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Research article
Andreas Enz
Universitätsmedizin Rostock
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9258-487X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.
Keywords
Revision arthroplasty, two-stage revision, periprosthetic joint infection, Certification, Incident reporting, Surveys
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- EndocertQuestionnairePJI.pdf
Endocert_Questionnaire_PJI.pdf, Questionnaire Title: “Principles of treatment for septic endoprosthesis revisions”, endoCert Questionnaire for Principles of treatment for septic endoprosthesis revisions for the endoprosthetic centers
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Editorial decision: Accept
On 24 Sep, 2020
Editor assigned
On 16 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 15 Sep, 2020
Version 2
Posted 11 Sep, 2020
No comments provided
Reviewer #2 agreed
On 14 Sep, 2020
Review #2 received
Received 14 Sep, 2020
Editorial decision: Minor revision
On 14 Sep, 2020
Reviewers invited
Invitations sent on 09 Sep, 2020
Reviewer #1 agreed
On 09 Sep, 2020
Review #1 received
Received 09 Sep, 2020
Editor assigned
On 08 Sep, 2020
Submission checks complete
On 07 Sep, 2020
Editor invited
On 07 Sep, 2020
No comments provided
Editorial decision: Major revision
On 05 Aug, 2020
Reviewer #3 agreed
On 03 Aug, 2020
Review #3 received
Received 03 Aug, 2020
Review #1 received
Received 21 Jul, 2020
Review #2 received
Received 21 Jul, 2020
Reviewer #2 agreed
On 02 Jul, 2020
Reviewer #1 agreed
On 30 Jun, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 23 Jun, 2020
Submission checks complete
On 22 Jun, 2020
Editor invited
On 22 Jun, 2020
First submitted
On 19 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Andreas Enz
Universitätsmedizin Rostock
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9258-487X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Editorial decision: Accept
On 24 Sep, 2020
Editor assigned
On 16 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 15 Sep, 2020
Version 2
Posted 11 Sep, 2020
No comments provided
Reviewer #2 agreed
On 14 Sep, 2020
Review #2 received
Received 14 Sep, 2020
Editorial decision: Minor revision
On 14 Sep, 2020
Reviewers invited
Invitations sent on 09 Sep, 2020
Reviewer #1 agreed
On 09 Sep, 2020
Review #1 received
Received 09 Sep, 2020
Editor assigned
On 08 Sep, 2020
Submission checks complete
On 07 Sep, 2020
Editor invited
On 07 Sep, 2020
No comments provided
Editorial decision: Major revision
On 05 Aug, 2020
Reviewer #3 agreed
On 03 Aug, 2020
Review #3 received
Received 03 Aug, 2020
Review #1 received
Received 21 Jul, 2020
Review #2 received
Received 21 Jul, 2020
Reviewer #2 agreed
On 02 Jul, 2020
Reviewer #1 agreed
On 30 Jun, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 23 Jun, 2020
Submission checks complete
On 22 Jun, 2020
Editor invited
On 22 Jun, 2020
First submitted
On 19 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
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.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- EndocertQuestionnairePJI.pdf
Endocert_Questionnaire_PJI.pdf, Questionnaire Title: “Principles of treatment for septic endoprosthesis revisions”, endoCert Questionnaire for Principles of treatment for septic endoprosthesis revisions for the endoprosthetic centers
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