General Information

Beginning in 2019, hospitals with service agreements in the Canton of Zurich have been tracking patients’ subjective outcome from hip and knee replacements, also known as PROMs (patient reported outcome measures). Officially, the quality programme for hip and knee replacements started in 2024. In this quality programme, process, indication and outcome quality are analyzed on the basis of comparisons between hospitals and are discussed with the clinics annually. The Amt für Gesundheit coordinates the annual quality analyses and quality circles in close cooperation with the SIRIS foundation and Swiss Orthopaedics. Beginning in 2026, Swiss Orthopaedics will become an official partner for all orthopaedic quality programmes and will aid in creating its content.

As a mandatory national prosthesis registry exists for knee and hip replacements, the Amt für Gesundheit has been matching the data from the register with routine data on a case basis since 2024. Through the matching, errors or missing cases can be identified and revised by the hospitals.

For the quality programme of hip and knee surgery primary and secondary surgeons for knee and hip replacements are documented and reported.

Expert Group

The expert group consists of representatives of the SIRIS foundation, Swiss Orthopaedics and the Amt für Gesundheit and will be listed soon.

Updates

• Preview 2026: After focusing on the (in-)completeness of the register for two years and after the hospitals added the missing cases in the spring of 2026, the focus will now be on the rate of revision of hip and knee replacements during the quality circle in the fall of 2026. Furthermore, it will be analyzed whether the subsequent addition of cases will lead to a different rate of revision in certain hospitals. Hospitals outside of the canton of Zurich will be matched for the first time in 2026. Here too, a retrospective collection of the missing cases is expected in 2027.

• Update 2025: The case-by-case matching of routine and registry data have revealed partial gaps in the SIRIS register and missing cases from hospitals (up to 25% of cases missing from hospitals). Consequently, the matched data is intended to be used in the future to ensure the completeness of register entries. All hospitals in Zurich are required to retrospectively collect their missing cases from the past 4 years. Only then can the validity of the annual SIRIS reports be guaranteed. In addition to the completeness of the register and insights into the revision rates, SIRIS compared PROMs (patient reported outcome measures) to the revision rates and reported them for each hospital. Furthermore, Prof. Dr. med. Hannes Rüdiger illustrated which measures led to lower revision rates in the Schulthess Clinic in an input presentation.

• Update 2024: The completeness of the register, process indicators and revision rates were the main focus of the quality analyses.