Operations included in the National Joint Registry (NJR) Quick links, go to: Hips > Knees > Ankles > Elbows > Shoulders > Trauma >
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1 Operations included in the National Joint Registry (NJR) Quick links, go to: Hips > Knees > Ankles > Elbows > Shoulders > Trauma > Version 5 December
2 Version control Version number Date Amendments 1 01/03/2003 New document 2 01/04/2004 Re-operation other than revisions added 3 01/12/2007 Re-operation other than revisions removed 3 01/04/2010 Inclusion of ankle procedure 4 01/04/2012 Inclusion of elbow and shoulder procedures 5 01/12/2013 Knee revision. Patella resurfacing procedures following a TKR clarified as a revision procedure and must be submitted on a K2 form. Hip revision: Posterior Lip Augment Device (PLAD) procedures following a primary clarified as a revision procedure and must be submitted on a H2 form. Version 5 December
3 HIP OPERATIONS s Primary total hip arthroplasty Total joint replacement - i.e. replacement of the femoral head with a stemmed femoral prosthesis and the insertion of an acetabular cup (with cement / without cement). Primary total hip resurfacing Single stage revision of - total hip - hip resurfacing First stage of two-stage revision of - total hip - hip resurfacing Hip resurfacing resurfacing of the femoral head with surface replacement femoral prosthesis and insertion of a resurfacing cup. The implantation of a PLAD device should be recorded as a single stage revision irrespective of whether any implants have been replaced The removal of implants as the first stage of a two-stage Normally carried out because of infection. Second stage of two-stage revision of - total hip - hip resurfacing Excision arthroplasty (Girdlestone) The implantation of new prostheses as a second procedure, following the removal of original implants in a separate (first) Complete arthrodesis of the hip following failure of a prosthesis. Hip operations excluded from the NJR Hemiarthroplasty Bipolar Arthroplasty Replacement of only the femoral head following fracture of the femoral neck. Another form of hemiarthroplasty. Version 5 December
4 KNEE OPERATIONS s Primary total knee arthroplasty Primary unicondylar knee arthroplasty Primary patello-femoral arthroplasty Single stage revision of First stage of two stage revision of Second stage of two stage revision of Conversion to Arthrodesis Amputation following failure of Total knee arthroplasty - i.e. replacement of both tibial and both femoral condyles with or without resurfacing of the patella (with cement / without cement). Unicondylar arthroplasty - i.e. replacement of one tibial condyl and one femoral condyl with or without resurfacing of the patella. Patello-femoral replacement i.e. where the femoral condyles are replaced and the patella is resurfaced. Note: Where no implants are removed and a patella button is implanted this would be recorded as a single stage revision. Removal of implants as first procedure in a two-procedure revision of any type of knee prosthesis. Normally carried out because of infection. Second procedure to implant new implants following previous procedure to remove original ones. Complete fusion of the knee joint following failure of any type of total joint replacement. Self-explanatory. Knee operations excluded from the NJR Version 5 December
5 ANKLE OPERATIONS s Primary total ankle arthroplasty Single Stage revision of First stage of two-stage revision of Second stage of two-stage revision of Conversion to Arthrodesis Amputation following failure of Total ankle arthroplasty - i.e. replacement using both tibial and talar components (with cement / without cement). Removal of implants as first procedure in a two-procedure revision of any type of ankle prosthesis. Normally carried out because of infection. Second procedure to implant new implants following previous procedure to remove original ones. Complete fusion of the ankle joint following failure of a total joint replacement. May also include fusion of the subtalar joint and sometimes more extensive fusion involving the joints of the midfoot. Self-explanatory. Ankle operations excluded from the NJR Version 5 December
6 ELBOW OPERATIONS s Primary total prosthetic replacement Primary Radial Head Replacement Total elbow arthroplasty - i.e. replacement using both humeral and ulnar components (with cement / without cement). Radial components may or may not be used The radial head is replaced. Radial head and stem implants Lateral Resurfacing Single Stage revision of First stage of two-stage revision of Second stage of two-stage revision of Conversion to Arthrodesis Excision Arthroplasty Amputation following failure of Humeral and ulnar resurfacing. Resurfacing of the humeral capitulum and ulnar. Resurfacing components are used. Removal of implants as first procedure in a two-procedure revision of any type of elbow prosthesis. Normally carried out because of infection. Second procedure to implant new implants following previous procedure to remove original ones. Complete fusion of the elbow joint following failure of a primary replacement. Complete arthrodesis of the elbow following failure of a prosthesis. Amputation above the elbow joint Elbow operations excluded from the NJR Version 5 December
7 SHOULDER OPERATIONS s Primary total shoulder arthroplasty Primary resurfacing arthroplasty of joint Primary shoulder hemi-arthroplasty Single Stage revision of First stage of two-stage revision of Second stage of two-stage revision of Conversion to Arthrodesis Amputation following failure of Total shoulder arthroplasty - i.e. replacement using both humeral and glenoid components (with cement / without cement). This may be a standard or reverse polarity shoulder construction. Shoulder resurfacing. The humeral head is resurfaced and used in conjunction with a glenoid resurfacing component A shoulder hemi-arthroplasty is the replacement of the humeral head only either using a humeral resurfacing component or humeral stem and head Removal of implants as first procedure in a two-procedure revision of any type of shoulder prosthesis. Normally carried out because of infection. Second procedure to implant new implants following previous procedure to remove original ones. Complete fusion of the shoulder joint following failure of a total joint replacement. Self-explanatory. Shoulder operations excluded from the NJR Version 5 December
8 Trauma Surgery and the NJR All total hip, total knee or total ankle replacements undertaken as a result of traumatic injury are within the scope of the NJR. This is the case whether or not such a procedure is performed immediately after the injury or as a result of the failure of more conservative treatments aimed at restoring normal joint function. Version 5 December
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Institute for Bone, Joint Replacement, Orthopaedics Spine and Sports Medicine
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For Commercial products, please refer to the following policy: Preauthorization via Web-Based Tool for Procedures
Medical Coverage Policy Total Joint Arthroplasty Hip and Knee EFFECTIVE DATE: 08/01/2017 POLICY LAST UPDATED: 06/06/2017 OVERVIEW Joint replacement surgery, also known as arthroplasty, has proved to be