0058

[36] Current status of Asian joint registries: a review. EFORT Open Reviews. 2025. DOI: 10.1530/eor-2024-0085

[37] Current national hand surgery registries worldwide. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420970155

[38] Large variation in timing of follow-up visits after hip replacement: a review of the literature. EFORT Open Reviews. 2022. DOI: 10.1530/eor-21-0016

[39] Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry. BMC Musculoskeletal Disorders. 2017. DOI: 10.1186/s12891-017-1455-y

[41] Intraoperative complications during revision shoulder arthroplasty: a study using the National Joint Registry dataset. Shoulder & Elbow. 2017. DOI: 10.1177/1758573216685706

[42] Survivorship of the fixed-bearing medial unicompartmental knee arthroplasty: mean 14-year follow-up in a single medical center. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07378-1

[43] Mid‐term results of Autologous Matrix‐Induced Chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surgery, Sports Traumatology, Arthroscopy. 2010. DOI: 10.1007/s00167-010-1042-3

[44] Risk of Revision Shoulder Arthroplasty After Anatomic and Reverse Total Shoulder Arthroplasty. Journal of the American Academy of Orthopaedic Surgeons. 2022. DOI: 10.5435/jaaos-d-21-01090

[45] Chapter 12 Hip Microinstability. 2019.

[47] Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118771676

[48] Increasing incidence of rotator cuff repairs—A nationwide registry study in Finland. BMC Musculoskeletal Disorders. 2015. DOI: 10.1186/s12891-015-0639-6

[49] Should we all go to the PROM? The first two years of the British Spine Registry. The Bone & Joint Journal. 2015. DOI: 10.1302/0301-620x.97b7.35391

[50] Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018. JSES International. 2021. DOI: 10.1016/j.jseint.2020.12.003

[51] Explant analysis and implant registries are both needed to further improve patient safety. EFORT Open Reviews. 2022. DOI: 10.1530/eor-22-0033

[56] Current Concepts Review - Methods for Locating Missing Patients for the Purpose of Long-Term Clinical Studies. The Journal of Bone & Joint Surgery*. 1998. DOI: 10.2106/00004623-199803000-00018

[59] Fractures around the hip: inducing life-like fractures as a basis for enhanced surgical training. Archives of Orthopaedic and Trauma Surgery. 2020. DOI: 10.1007/s00402-020-03628-8

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