[Effects of quality assurance in arthroplasty : An evaluation of the development of the semi-annual hospital evaluations of the German Arthroplasty Registry (EPRD)].

Abstract

Background: Quality assurance in arthroplasty is based on established systems such as the German Arthroplasty Registry (EPRD) and the EndoCert certification system. These systems enable continuous improvement in the quality of care through targeted feedback and audits. After the introduction of the semi-annual EPRD hospital evaluations, detailed analyses and comparisons of their revision rates for hip and knee arthroplasties (THA, TKA) became possible for the hospitals.

Aim of the study: The aim of this study was to compare and evaluate the standardised revision ratios (SRR) of the EPRD clinics.

Materials and methods: The study analysed whether poor results in previous evaluations led to an improvement over time. The analysis was based on hospital evaluations from June 2020 and December 2023 for elective THA with cementless stems and standard TKA. Of the 603 clinics with THA responses, 315 were analysed, compared to 360 of the 588 TKA clinics.

Results: The results show that regular feedback mechanisms can improve the quality of care; 69.2% of clinics were able to maintain or improve the quality of their THA care and 70.6% of clinics were able to maintain or improve their TKA care. No dependence on case volumes was found, which indicates that all EPRD clinics can benefit equally from the feedback.

Discussion: The hospital evaluations enable precise tracking of results, promote transparency and reveal potential for improvement. In view of new legislation such as the Implant Register Act and the hospital reform, it is essential to further strengthen existing systems such as the EPRD and EndoCert and integrate them even more closely into clinical practice in order to ensure the quality of care in the long term.