Numbers of hip, knee and shoulder prostheses, as well as the amount of economical resources dedicated to this surgery are constantly growing in Italy. There are many types of prosthesis and techniques, but basically no control on their efficacy and effectiveness is applied. The Register represents therefore a crucial Evidence-Based Medicine tool. Taking into consideration the wide range of implants and techniques, and the very low rate of failure (approx. 10% at fifteen years follow-up), differences in performance can be significantly observed only if many centers (ideally all the national ones) adhere to tracking activity.
The Register of Orthopaedic Prosthetic Implants (R.I.P.O) was initiated at the Istituto Ortopedico Rizzoli in 1990. All the Orthopaedic Units in the Region Emilia-Romagna (approx. 4 milions inhabitants) joined to it starting from January 2000. It consists of a data-base, where clinical conditions of patients, surgical procedure, type (batch and code) and fixation of implant are recorded, either for primary and revision hip and knee and shoulder prosthesis surgery. The endpoint is the revision of at least one component. At 31st December 2014 the Register collected data of nearly 88,000 total hip-replacements, 34,000 hemiarthoplasties, 14,000 revisions, 70,000 knee replacements and 5,000 knee revisions as well as 3,500 shoulder prostheses. More than 100 different types of commercial hip prostheses and 70 knee prostheses are followed to evaluate their outcomes. Risk factor associated to patient or to prostheses are statistically evaluated. The Register is partially founded by Assessorato alla Sanità , Emilia-Romagna. The structure of the database satisfies typical requirements of multi centric databases. Surgeons are requested to fill in some information and attach stick label of single components of the prosthesis (for this purpose a registration form is available). Specific procedures assure the quality of the data-entry process that is centrally carried out.