Response to the letter “Spanish arthoplasty register” from M. Fernández Fairén, R. Llopis and A. Rodríguez

Dear Editor,

We share the view of doctors M. Fernández Fairén, R. Llopis and A. Rodríguez on the importance of prospective clinical registers of orthopedic devices.¹ As explained by the doctors, their existence allows information on the effectiveness and safety of prostheses to be collected systematically after their commercialization (post-commercialization epidemiological monitoring). A good example of this is the problems detected by the Norwegian register in implants with metal-metal friction coupling based on the analysis of surface prostheses.² We also support the idea that it is necessary to put in place a national, or at least peninsular, register, equivalent to those currently in existence in England, Sweden and Australia.³ This idea was already expressed in the Spanish Official State Gazette on 26 December 2003, whereby the Ministry of Health published a ministerial order (ORDEN SCO/3603/2003 from 18 December) regulating the creation of National Implant Registers, which included knee and hip prostheses, among others. In spite of this, to date, no such register exists and it is only the initiative of the scientific societies of some autonomous regions, with the support of their corresponding health authorities, that stimulates the creation of arthroplasty registers.⁴

The arthroplasty register of Catalonia (RACat) was founded in 2005 thanks to the initiative of the Catalan Society of Traumatology and Orthopedic Surgery, the Catalan Health Service and the Healthcare Quality and Evaluation Agency of Catalonia. Currently, over 50 centers from the public hospital network are sending information on knee and hip arthroplasties (primary and revisions) to RACat, which represents over 80% of the activity conducted in Catalonia. RACat has proven its quality and capacity for analysis of medical practice in several scientific publications^5–7 and reports⁸ by providing information on patients, prosthesis models employed, characteristics, and short-, medium- and long-term results. RACat actively publishes its results at scientific gatherings of the Catalan and Spanish Societies of Orthopedic Surgery, as well as the International Society of Arthroplasty Registers. RACat is a member of the European Arthroplasty Registry and the International Consortium of Orthopaedic Registries (ICOR).

We applaud and support the initiative of developing a Spanish arthroplasty register and extend an invitation to capitalize on the existing experience in the National Healthcare System which could contribute knowledge about the creation of an equivalent implant register, according to ICOR agreements.⁹