The Register of Orthopaedic Prosthetic Implants (RIPO) was initiated at the Rizzoli Orthopaedic Institute in 1990.
All the Orthopaedic Units in the Emilia-Romagna region (more than 4 million inhabitants) joined it starting from January 2000. It consists of a data-base, where clinical conditions of patients, surgical procedure, type and fixation of implant are recorded, for either primary or revision hip and knee prosthesis surgery. The failure endpoint definition in the register is revision.
By December 31st, 2014 the Register collected data of nearly 88,000 total hip-replacements, 34,000 hemiarthoplasties, 14,000 revisions and 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 60 knee prostheses are followed to evaluate their outcomes. The Register is co-funded by Health Department of the Emilia-Romagna region.
The structure of the database satisfies typical requirements of multi-centric databases. Surgeons are requested to fill in some information and attach stick labels of the single components of the prosthesis (for this purpose a registration form is available). Specific procedures assure the quality of the data-entry process. Once a year a single report of activity is prepared for each of the 60 orthopaedic units. Some of them are on the RIPO web site and can be compared to the activity in the whole Emilia-Romagna region.
The register co-operates with the orthopedic doctors to define observational studies and evaluate joint prostheses or innovative techniques. Moreover, the Register is able to identify in real time the patients on whom a certain joint prosthesis was implanted. Those at risk of precocious failure on the basis of recalling made by the Health Ministry or manufacturers can thus be identified. At this point orthopaedic surgeons may be enabled to promptly adopt all the necessary measures to defend the health of the patient.
RIPO co-operates with the Health Department (Emilia-Romagna Region) for the management of cost-efficacy analysis of hip prostheses, and can supply services for post-marketing surveillance monitoring the clinical performances of both a single device and a group of devices implanted in the Emilia-Romagna region.
Technological partner for computer management of the database is CINECA of Bologna.