Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Straße 142, 18059, Rostock, Germany.
Klinik für Orthopädie und Unfallchirurgie, Klinikum Nürnberg Süd, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Breslauer Straße 201, 90471, Nuremberg, Germany.
BMC Musculoskelet Disord. 2020 Oct 19;21(1):694. doi: 10.1186/s12891-020-03670-y.
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.
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%.
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.
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.
人工关节假体周围感染（PJI）是关节置换领域的一种严重并发症。尽管初次关节置换的数量不断增加，但对于 PJI 的治疗尚未建立统一的治疗标准。
对德国 PJI 治疗原则进行了一项调查。共纳入 515 个 EndoProthetikZentren（EPZ），应答率为 100%。
对于早期感染，97.6%的中心采用保留假体的方法（DAIR）。不到 50%的中心采用一期置换。如果实施，这种治疗需要对患者进行选择以获得成功的治疗。所有中心均进行二期置换，且大多数中心在两期之间植入水泥固定间隔器。75%的中心采用中心为基础的概念治疗 PJI。
各中心尚未完全实现 PJI 标准的统一。认证内进一步的改进已经启动。展示了德国最相关的治疗选择。带水泥固定间隔器的二期翻修是应用最广泛的治疗方法。这些原则的阐述有助于进一步制定标准化的治疗指南和定义。
