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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:

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: 
Telephone: 0845 345 9991  Email:

Definition of Joint Revision Replacement



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.


Forthcoming Events:

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 involved with the NJR process in your hospitals are welcome - including, data entry, pre-assessment, theatre, clinical governance staff, surgeons, managers and nurses. The NJR is holding the next of these regional events this Autumn, the first one is being held at Somerset Cricket Club in Taunton, on Tuesday 9th October and the second one is being held at Malone House in Belfast, Northern Ireland, on Thursday 8th November. 

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.



Staying in touch

  Telephone on 0845 345 9991 or email: 
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