27 July 2022

Arthroplasty Registries: Indicator of Where to Have Joint Replacement


The demand for hip and knee joint replacement procedures is still high due to the increasing geriatric population. For example, over 1M hip and knee replacement surgeries are performed in the U.S. annually. On average, 12% of joint replacement procedures worldwide require revision surgery after 10 years, therefore arthroplasty registries provide a good indication of the best-performing implants and countries with the lowest reoperation rate.

Global arthroplasty registries offer yearly reports containing data on implant revision risk and allowing surgeons to be in the loop on implant performance, which affects their decision to choose a specific implant for the surgery. The data available through the registry gives information about the implants, the frequency of reoperations, and risk factors associated with implants and surgical devices. At the same time, a uniform benchmarking system facilitates comparing implant performance per the recognized standard and the performance of other implants.

Joint replacement revision is usually recommended when the implants wear out after a certain period, are dislocated, or produce pain.

Low reoperation rate in Lithuania

According to Sarunas Tarasevicius, a surgeon at Nordorthopaedics Clinic, a leading international orthopedic center in Kaunas, Lithuania, a person considering a joint replacement surgery can look up the implant in the registry and see its performance rate over a certain period.

“The registry’s data gives a person an insight into the most common reasons for reoperations and why the joint implants need changing after a certain period,” the surgeon added. “With all this information at hand, the person can take precautions to minimize the need for revision surgery.”

Lithuania is one of the 13 countries worldwide recognized as true members of the International Society of Arthroplasty Registries, meaning it reaches a 90% rate of procedure registration nationally to qualify as a member. Only 9% of total joint replacement surgeries in Lithuania require revision procedures at the 10-year mark. In comparison, the operation rate in the U.S. is 17%.

Different types of implants to suit patients of all ages

The strategy for choosing the best-performing joint implant is mainly influenced by the quality parameters, and Lithuanian medical institutions use the ones which have the most extended durability, as confirmed by national and global data.

“Surgeons in Lithuania rely heavily on scientific publications and arthroplasty registries to make an informed decision about the best possible option for a patient. For example, the information contained there allows them to decide on hip implant fixation type—cement or mechanical,” dr. Tarasevicius said. “A younger active patient typically gets a hip implant with mechanical fixation while older patients are recommended cement fixation to ensure long-lasting results.”

Speaking of hip replacements, the registry’s data on implants also may suggest acetabular type—standard or dual mobility. Patients with a higher risk of falls and weaker muscles should get dual mobility acetabulum to reduce the chances of dislocation.

The surgeon also attributed the higher performance rate of joint implants inserted in Lithuanian medical institutions to surgeons’ competence and extensive experience gathered throughout many procedures.

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