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Bone & Joint Open
Vol. 3, Issue 9 | Pages 716 - 725
15 Sep 2022
Boulton C Harrison C Wilton T Armstrong R Young E Pegg D Wilkinson JM

Data of high quality are critical for the meaningful interpretation of registry information. The National Joint Registry (NJR) was established in 2002 as the result of an unexpectedly high failure rate of a cemented total hip arthroplasty. The NJR began data collection in 2003. In this study we report on the outcomes following the establishment of a formal data quality (DQ) audit process within the NJR, within which each patient episode entry is validated against the hospital unit’s Patient Administration System and vice-versa. This process enables bidirectional validation of every NJR entry and retrospective correction of any errors in the dataset. In 2014/15 baseline average compliance was 92.6% and this increased year-on-year with repeated audit cycles to 96.0% in 2018/19, with 76.4% of units achieving > 95% compliance. Following the closure of the audit cycle, an overall compliance rate of 97.9% was achieved for the 2018/19 period. An automated system was initiated in 2018 to reduce administrative burden and to integrate the DQ process into standard workflows. Our processes and quality improvement results demonstrate that DQ may be implemented successfully at national level, while minimizing the burden on hospitals.

Cite this article: Bone Jt Open 2022;3(9):716–725.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 248 - 248
1 May 2006
Kamath S Pegg D
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Background A further two changes to the technique of primary Total Hip Arthroplasty (THA) have recently been advocated, computer assisted surgery and access by mini incision(s). These add to the potential different ways the surgeon can perform THA and are still in an early evolutionary stage. However, they add further fuel to the question, what is the best technique for THA ?

Method We considered the procedure of THA and broke it down into the main component stages. We then assessed the various possible different options for each different stage from the literature and a survey of 14 Orthopaedic Surgeons (6 consultants, 2 associate specialists and 6 trainees).

Results We calculate that THA can be performed by at least 1.08 x 1011 different unique techniques. We were unable to find any consensus on the best technique for THA.

Conclusions This massive diversity causes problems with informed consent, research and training. NICE and NJR have issues regarding choice of implant but we believe the choice of surgical technique for THA can play an even more important role in outcome.