The Scottish Arthroplasty Project: Scotland's approach to a National Joint Registry

The core function of joint registries is to collect, collate, and present data about patients who undergo joint replacement surgery, and afford clinicians and administrators a range of analytic functions to monitor service performance. This article describes the development, evolution, and future of arthroplasty registries, drawing particularly from the experience of the Scottish Arthroplasty Project (SAP). The SAP was established in 1999 and is one of the oldest arthroplasty registries in the world. It collects information on patients undergoing hip, knee, ankle, shoulder, and elbow arthroplasty. The primary aim is to encourage continual improvement in the quality of care provided for arthroplasty patients in Scotland. It is distinct in terms of administration and methodology from the National Joint Registry (NJR) of England, Wales, and Northern Ireland as it monitors patients rather than implants. Since its inception, its work has contributed to a reduction in overall complication rates and a significant decrease in hospital length of stay for the growing number of patients undergoing arthroplasty. It continues to provide a robust database that is used to underpin national guidance through data-driven research. The research carried out by dedicated SAP fellows has enhanced the research portfolio of the SAP and raised its profile through high quality peer-reviewed publications. The SAP continues to evolve and by collaborating with other Scottish registries it will provide larger datasets containing greater diversity and granularity of information. These developments as well as ongoing analysis of existing areas ensure that the SAP continues to maintain and improve standards in arthroplasty across Scotland.