Thousands of people have joint replacement surgery every year and the National Joint Registry gathers together data on the outcomes of these surgeries. This allows surgeons and hospitals to monitor the success of their operations and ensure that the devices used are safe and effective. Individuals can also use the Registry to inform themselves better about the surgery which they are having.

Why is this work needed?

Tens of thousands of joint replacement operations take place in the UK every year. Without collecting data about the outcomes of these procedures, it is difficult to fully inform people of their options, promote improvements in treatment and identify areas where the outcomes could be improved. Maintaining a patient register also allows for comprehensive patient recall, if necessary.

What is happening?

The National Joint Registry (NJR) collects information on joint replacement surgery and monitors the performance of joint replacement implants. This data is then used to monitor the performance of the implants and the effectiveness of different types of surgery, as well as supporting research and allowing people to access their own records.

What are the benefits?

Hospitals and surgeons can use the NJR to get feedback on their performance and work on improving the outcome for their patients. The database can also monitor if the devices used are effective, supporting surgeons in picking the right device for the right individual. For example, in 2010 the NJR identified higher than expected revision (re-do surgery) rates for metal-on-metal hip implants, leading to the prompt removal of this type of implant from the market.

People who need joint replacement surgery can also use the NJR to better inform themselves by checking information about their consultant’s practice, the hospital where their operation will be carried out, and being supported to access their own data. See the link to the Hospital and Surgeon Profile service below.

What type of data is involved?

The NJR combines Hospital Episode Statistics (HES) data and Patient Reported Outcome Measures (PROMs). Data such as type of surgery received, which part of the body and side of the body are collected. Patients can consent to having their personal details recorded alongside their operation details which can further help to improve patient safety, for example whether a certain surgery is more or less appropriate for different age groups, comorbidities, etc.

Data quality is a key focus for the NJR – they conduct annual audits to review data completeness, accuracy and timeliness of completion, which better ensures that the data can be used more effectively which ultimately benefits patients. Hospitals can achieve certification as a Quality Data Provider by demonstrating how they have met stringent targets for best data practice, increased engagement and awareness of the importance of quality data collection for ultimately improving patient outcomes.

As a national registry, it Is mandatory for hospitals in England, Wales and Northern Ireland to collect and submit data about joint replacement surgery to the registry.

The data consists of:

  • Identifiable data, used to link datasets together, with the consent of the patient
  • Data about the hospital and surgeon for assurance about the care being delivered
  • Data about the medical devices used in the surgery to monitor their safety and efficacy

NJR data can be linked with other NHS datasets such as Hospital Episode Statistics (e.g. how might other health conditions affect surgery outcomes?), Civil Registration Data (e.g. is the patient still alive and if not when did they die?), and Patient Recorded Outcome Measures (e.g. what is a patients experience in terms of health and function after surgery?). These combined datasets are de-identified for analysis and reporting.

Data collected via the NJR may be used for medical research but only if it has passed ethical review and if the outcomes are expected to provide significant benefits to healthcare. Any data provided for this reason is de-identified.

Who funds and collaborates on this work?

Hospitals are mandated to an annual subscription to the registry at a rate which has been calculated to cover the costs of running the registry and delivering its work programmes, according to the number of procedures carried out by the hospital in the previous year.

It also seeks income streams through industry subscriptions to their data and reporting services, charges for data sharing requests, etc.

Where can I go for more information?


National Joint Registry homepage

How the NJR manages your data

National Joint Registry’s Surgeon and Hospital Profile website

Using health information to monitor the performance of joint replacement surgery - see page 14

NJR Patient Information Booklet