I'm a Surgeon
Welcome to the National Ligament Registry: designed by surgeons for the benefit of patients.
The registry collects information on ACL reconstruction but will be expanded later to record outcome of other ligament procedures.
How was it started?
The NLR was initiated with the agreement of BASK, BOSTA and the BOA and has been developed by a core group of surgeons, with the aim of producing a registry where the data was owned by the surgeons who input it i.e. independent of any government or organisation.
Having control over the data will ensure that it will only be used in constructive ways to benefit both surgeons and patients. This has been achieved with the excellent cooperation of the orthopaedic industry who, along with BASK, have provided the early ongoing funding.
How is the NLR run?
BASK is the "controlling organisation" for the NLR and the "NLR Steering Group" is a sub-committee of the BASK Executive. The Chairman is appointed by the BASK executive and members of the steering group will be appointed by open application. The research arm of the NLR will be the Chairman of the BASK Research Committee and the committee members will be selected through the BASK Executive, via open application.
What are the aims?
The requirements for and potential benefits of a registry - to patients, surgeons, industry and the NHS - have previously been written about and published. The aims of the NLR will be to ensure a high quality of surgical performance (accepting the essential role of rehabilitation) when undertaking ACL reconstruction in the UK.
The outcome and performance of the differing types of graft and fixation devices can be compared, and this is an ideal environment for the controlled introduction of new techniques and products.
Who is it for?
All knee surgeons who undertake ACL reconstruction are invited to support this initiative and enter the relevant data for all their patients. The registry will allow a central point for the collection and comparison of each surgeon"s outcome scores, simple interpretation and representation of these scores and comparison to a national "average". Involvement is likely to eventually play a key role in appraisal and revalidation for knee ligament surgeons.
What data is being collected?
Data to be collected is as follows:
Pre-operation: 4 subsets need to be collected:
- Patient demographic data (incl. Email, contact details, NHS number etc.)
- ACL injury data
- Clinical scores:
- KOOS score
- Tegner activity score
- IKDC subjective score
- EQ5D general health score
- Surgical operative data
Post-operative (1 year / 2 years / 5 years)
- Details of any revision of the reconstruction (including date, indication and cause of failure if known).
- Any other related (not revision) surgery - date, indication, operation.
- Clinical scores:
- KOOS score
- Tegner activity score
- IKDC subjective score
- EQ5D general health score
How will it work with the Scandinavian registries?
The Scandinavian Registries have been established for several years and have provided the framework for the NLR. The UK NLR is extremely grateful for their cooperation. However, it is important to tackle the two major issues for registries - cost and declining follow up rates.
Hopefully the UK registry is designed in such a way that there will be a high follow up rate of outcomes, and it will be possible to compare results to the other registries.