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THE IRISH NATIONAL JOINT REPLACEMENT REGISTRY: A CONCEPT– A NATIONWIDE REVIEW OF ORTHOPAEDIC CONSULTANTS AND SPECIALIST REGISTRARS OPINIONS.



Abstract

Introduction: Despite the documented benefits, some countries have yet to agree on the establishment of a national arthroplasty registry.

Aim: The objective of this study was to determine the opinions regarding the establishment of an Irish National register from the Consultant Orthopaedic Surgeons and Senior Orthopaedic trainees in Ireland. We also aim to find the possible reasons why a national joint register has not been established in Ireland.

Method: We have undertaken a questionnaire study to sample the opinions of the Consultant orthopaedic surgeons and Specialist registrars(SR), regarding establishment of an Irish national joint register. The questions asked related to opinions about the setting up, purpose and maintenance of an Irish National Joint Register.

Results: A total of 79 responses were received of 114 questionnaires distributed (a 69% first response rate). 97% believe it is time we set up a registry, 94% will contribute and 81% say it should be made compulsory for unwilling Surgeons and Hospitals to participate. 82% of respondents felt the set up cost should be borne by the government (Health Service Executive). Only10% of consultants agreed that the IOA should be involved in the cost bearing. Despite the overwhelming support for a national register, privacy and liability issues were major concern. 58% of the total respondents strongly agree/agree that access to registry report by the general public can expose surgeons and Hospitals to a medicolegal loophole; hence access to database should be restricted. 78% strongly agree/agree that the registry data may be used as benchmarking tools by the administrators of health-care systems to discriminate methods, implants, surgeons and hospitals, which are found to be underperforming.

Conclusion: There are considerable logistical challenges involved in the establishment of any registry. Other countries have done it successfully, and the benefits are well documented. This subject has endorsement from the Professionals as demonstrated by this study. In a litigious society such as ours, legislation may be required to further protect the integrity of a national joint replacement registry to ensure that the data are used as intended—to serve as an early warning system for premature device failure and to improve outcomes for our patients.

Correspondence should be addressed to Mr Richard Wallace at Musgrave Park Hospital, 20 Stockman’s Lane, Belfast BT9 7JB, Northern Ireland.