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Welcome from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man


Hip, knee, ankle, elbow and shoulder joint replacements are common and highly successful operations that bring many patients relief from pain and improved mobility. Thousands of these joint replacement operations take place in the UK every year.

The National Joint Registry (NJR) was set up by the Department of Health and Welsh Government in 2002 to collect information on all hip, knee, ankle, elbow and shoulder replacement operations, to monitor the performance of joint replacement implants and the effectiveness of different types of surgery, improving clinical standards and benefiting patients, clinicians and the orthopaedic sector as a whole. Northern Ireland joined in 2013 and the Isle of Man in 2015.

Latest NJR News:

NJR is recruiting for a new Deputy Director of Operations

This is a key position. You will be at the heart of NJR management, overseeing all aspects of NJR business, contracts and finance, managing significant projects and work streams to ensure the NJR fulfils its strategic objectives, and providing support in a deputising role to the Director of Operations.  If you are seeking a new and exciting challenge to take a lead management role with an internationally recognised clinical register and have the relevant experience and skills we would love to hear from you.

Please click the link for further details: Job Description - Deputy Director of Operations, NJR Management Team

Closing date is 3rd February 2019


NJR Statement regarding metal-on metal implants
The majority of patients with metal-on-metal hip replacements do very well but because of the negative side-effects that have been experienced by a small number of patients, careful follow-up for all has been important. In accordance with the patient-safety driven mission of the National Joint Registry (NJR), patients with any metal-on-metal implant who have consented to their data being registered, have been identified and recalled for monitoring. Without such a comprehensive registry, working in the interests of patients, hospitals would be unable to identify which patients had specific implants.
The NJR enables the mandatory collection of data on hip, knee, ankle, elbow and shoulder joint replacements and its organisational structure encompasses various specialist groups, such as the implant scrutiny committee, and surgeon performance committee, which closely monitor  the performance of implants, hospitals and surgeons. Where there are performance issues, these can be quickly processed and addressed in line with NJR procedures and in the case of implants, referred for consideration by the Regulator [MHRA] and expert representatives, such as those on the Orthopaedic Expert Advisory Group, who proposed the alert and recommendations made regarding metal-on-metal hip implants by the MHRA in 2010. 
NJR therefore advises any patients who have had metal-on-metal implants that should they be concerned about symptoms that they consider may be related to their implants, they should consult their Surgeon or GP, who can discuss these with them.  

Definition of Revision Joint Replacement

Bess Executive and NJR Implant Scrutiny Committee



A joint statement from the NJR Implant Scrutiny Committee and the Executive Council of the British Elbow and Shoulder Society (BESS) on the definition of revision joint replacement.

The NJR have recently updated the MDS forms for primary and revision shoulder and elbow replacements. This was after input and collaboration with BESS Counciland the BESS Arthroplasty Working Groups. During that process it became clear that revision surgery means any further operation on a patient's joint replacement to remove, change or reduce any of the components. It has been suggested by some stakeholders that some shoulder arthroplasty procedures should be considered a ‘conversion’ rather than a ‘revision’.

The failure of a replaced shoulder or elbow joint is usually multifactorial and can be a complex interaction of patient, implant and surgical factors. Conversion implies that the implant construct is blameless in any failure mechanism and this can be misleading. Therefore in relation to shoulder and elbow replacement surgery, BESS and the NJR Implant Scrutiny Group will continue to consider a revision as any further operation to remove, change, add or reduce any of the components, and such procedures will be recorded thus on the new MDS forms.


Measuring NJR Compliance – dealing with outsourced cases

NJR Compliance measures the proportion of cases reported to NJR, compared to cases reported to other sources of comparative data, such as HES.  This provides a basis for NJR to report on the completeness of its data.  NJR Compliance is also used as part of the Best Practice Tariff calculation for hip and knee surgery.  
Where cases are outsourced to another provider, but reported through HES by the originally commissioned Trust, some procedures may be reported as ‘missing’ from the NJR.  This is because the corresponding NJR record will have been submitted by the outsourced provider and the HES record does not accurately record the identity of that outsourced provider. 
To prevent such cases being reported as ‘missing’ from the NJR, it is essential to complete the SITETRET field in HES with the NACS code (formerly the ODS code) of the organisation to which the procedure has been outsourced.   Completion of this field enables NJR to exclude the record from the data it expects to be recorded for the Trust, whilst also enabling NJR to ensure that the corresponding record has been submitted by the outsourced provider.
Any queries should be directed to the NJR Service Desk using the following contact details: Tel 0845 345 9991  or


The National Joint Registry is pleased to invite all staff in both the NHS and independent sector to attend the NJR programme of free-to-attend regional events.

All staff in both the NHS and the independent sector who are involved in the collection of data for NJR or any aspect of joint surgery are invited to attend these events including, clinicians, data entry, pre-assessment, theatre, clinical governance staff, surgeons, managers and nurses.

Our regional events this Autumn 2018 have been held in October at Somerset Cricket Club in Taunton and in November at Malone House in Belfast, Northern Ireland. Our 2019 events will be in May and October, details will shortly follow and be posted here and on the events section of this website.



NJR publish Public and Patient Guides to joint replacement surgery ►

hip replacement knee replacement ankle elbow joint replacement statistics data
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