2 April 2016

National Quality Registry for Knee Arthroplasty

  • Registry Manager: Region Skåne
  • Registry Centre - affiliation: Registry Centre Syd
  • Start year: 1975
  • Classifications used: Own variant of ICD8
  • This registry contains data on: Diagnoses, Intervention, Inpatient Care, PROM

Description of registry

At the initiative of the Swedish Orthopaedic Society, a national register regarding knee arthroplasty surgeries was started in Lund in 1975. The profession had realised that it would be difficult for individual surgeons to base their choice of optimal implants and operative techniques on their own experience and thus started the project, which became the first national arthroplasty registry in the world. The aim was to, at an early stage, detect which implants were suitable, and unsuitable, for use in patients with different types of knee disease. Further, by informing surgeons of the results, the registry enables them to limit their use of unsuitable prostheses and/or methods and thus decrease patient suffering and costs.

During the first decade of the registration, more than 15 percent of knee arthroplasty patients had to have their prosthesis re-operated within 10 years. Advancement in implant design and surgical methods together with surgeons selecting what was known to work resulted in constant improvement over time. During the last decade only 4 percent of the knee arthroplasties needed revision within 10 years, which is among the lowest if not the lowest rate in the world.

For many years, the Knee Arthroplasty Register has utilized a minimal dataset containing information on where the surgery was performed (hospitals), on the patient (age, diagnosis, and laterality) and on the surgery (the implant type and its fixation (cementation). After a primary surgery, the patient is monitored to identify any failures involving the implant resulting in further surgery, and in such cases the register also gathers information on the reason for failure as well as the type of revision.

In 2009, the minimal dataset was extended to include more information concerning the patients, technical details, and on the prophylaxis and anaesthesia used. The reporting form can be found at the back of the annual report of the register, available at: www.knee.se

Population

All surgeries, in which knee prostheses are inserted, removed or replaced in people possessing Swedish personal identity numbers and who are living in Sweden. In 2014 there were 13,000 primary operations and just over 800 re-operations (revision procedures).

Age limitation in the registry

All ages are included.

Total volume of registry

By the end of 2014 there were 228,000 primary operations and 17,000 revisions.

Volume over the past operating year

In 2014 there were 13,000 primary operations, and 900 revisions.

Coverage rate

The coverage rate is 100 percent (i.e. all hospitals performing knee prosthesis surgeries report to the registry). The registry is 97 percent complete as concerns primary operations, according to data-matching against the patient registry.

References on validations

The registry was validated in 1997 (Validation of the Swedish Knee Arthroplasty Register. A postal survey regarding 30,376 knees operated on between 1975 and 1995. Acta Orthop Scand 1999; 70(5): 467-472.)

Data has been matched against the patient registry for the past several years, and in autumn 2011, a study was conducted on data quality through visits to nine randomly selected hospitals. The report was sent to the Swedish Association of Local Authorities and Regions (SKL) in the spring of 2012. Since then similar validation has been performed at 13 additional hospitals and the results published in the annual report.

Note: Variable lists are updated on a regular basis and should therefore be seen as preliminary. For the latest version, please contact the registry.

Category: Musculoskeletal system

Certification level: 2

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