Joint Registries ~ Context for
Metal on Metal Hip Replacement Patients


The Joint Registry sites listed at the foot of this page contain both metal on metal hip replacement and general hip (and other joint) replacement information & resources.

I have included the links on the basis that they may be of interest and of use to Visitors to this site, but recommend that you carry out your own assessment of the objectives, agendas, governance and relative independence of each site.

Also, for the avoidance of doubt, none of the sites listed below have any relationship with, nor have they endorsed this Site in any way.

No doubt there are other Registries which I have not yet found. If you know of one that should be added to the list then please contact me. Thanks.

Why do Joint Registries exist?

Joint registries exist to improve the quality of patient outcomes and ensure the cost effectiveness and quality of joint replacement surgery.

The registries do this primarily by collecting data on individual hip, knee, elbow, ankle and shoulder joint replacements. The consolidated data allows each registry to monitor the performance of different implants and the effectiveness of different types of surgery.

The registries feed back and share the insights gained on patient outcomes. This supports improvements in clinical standards to the benefit of patients, clinicians and the wider orthopaedic implant industry.

The scope of data collection extends to include prostheses made of the full range of available materials, and of different designs. Taking hip surgery as an example, data would be collected on prostheses constructed of the full range of materials including, but not limited to metal hip replacement implants.

One important benefit of the work of joint replacement registries is that insights from the data can provide an early warning of potential patient safety issues.

For example, if an emerging trend of suboptimal patient outcomes is identified within the data for a particular prosthesis (identified by manufacturer's brand & catalogue number) and for a specific subset of the patient population, than this can trigger more detailed analysis and investigation.

These types of insights feed into broader decisions by regulators and manufacturers about whether it is necessary to recall a specific hip implant product. In recent years, insights from joint registries in various countries have made significant contributions to the identification of concerns about the safety of some metal hip replacement implants.

The data collected can also be used in other ways, including assessment and comparison of the relative performance of hospitals and orthopaedic surgeons.

The Development History of Joint Registries

Right back from the pioneering days of joint replacement surgery in the 1960s, joint registries have been established typically on a country by country basis. Through the seventies and eighties registries were founded in just a handful of countries such as Sweden and Norway.

Momentum gathered in the nineties and 'noughties' with more countries creating their own registries, including Denmark, Canada, Australia and England & Wales.

Looking from a top down perspective, the development process has been piecemeal with individual countries taking the initiative to establish joint registries locally, but doing so in the absence of an overarching global framework.

With the benefit of hindsight, most interested parties would have wished to have an overarching framework in place from the start in order that data could be collected on a consistent basis at country level, thereby enabling a more effective international consolidation of data and more powerful insights into clinical outcomes.

As a consequence of this history, although the majority of joint registries are substantially aligned in terms of their strategic objectives, there is inevitably some divergence in terms of data collection approaches, standards and methodologies at country level.

In 2004 the first international society of registries was established - the International Society of Arthroplasty Registries. Later in 2011 the FDA launched The International Consortium of Orthopedic Registries in a further attempt at global coordination, consolidation and in the pursuit of global standardization and insight.

Relevance to Metal on Metal
Hip Replacement Recalls

The issues and concerns that have emerged in recent years relating to metal on metal hip replacement implants have highlighted the critical importance and benefits of the work undertaken by the joint registries around the world.

The development and introduction of metal on metal hip replacement systems was founded on the desire by clinicians and orthopaedic implant manufacturers to create high performing and cost effective products to the overall benefit of patients. Unfortunately, a small proportion of these metal on metal hip implant products have not performed as expected and have been recalled.

Without doubt, the insights on the performance of metal on metal hip replacement components generated by joint registries in various geographies has enabled and accelerated the process of problem identification, and ultimately where required, product recall.

List of Registries

National Joint Registries


Name & Link


Australian Orthopaedic Association National Joint Replacement Registry


Canadian Joint Replacement Register


Danish Hip Arthroplasty Register

England & Wales

National Joint Registry of England and Wales


Register Orthopaedic Implants Lombardo


Registro dell'implantologia Protesica Ortopedica (RIPO)


Dutch Arthroplasty Register (LROI)

New Zealand

New Zealand Joint Registry


Norwegian Arthroplasty Register


Portugese Arthroplasty Register


Romanian Arthroplasty Register


Scottish Arthroplasty Project


Slovak National Arthroplasty Register

Spain (Catalonia)

Catalan Arthroplasty Register


Swedish Hip Arthroplasty Register

United States

American Joint Replacement Registry

United States

Kaiser Permanente National Implant Registries

Regional Joint Registries


Name & Link


European Arthroplasty Register

International Societies of Joint Registries

Name & Link

International Society of Arthroplasty Registers

International Consortium of Orthopaedic Registries

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