The German Arthroplasty Register.

Since 1989, as a result of the Health Reform Act, German hospitals have been obliged to participate in measures for external quality assurance. The objective is to document and assess selected services—including the use and check of artie cial hips and knee joints—within the framework of quality assurance measures. The organisation of this documentation was transferred to the Quality Assurance Ofe ce (Servicestelle Qualitatssicherung, SQS) in Dusseldorf. Documentation started in some States (Lander) in 1997. Despite the extensive and expensive SQS documentation in the area of arthroplasty, however, the project did not fule l the expectations (Griss 1998). A new organisation, the Bundesgeschaftsstelle fur Qualitatssicherung (BQS) recently started a new documentation project, but the structure for the analysis of data does not exist at the moment, and it is unknown how this will be achieved. The Verein EndoprothesenRegister was founded in 1994 with the objective of quality assurance for members of the biomaterial working group of the German Society of Orthopaedics and Traumatology (Deutsche Gesellschaft fur Orthopadie und Traumatologie), the association of surgeons for biomaterials of the German Society of Surgery (Deutsche Gesellschaft fur Chirurgie) and the German Society of Trauma Surgery (Deutsche Gesellschaft fur Unfallchirurgie), as well as representatives of the industry. In 1997, the association started to set up an arthroplasty register based on the Scandinavian model (Lang and Willert 2001).