Australian joint replacement registry reaches milestone in reporting

9 October 2019

Almost 1.5 million joint replacement procedures have been recorded in Australia’s joint registry since 1999, with significant changes in surgical practice meaning better quality of life for those that undergo replacement surgery now compared to when records began twenty years ago.

According to new analysis from the Australian Orthopaedic Association’s Joint Replacement Registry (AOANJRR) Annual Report, released this week, world-class surgeon performance and advancements in surgical techniques have meant that Australians who undergo joint replacement surgery have increasingly better outcomes.

Australian Orthopaedic Association (AOA) President Dr David Martin said that the data was broken into three time periods, revealing stunning insights into how far the profession has come.

“While the vast majority of patients that have had joint replacement surgery since 1999 have had excellent outcomes, the 2019 AOANJRR Annual Report reveals the results are even better for those that have had surgery after 2013.”

The biggest factors impacting the results for hip surgery are the decreased use of metal-on-metal prostheses, total hip resurfacing and exchangeable neck prostheses. A large proportion of improvements in knee replacement surgery over the same timeframe can be attributed to reduction in the use of unicompartmental knee replacement and reduced revision for loosening and pain when total knee replacement is used.

“Over the last two decades the AOANJRR has enabled Australian orthopaedic surgeons and their patients access to data that has not only transformed and improved surgical outcomes, but has led to many thousands of Australians to experience a better quality of life,” Dr Martin said.

The AOANJRR has also launched a new initiative that will collect specific patient information about their replacement surgery.

“Due to the large number of patients undergoing joint replacement operations, the AOANJRR has implemented a fully electronic data system where individual patients complete two surveys that collect general health information from the patient (including age, weight, height) as well as pain thresholds and the impact pain has on activities performed prior to and following surgery.

“The collection of patient data will complement replacement device performance data and is initially being rolled out in 45 hospitals prior to full implementation across all Australian hospitals by 2022,” Dr Martin said.

As in previous years, hip, knee and shoulder devices that have higher than anticipated levels of revision have been identified.

“This year, 10 new prostheses – seven total conventional hip combinations, one acetabular prosthesis, and two total knee combinations – have been identified as having higher than anticipated rates of revision and have been forwarded to the Therapeutic Goods Administration for further review.

“This is particularly pleasing and confirms decisions made by the Federal Government a number of years ago to increase clinical evidence requirements before new joint replacement devices are approved – a decision made based on AOANJRR data.

“Since its inception in 1999, the AOANJRR has had a strong relationship with the Federal Government. Thanks to this relationship, Australia is at the forefront of identifying how best to achieve optimum results in orthopaedic surgery that contribute to restoring a pain-free, active and healthy lifestyle for hundreds of thousands of Australians, in turn saving many millions of dollars in health and welfare expenditure,” said Dr Martin.

The 20th Annual AOANJRR Annual Report can be downloaded at

Appendix 1: Total hip, knee and shoulder replacement procedures in 2018