Type of product
Primary research project

Start date
April 2004

Aim and objectives

Hip and knee arthroplasties are effective surgical procedures that improve the patients' quality of life, increase their functional abilities, and reduce pain. However, the existing technological change and the lack of long term information about many of the available prostheses models may imply introducing in the market models with substandard results.

Most of the currently available registers were made after the initiative of scientific societies, although funding is usually public. Despite the objectives of each of the registers were differently worded, they all could be summarised as: assessment and diffusion of the results aimed at helping improve the health care quality. The Swedish hip and knee registers were the first to be implemented in the 70s, and since then, other countries have developed their own registers (see table).

The Catalan Arthroplasty Register (RACat) was created after a joint initiative by the Catalan Society of Orthopaedic Surgery (SCCOT), the Catalan Health Service–CatSalut and the Catalan Agency for Health Technology Assessment and Research (CAHTA), the latter being in charge of managing the project.

The objectives of RACat are:

• To describe the characteristics of the operated population, of the interventions, and of the prostheses used.
• To assess the prostheses results in terms of survival.
• Periodically release information on the results of the arthroplasties interventions to health care professionals and managers.

The aim of RACat is to contribute to the improvement of health care quality, by offering information on the results of arthroplasty interventions.

Organizational aspects of the project and funding
The ruling organs of the RACat are the Steering Committee and the Advisory Committee. The Steering Committee is formed by a representative of each organisation (the Chairman of SCCOT, the Deputy Director of the CatSalut, and the Director of the CAHTA), and its function is to guarantee the proper use of the RACat data and the obtained results, following the current Good Scientific Practices regulations. The Advisory Committee is formed by 8 representatives of SCCOT, 5 representatives of the CatSalut and 3 representatives of the CAHTA, and its functions are to oversee and give advice during the whole process of development and analysis of the RACat.

To help each centre carry out the project, the RACat has a Technical Group formed by a health care professional and a member of the hospital information systems staff. These technicians make the Plenary Council, which is the forum where the RACat results are presented, and the problems presented by each centre are solved.

Funding: CAHTA and CatSalut

Description of the technology
This project counts with the participation of 51 centres of the Catalan Public Utilisation Hospital Network (XHUP). It is expected to invite private centres also to participate in it. Centres send their information to RACat through the CatSalut Applications Portal. This can be made either entering the data directly into the application or sending a file with the data in a previously established format. The information that centres should send RACat consists of the patients' identifying data, and the health care episode and the prosthesis information (manufacturer's name, reference number and batch number of each part of the prosthesis).

Periodically, the CAHTA will review the quality of the information sent to RACat, and a report is created with all the errors, to be sent to all centres. Apart from the errors report, each centre receives a report with an analysis of the data sent at that time.

To collect the information related to the surgical procedure, a surgical sheet was designed by RACat in collaboration with SCCOT. This sheet is expected to be implemented by the participating centres once the current information system is considered to be working satisfactorily.

Diffusion of the RACat results is made through the reports sent to each centre, the publication of the newsletter RACat Informatiu, and the presentations made in the Plenary Council. On the other hand, the global RACat results are to be published in a web site, and also in an annual report, once the quality of the available data is deemed adequate.

Contact persons 
Vicky Serra-Sutton (vserra@aatrm.catsalut.cat )
Olga Martínez (omartinez@aatrm.catsalut.cat )
Mireia Espallargues (mespallargues@aatrm.catsalut.cat )

Table. Identificative data of the arthroplasty registers

Country	Name of the register	Created in	Type of prosthesis
Europe
Europe	European Arthroplasty Register	2002	Hip and knee
Scotland	Scottish Arthroplasty Project	1999	Hip and knee, ankle, finger & toe, shoulder and wrist
England and Wales	National Joint Registry for England and Wales	2003	Hip and knee
Denmark	Danish Hip Arthroplasty Register	1995	Hip
	Danish Knee Arthroplasty Register	1997	Knee
Finland	Finnish Arthroplasty Register	1980	Hip and knee, elbow, ankle, finger, shoulder and other
Emilia-Romagna (Italy)	Register of Orthopedic Prosthetic Implantology	2000	Hip and knee
Norway	National Arthroplasty Register	1987	Hip and knee, elbow, ankle, finger & toe, shoulder and wrist
Romania	Romanian Arthroplasty Register	2001	Hip, knee, elbow and shoulder
Sweden	Swedish National Hip Arthroplasty Register	1979	Collaboration between both registers was established in 2002
	Swedish National Knee Arthroplasty Register	1975
Other countries
Australia	National Joint Replacement Registry	1999	Hip and knee
Canada	Canadian Joint Replacement Registry	2002	Hip and knee
New Zealand	National Joint Register	1998	Hip, knee, shoulder, elbow and ankle