title: Do joint registries report true rates of hip dislocation?
abstract: BACKGROUND
  Despite advances in primary THA, dislocation remains a common complication. In New Zealand (NZ), dislocations are reported to the National Joint Registry (NJR) only when prosthetic components are revised in the treatment of a dislocation. Closed reductions of dislocated hips are not recorded by the NJR.
  
  
  OBJECTIVE
  We compared the true dislocation rate for patients receiving primary THA in the Wellington region with the rate reported by the NZ NJR for the same group of patients.
  
  
  METHODS
  The NZ NJR identified 570 patients undergoing primary THA from January 1, 2008, to December 31, 2009, with addresses in the Wellington region. The mean age was 67.5 years (range, 27-96 years). The minimum followup was 2 years (mean, 3 years; range, 2-4 years).
  
  
  RESULTS
  Six patients required revision of at least one component for dislocation. There was 100% agreement between the hospital database and the NJR. Using the NJR criteria of revision of any component as an end point, the dislocation rate in the Wellington region after primary THA was 1.05%. The hospital database identified a further eight patients who presented with a dislocation of their primary THA and underwent a closed reduction. These patients were not recorded by the NJR. The true rate of all dislocations, which includes closed reductions, was 2.46%.
  
  
  CONCLUSIONS
  This article documents the discrepancy between the NZ NJR reported rate of revision for dislocation and the true rate of dislocation in primary THA. We recommend documentation of all dislocations by NJR in their database to allow more accurate comparisons between centers and research outcomes.
  
  
  METHODS
  Level IV, clinical research study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand. peterdevane@yahoo.co.nz
authors.forename: Peter A
authors.initials: PA
authors.lastname: Devane
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Wraighte
authors.forename: David C G
authors.initials: DC
authors.lastname: Ong
authors.forename: J Geoffrey
authors.initials: JG
authors.lastname: Horne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006621:Hip Joint; D006801:Humans; D004204:Joint Dislocations / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012042:Registries