title: Lessons learned from managing a prospective, private practice joint replacement registry: a 25-year experience.
abstract: BACKGROUND
  In 1984, we developed a private practice joint replacement registry (JRR) to prospectively follow patients undergoing THA and TKA to assess clinical and radiographic outcomes, complications, and implant survival. Little has been reported in the literature regarding management of this type of database, and it is unclear whether and how the information can be useful for addressing longer-term questions.
  
  
  OBJECTIVE
  We answered the following questions: (1) What is the rate of followup for THA and TKA in our JRR? (2) What factors affect followup? (3) How successful is this JRR model in capturing data and what areas of improvement are identified? And (4) what costs are associated with maintaining this JRR?
  
  
  METHODS
  We collected clinical data on all 12,047 patients having primary THA and TKA since 1984. Clinical and radiographic data were collected at routine followup intervals and entered into a prospective database. We searched this database to assess the rate of successful followup and data collection and to compare the effect of patient variables on followup. Costs related to database management were evaluated.
  
  
  RESULTS
  Followup was poor at every time interval after surgery, with a tendency for worsening over time. Patients with a complication and those younger than 70 years tended to followup with greater frequency. There were difficulties with data capture and substantial expenses related to managing the database.
  
  
  CONCLUSIONS
  Our findings highlight the difficulties in managing a JRR. Followup is poor and data collection is often incomplete. Newer technologies that allow easier tracking of patients and facilitate data capture may streamline this process and control costs.
authors.affiliation: New Mexico Orthopaedics, Center for Joint Replacement, 201 Cedar SE, Suite 6600, Albuquerque, NM 87106, USA. carothersjt@nmortho.net
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Carothers
authors.forename: Richard E
authors.initials: RE
authors.lastname: White
authors.forename: Krishna R
authors.initials: KR
authors.lastname: Tripuraneni
authors.forename: Mohammad W
authors.initials: MW
authors.lastname: Hattab
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Archibeck
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011331:Private Practice; D011446:Prospective Studies; D011859:Radiography; D012042:Registries; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome