Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review

Eur J Orthop Surg Traumatol. 2024 Feb;34(2):1219-1251. doi: 10.1007/s00590-023-03691-y. Epub 2023 Sep 28.

Abstract

Purpose: Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II-IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II-IV JARs must be created to effectively assess and categorize these data.

Methods: Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II-IV JARs worldwide. The secondary aim was to record their lifetime, publications' number and frequency and recognise differences with national JARs.

Results: One hundred five Level II-IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case-control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies.

Conclusions: This is the first study mapping all Level II-IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.

Keywords: Arthroplasty registry; Arthroplasty replacement; Hospital-based registry; Joint registry; Regional registry; Registry level.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Cross-Sectional Studies
  • Hospitals
  • Humans
  • Registries
  • Reoperation
  • Retrospective Studies