In August 2010, an implant used for hip replacements by DePuy (ASR) was recalled globally due to poor patient outcomes and adverse events. In Ireland, an estimated 3,500 people had received this implant following hip replacement surgery. As there was no national implant register in place at that time, hospitals had to undertake a lengthy review of all theatre diaries and patient charts to identify patients who may have received these implants.
This global recall highlighted the need in Ireland to have a national register for such implants. In 2014, work commenced on the development of the Irish National Orthopaedic Register (INOR) under the governance of NOCA. Currently, INOR is being rolled out across all public hospitals providing elective joint replacement surgery, with scoping underway for the inclusion of private hospitals also.
The main objective of INOR is to monitor the safety of implants and support hospitals should an implant recall occur. Most hospitals (apart from INOR hospitals) retain detailed records for hip and knee surgery on paper, and prior to the project, there was no national mechanism for the management of data on joint replacement surgery in Ireland.
INOR’s secondary objective is to define the epidemiology of joint replacement surgery in Ireland, provide timely information on the outcomes of joint replacements and identify risk factors for a poor outcome and to assist in the assessment and education of clinicians.