The National Joint Registry (NJR) has recorded joint replacement surgery carried out in England, Wales, Northern Ireland, the Isle of Man and Guernsey since 2003, and is one of the largest datasets of its kind anywhere in the world. Every implant used, and how it performs over the years that follow, is logged against the unit that carried out the operation.
Alongside that outcome data, the NJR runs an annual programme of local data audits. Hospitals that meet its targets – submitting complete and accurate records, achieving high patient consent rates for inclusion, and responding promptly to registry safety alerts – are recognised as NJR Quality Data Provider units. The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry, where Mr Jermin carries out his NHS practice, has been awarded this status. It is worth being precise about what that recognises: it measures the quality and completeness of a hospital’s data and its responsiveness to safety alerts, rather than ranking surgical outcomes.
That distinction matters, because registry figures are easy to misread. Implant survivorship – the proportion of replacements still in place after a given number of years – is the measure most often quoted, but it is influenced heavily by the age and activity level of the patients a unit treats. A hospital carrying out complex work on younger, more active patients may show different figures from one treating an older group, without either being better or worse.
For patients, the registry has two practical uses. It acts as an early warning system for implants that underperform, which is one reason Mr Jermin uses systems with long and well-documented track records. And it means that once you have had a knee replacement, your operation is on record, so any future question about that implant can be traced. The NJR publishes hospital and surgeon profiles that anyone can look up.
