By: 29 September 2020
The National Joint Registry’s 17th Annual Report highlights continued successful outcomes across all types of joint replacement procedures

The National Joint Registry (NJR) which covers England, Wales, Northern Ireland the Isle of Man and the States of Guernsey, has published its annual report, which evidences outcomes across all types of joint replacement procedures being performed.

The registry, which was recently described in Parliament as a global exemplar, monitors the performance of hip, knee, ankle, elbow and shoulder joint replacements, to identify implants that are not performing well, so that appropriate follow-up action can be taken and also drives improvements to clinical outcomes for the benefit of future patients.

The 17th Annual Report of the NJR presents patients’ outcome data visually in tables and graphs for procedures across each of the joints, as well as implant and hospital outcomes. The published figures bring the total number of records in the registry to over 3.16 million, ranking it as the largest of its kind in the world.  Well over a million hip replacements and a million knee replacements have now been recorded since the NJR began its work.

The NJR is also the biggest and most comprehensive source of information for implants anywhere in the world and there has been considerable work this year to develop NJR implant classifications and drill down the analysis of the performance of implants in all joints, which will be useful to surgeons and patients alike, in choosing the best performing implants.

Even more joint replacements than ever before across all of the joints were carried out in 2019, with just under a quarter of a million records submitted to the NJR by hospitals during this period.  As the report is based on data up to the end of 2019, outcomes are not affected by the Covid-19 pandemic.

Key messages this year are:

  • the number of hip, shoulder, ankle and elbow replacements have all increased since last year;
  • primary procedures were performed for osteoarthritis in 90 per cent of cases of hip replacement and over 98 per cent for knee replacements;
  • more hip and knee replacements were carried out in women versus men, consistent with the increased incidence of osteoarthritis in women;
  • for the majority of patients undergoing hip or knee replacement over the age of 75, the replacement will last for the rest of their lives.

Commenting on the outcome data analysis presented in the report, NJR Medical Director, Mr Tim Wilton said, “The NJR is the largest and most comprehensive national audit of joint replacement surgery in the world. The data in this report enables multiple stakeholders, the most important being patients, to see the outcome performance of implants and consider patient-related factors that influence outcome.

The NJR is thankful to all joint replacement patients for giving their permission for the registry to record procedure details, which provides data for the important analysis contained in the report. This in turn enables a more informed decision-making process for future joint replacement patients and also serves to improve performance outcomes.”

The Report was launched at the British Orthopaedic Association’s Online Congress, to an international delegation of orthopaedic surgeons.
The full report and more data on clinical activity during the 2019 calendar year can be found at online at