Evidence based musculo-skeletal treatment.

The importance of quality assurance for evaluating the treatment of musculo-skeletal disorders became obvious in the 70-ies when the new “joint implants” were rapidly introduced and the operations widely spread. The Ž rst multicenter register with standardized follow-up were started in Switzerland by Maurice Müller, on hip arthroplasty, and in Sweden Göran Bauer on knee arthroplasty in the mid 70-ies www.ort.lu.se/knee, www.jru.orthop.gu.se. It took almost 25 years before central documentation in joint registries were regarded as feasible and accepted among orthopedic surgeons. It is now becoming imperative that orthopedic surgeons have evidence-based information on techniques, materials and risk factors on joint implants in non-selected clinics in a general population. At the moment implant registers have been developed in a number of countries like United Kingdom, Australia, New Zealand, Norway, Denmark, Finland and Canada and it is on its way in several other countries. A joint register is now initiated by the National Institute of Health in Italy. A consensus has however still not been reached in many major countries on mandatory and even voluntary participation. Evidence based musculo-skeletal treatment