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

Authors: Christina Rimke; Andreas Enz; Hermann Josef Bail; Peter Heppt; Bernd Kladny; Gabriela von Lewinski; Christoph H. Lohmann; +3 Authors

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

Abstract

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 wasconducted. 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.

Keywords

Reoperation, Certification, Prosthesis-Related Infections, Diseases of the musculoskeletal system, Incident reporting, Surveys, Anti-Bacterial Agents, Revision arthroplasty, RC925-935, Debridement, Germany, Two-stage revision ; Anti-Bacterial Agents/therapeutic use [MeSH] ; Surveys ; Humans [MeSH] ; Retrospective Studies [MeSH] ; Revision arthroplasty ; Certification ; Reoperation [MeSH] ; Germany/epidemiology [MeSH] ; Periprosthetic joint infection ; Incident reporting ; Prosthesis-Related Infections/epidemiology [MeSH] ; Prosthesis-Related Infections/therapy [MeSH] ; Prosthesis-Related Infections/diagnosis [MeSH] ; Debridement [MeSH] ; Orthopedics and biomechanics ; Research Article, Two-stage revision, Periprosthetic joint infection, Humans, Research Article, Retrospective Studies

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    selected citations
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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    15
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
15
Top 10%
Average
Top 10%
Green
gold