International Comparison and Standardization of Implant Outlier Detection Methods in Total Knee Arthroplasty Registries

Joint replacement registries are essential for ensuring the safety and effectiveness of medical implants used in knee replacement surgery. By tracking implant outcomes over time, these registries help identify designs that fail more often than expected so they can be reviewed or removed from clinical use. However, different countries currently use different statistical methods to identify poorly performing, or “outlier,” implants. This lack of consistency limits international comparison and shared learning.
This project is an international research collaboration between the University of Waterloo and Leiden University Medical Center in the Netherlands. The research will compare how national joint replacement registries, including those in Canada and the Netherlands, analyze and monitor implant performance. Working with experts from the Dutch Arthroplasty Register, the project will examine how different analytical choices, such as risk adjustment and comparison strategies, affect which implants are flagged as potential concerns.
The objective is to develop a standardized approach to implant performance monitoring that could be applied across countries. Improving consistency in registry methods will support better decision-making by clinicians and regulators and ultimately enhance patient safety worldwide.

Faculty Supervisor:

Elise Laende

Student:

Partner:

Leiden University Medical Centre

Discipline:

Engineering

Sector:

Education

University:

University of Waterloo

Program: