Where Are We Now?

In their study, Paxton and colleagues created a risk calculator to help individual patients and their surgeons better understand the risks of undergoing revision surgery following total hip or knee replacement. Risk calculators are helpful additions to facilitate shared-decision making among patients and physicians as they allow patients to better understand the potential for experiencing an adverse outcome. Importantly, the current study also highlights some of the benefits that can result from the collection of patient data in clinical registries by enabling the development and implementation of this risk calculator.

Where Do We Need To Go?

Future expansion of participation in clinical registries can lead to the development of even more accurate risk calculators for a broader range of complications and clinical outcomes. Specifically, larger data sets will allow for analysis of additional potential risk factors for revision and refine the ability of risk calculators to predict any particular patient’s risk of an adverse outcome. Additionally, the incorporation of patient-reported outcome measures of pain and function into large-scale orthopaedic registries would allow for the development of risk calculators to help predict clinical outcomes. Patients would benefit from data on the likelihood of achieving pain relief and functional improvements since those are the outcomes of greatest interest to them.

How Do We Get There?

Ultimately, the goal of clinical orthopaedic registries is to improve our understanding of surgical outcomes. This paper is an important example of the tools that can be developed as a result of a strong commitment to the collection of patient followup data in a registry. As these tools improve, their use will have greater impact in benefitting patients and surgeons. The incorporation of patient-reported outcomes in orthopaedic registries holds particular promise for helping patients and surgeons understand the risks and benefits of undergoing total joint replacement.