Evaluation of the standard procedure for the treatment of periprosthetic joint infections (PJI) in Germany - results of a survey within the EndoCert initiative

BMC Musculoskeletal Disorders

Holger Haas¹  Hermann Josef Bail²  Gabriela von Lewinski³  Bernd Kladny⁴  Peter Heppt⁵  Christina Rimke⁶  Wolfram Mittelmeier⁶  Katrin Osmanski-Zenk⁶  Andreas Enz⁶  Christoph H. Lohmann⁷ 

[1] Allgemeine Orthopädie, Unfallchirurgie und Sportmedizin, Gemeinschaftskrankenhaus St Elisabeth St Petrus St Johannes gGmbH;Klinik für Orthopädie und Unfallchirurgie, Klinikum Nürnberg Süd, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg;Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen;M&I Fachklinik Herzogenaurach;OCE Orthopädie Centrum Erlangen;Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock;Orthopädische Universitätsklinik, Otto-von-Guericke Universität Magdeburg;

关键词: Revision arthroplasty;    Two-stage revision;    Periprosthetic joint infection;    Certification;    Incident reporting;    Surveys;   

DOI  :  10.1186/s12891-020-03670-y

来源: DOAJ

【 摘 要 】

Abstract Background The periprosthetic joint infection (PJI) is a severe complication in the field of arthroplasty. Despite the rising number of primary joint replacements, no unified therapeutic standard has been established for the treatment of PJI yet. Methods A survey on the principles of treatment of PJI in Germany was conducted. A total of 515 EndoProthetikZentren (EPZ) were included, resulting in a response rate of 100%. Results For early infections 97.6% of the centers use prosthesis-preserving procedures (DAIR). A one-stage exchange was implemented by less than 50% of the centers. If implemented, this treatment entails a prior selection of patients for a successful treatment. The two-stage exchange is performed in all centers, and most centers proceed with the implantation of a cemented spacer between stages. 75% of the centers proceed with a center-based concept for the treatment of PJI. Conclusion The aim of a uniform PJI standard at the centers has not yet been fully achieved. Further improvements within the certification were initiated. The most relevant treatment options in Germany are displayed. The two-stage revision with a cemented spacer is the most widely implemented treatment. This exposition of principles could help for the further development of standardized treatment guidelines and definitions.

【 授权许可】

Unknown