Development of a pilot cartilage surgery register

Evaluating the Use of PROMs in Paediatric Orthopaedic Registries

Patient-reported outcome measures (PROMs) provide structured information on the patient's health experience and facilitate shared clinical decision-making. Registries that collect PROMs generate essential information about the clinical course and efficacy of interventions. Whilst PROMs are increasingly being used in adult orthopaedic registries, their use in paediatric orthopaedic registries is not well known. The purpose of this systematic review was to identify the frequency and scope of registries that collect PROMs in paediatric orthopaedic patient groups. In July 2023, six databases were systematically searched to identify studies that collected PROMs using a registry amongst patients aged under 18 years with orthopaedic diagnoses. Of 3190 identified articles, 128 unique registries were identified. Three were exclusively paediatric, 27 were majority paediatric, and the remainder included a minority of paediatric patients. One hundred and twenty-eight registries collected 72 different PROMs, and 58% of these PROMs were not validated for a paediatric population. The largest group of orthopaedic registries collected PROMs on knee ligament injuries (21%). There are few reported dedicated orthopaedic registries collecting PROMs in paediatric populations. The majority of PROMs collected amongst paediatric populations by orthopaedic registries are not validated for patients under the age of 18 years. The use of non-validated PROMs by registries greatly impedes their utility and impact. Dedicated orthopaedic registries collecting paediatric-validated PROMs are needed to increase health knowledge, improve decision-making between patients and healthcare providers, and optimise orthopaedic management.

The First Report of the International Cartilage Regeneration and Joint Preservation Society's Global Registry

OBJECTIVE

The International Cartilage Regeneration and Joint Preservation Society's (ICRS's) global registry, aims to be the best source of information for patients and an unbiased resource of evidence-based medicine for scientists and clinicians working to help those unfortunate enough to suffer the pain and disability associated with articular cartilage lesions. This article constitutes the scientific summary of the reports' main findings.

DESIGN

The article outlines the historical precedents in the development of orthopedic registries from the earliest tumor registries, then local arthroplasty databases that led ultimately to international collaborations between national arthroplasty and soft tissue registries. The ICRS global cartilage registry was designed from the outset as a GDPR (General Data Protection Regulation) compliant, multilingual, multinational cooperative system. It is a web-based user-friendly, live in 11 languages by end 2019, which can be accessed via https://cartilage.org/society/icrs-patient-registry/. Patients and clinicians enter data by smartphone, tablet, or computer on any knee cartilage regeneration and joint preservation treatment, including the use of focal arthroplasty. Knee Injury and Osteoarthritis Outcome Score and Kujala patient-reported outcome measures are collected preoperatively, 6 months, 12 months, and annually for ten years thereafter. EQ-5D data collection will allow cost-effectiveness analysis. Strengths, weaknesses, and future plans are discussed.

RESULTS

Since inception the registry has 264 users across 50 countries. Major findings are presented and discussed, while the entire first ICRS global registry report is available at https://cartilage.org/society/icrs-patient-registry/registry-annual-reports/. Conclusion. A measure of the maturity of any registry is the publication of its findings in the peer reviewed literature. With the publication of its first report, the ICRS global registry has achieved that milestone.

Total ankle arthroplasty and national registers: What is the impact on scientific production?

PURPOSE

The purpose of this systematic review was to analyze clinical studies on total ankle replacement (TAR) whose data were extracted from national registers.

METHODS

A systematic review of the literature, to identify all studies reporting outcomes after TAR, was performed. Two independent investigators performed the research using MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase and Cochrane Databases (1950 to December 2017). The search terms used were "total ankle replacement" or "total ankle arthroplasty" AND "register" or "registers" or "registry" or "registries" or "national registry" or "national register".

RESULTS

Analysis of the literature included 18 articles from 2007 to 2017. Of these 5 articles performed a comprehensive analysis of the national registers, 5 articles evaluated complications and reasons of failure after TAR, 6 articles made a specific outcome register analysis, one article compared TAR and ankle arthrodesis while the last one analyzed the role of TAR in patients with rheumatoid arthritis.

CONCLUSIONS

Scientific publications extracted from national joint registers for total ankle replacement provide useful but heterogeneous information on implants survivorship, implant models and risk factors. There is still a discrepancy between the data reported by designers in clinical studies and the data reported by the registries. The centralization of registers in specialized hospitals with dedicated surgeons, the use of patient reported outcomes (PROMs) in association with surgeon assessments and periodical publications can improve the development of registries and consequently of the literature in this regard.