MAINTAINING A HIP REGISTRY FOR 25 YEARS - MAYO-CLINIC EXPERIENCE

A computerized database was established for all total joint replacemen ts done at the authors' institution, To date the registry contains inf ormation on more than 56,000 arthroplasties of which more than 30,000 involve the hip, The registry was designed to determine the effectiven ess of total hip arthroplasty as a function of implant design, surgica l technique, and patient selection, Furthermore, by maintaining and up dating the patient record, data regarding success or anticipated failu re could be communicated to the patient. Finally, this resource would provide reliable information that could be communicated to the orthope dic community, Patients are routinely evaluated at 1, 2, and 5 years p ostoperatively and at 5-year intervals thereafter by examination or le tter or telephone questionnaire, Followup of patients at each interval is approximately 95%, Patients are more likely to respond by question naire (rather than be seen in person) if they are older, if a longer t ime has elapsed since surgery, or if they live a long distance from th e clinic, Data are collected by five full time employees including com puter and statistical support specifically assigned to the project, Th e annual joint registry budget is in excess of $400,000, Unfortunately , the future of this endeavor is challenged by the needs to: (1) show cost effectiveness of the activity; (2) update and validate outcomes i nstruments used as input into the database; and (3) maintain satisfact ory followup rates in a medical economic environment that often discou rages patient return visits or local assessment.