人工关节置换是治疗终末期骨关节疾病的主要方法。随着我国人口老龄化加剧、骨关节炎发病率增加，我国关节置换手术数量呈增多趋势。国家人工关节耗材集采政策实施后，国产假体的临床使用比例显著提升，但因国内尚未开展全国统一的人工关节队列研究，缺乏真实数据来评价相关假体质量并早期识别术后翻修风险，难以满足提升医疗质量、加强医保监管与促进产业升级的需求。根据国际上多项已开展的人工关节置换队列研究，建立国家统一的人工关节登记系统可早期识别翻修风险、降低医疗成本、提升医疗质量。我国现已建成全国统一医保信息平台，医保数据覆盖广、时序长、样本量大并与支付政策深度联动，为开展人工关节置换队列研究提供了重要基础。本文系统梳理国内外人工关节置换队列研究现状，分析基于医保全流程数据构建中国人工关节置换队列的可行性、价值与局限性，并从统一数据标准、完善指标体系、优化随访机制等方面提出改进建议，为提升临床诊疗质量、完善高值耗材监管、推动国产医疗器械产业发展提供参考。

Joint arthroplasty is the main treatment for end-stage joint disease. China’s population is aging and osteoarthritis is becoming more common. As a result, the number of arthroplasty procedures continues to grow. National volume-based procurement has substantially increased the use of domestic implants. China, however, has not yet conducted a unified nationwide arthroplasty cohort study. It therefore lacks the real-world data needed to assess implant quality and to detect revision risk early. This shortfall makes it harder to improve care, strengthen insurance oversight, and advance the domestic device industry. Experience from cohort studies in other countries shows that a unified national arthroplasty registry can identify revision risk early, lower medical costs, and improve quality of care. China has now completed a unified national medical insurance platform. Its data cover nearly the entire population, span long periods, reach a large scale, and link directly to payment policy. Together these features provide a strong basis for arthroplasty cohort research. This article reviewed the current state of arthroplasty cohort studies in China and abroad. It analyzed the feasibility, value, and limitations of building a Chinese arthroplasty cohort from full-process medical insurance data. It then offered recommendations for standardizing data, refining outcome measures, and improving follow-up. The aim is to inform better clinical care, stronger regulation of high-value implants, and the growth of China’s domestic medical device industry.