title: Loss to follow-up after arthroplasty: a new use for registry data.
abstract: We assessed the outcome of patients who were lost to follow-up after arthroplasty by a single surgeon. The aim was to validate the surgeon's data set with the Australian Orthopaedic Association National Joint Replacement Registry and determine the outcome of those patients lost to follow-up. Prospective data on patient demographics, operative details and outcomes of the surgeon's 1192 primary unicompartmental knee arthroplasty (UKA) procedures were analysed. There were 69 knees in patients who were lost to follow-up, among whom the Registry identified 31 deaths and eight revisions. The cumulative percentage revision (CPR) at seven years using the additional Registry data was 8.8% (95% confidence interval (CI) 7 to 11). Using the surgeon's data, the CPR at seven years was 8% (95% CI 6.3 to 10.1) for the best-case scenario where loss to follow-up was excluded, and 16% (95% CI 13.8 to 19.4) for the worst-case scenario, where all patients lost to follow-up were deemed to have been revised. There was a significantly higher mortality rate in those patients lost to follow-up. This study demonstrates that a national joint registry can be used by individual surgeons to establish more accurate revision rates in their arthroplasty patients. This is expected to facilitate a more rigorous audit of surgical outcomes by surgeons and lead to more accurate and uniform reporting of the results of arthroplasty in general.
authors.affiliation: Hurstville Knee Clinic, Suite 406, 12 Ormonde Pde, Hurstville, New South Wales 2220, Australia. neville@2easytel.com.au
authors.forename: N J
authors.initials: NJ
authors.lastname: Rowden
authors.forename: J A
authors.initials: JA
authors.lastname: Harrison
authors.forename: S E
authors.initials: SE
authors.lastname: Graves
authors.forename: L N
authors.initials: LN
authors.lastname: Miller
authors.forename: R N
authors.initials: RN
authors.lastname: de Steiger
authors.forename: D C
authors.initials: DC
authors.lastname: Davidson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D013021:South Australia; D016896:Treatment Outcome