title: New Zealand Joint Registry data underestimates the rate of prosthetic joint infection.
abstract: Background and purpose - Recent studies have revealed deficiencies in the accuracy of data from joint registries when reoperations for prosthetic joint infections (PJIs) are reported, particularly when no components are changed. We compared the accuracy of data from the New Zealand Joint Registry (NZJR) to a multicenter audit of hospital records to establish the rate of capture for PJI reoperations. Methods - 4,009 cases undergoing total knee or hip arthroplasty performed at 3 tertiary referral hospitals over a 3-year period were audited using multiple hospital datasets and the NZJR. The number of reoperations for PJI that were performed within 2 years of the primary arthroplasty was obtained using both methods and the data were compared. Results - The NZJR reported a 2-year reoperation rate for PJI of 0.67%, as compared to 1.1% from the audit of hospital records, giving the NZJR a sensitivity of 63%. Only 4 of 11 debridement-in-situ-only procedures and 7 of 12 modular exchange procedures were captured in the NZJR. Interpretation - The national joint registry underestimated the rate of reoperation for PJI by one third. Strategies for improving the accuracy of data might include revising and clarifying the registry forms to include all reoperations for PJI and frequent validation of the registry data against other databases.
authors.affiliation: a Orthopaedic Department , North Shore Hospital , Auckland ;
authors.forename: Mark
authors.initials: M
authors.lastname: Zhu
authors.affiliation: b School of Medicine , University of Auckland , Auckland ;
authors.forename: Saiprasad
authors.initials: S
authors.lastname: Ravi
authors.affiliation: c New Zealand Joint Registry ;
authors.forename: Chris
authors.initials: C
authors.lastname: Frampton
authors.affiliation: d Department of Infectious Diseases , Middlemore Hospital , Auckland , New Zealand.
authors.forename: Chris
authors.initials: C
authors.lastname: Luey
authors.affiliation: a Orthopaedic Department , North Shore Hospital , Auckland ;|b School of Medicine , University of Auckland , Auckland ;
authors.forename: Simon
authors.initials: S
authors.lastname: Young
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012042:Registries; D012086:Reoperation / Q000639:trends; D012189:Retrospective Studies