Surgical Registries

The first known medical registry was the National Leprosy Registry of Norway which was established in 1856. The use of registries in orthopedic surgery has evolved since the first arthroplasty registry was created in the 1970s. Today, they are used by many orthopedic sub-specialties and often include patient reported outcome measures in addition to the traditional endpoint of revision surgery. The primary goals of these registries are to improve patient outcomes through detecting implants or surgical techniques with inferior results or early failures, and to identify prognostic factors that may influence choice of treatment and outcome. By collecting a large volume of data and following outcomes over time, registries are an extremely valuable research tool that can lead to high quality and potentially practice-changing studies. Annual reports provide feedback to surgeons, hospitals, government, and society as a whole and can also impart regional or surgeon specific data. In designing an orthopedic registry, one must be cognizant of the limitations and challenges to be overcome. Since the strength of a registry is based on the accuracy and completeness of the data, a high compliance rate is crucial, and represents the greatest challenge. In the future, it is expected to see more international registry-based collaboration, expansion of current surgical registries to include non-surgical patients, use of register-based RCTs and machine learning.