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Rupp, Markus ; Kerschbaum, Maximilian ; Freigang, Viola ; Bärtl, Susanne ; Baumann, Florian ; Trampuz, Andrej ; Alt, Volker

PJI-TNM als neues Klassifikationssystem für Endoprotheseninfektionen

Rupp, Markus, Kerschbaum, Maximilian , Freigang, Viola, Bärtl, Susanne, Baumann, Florian, Trampuz, Andrej und Alt, Volker (2021) PJI-TNM als neues Klassifikationssystem für Endoprotheseninfektionen. Orthopäde 50, S. 198-206.

Veröffentlichungsdatum dieses Volltextes: 18 Mrz 2021 06:14
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.45197


Zusammenfassung

Background Current classifications for periprosthetic joint infections (PJIs) often lack a detailed description of the overall underlying situation of a patient. The PJI-TNM classification uses the principles of the TNM classification from oncology for the description of critical parameters in PJIs: affected joint, type of implant and implant stability, soft tissue conditions, maturity of biofilm ...

Background Current classifications for periprosthetic joint infections (PJIs) often lack a detailed description of the overall underlying situation of a patient. The PJI-TNM classification uses the principles of the TNM classification from oncology for the description of critical parameters in PJIs: affected joint, type of implant and implant stability, soft tissue conditions, maturity of biofilm formation, causative microorganism, comorbidities of the patient and recurrence of infection. The aim of the current work is to evaluate the feasibility of this new PJI-TNM classification in clinical practice. Methods The PJI-TNM classification was used in 20 patients with hip, knee and shoulder PJIs. Based on a retrospective chart review, the respective parameters T (tissue and implants), N (non-eukaryotic cells and fungi), M (morbidity) and r (reinfection) were classified for each case. Results All 20 cases (12 male, 8 female, average age 72.2 (40-88 years)) with 13 hip, 6 knee and 1 shoulder PJIs were to be classified with the new TNM-PJI classification system. There was a considerable heterogeneity among the cases: 12 protheses were fixed (T0), 6 were loosened (T1) and 2 were associated with a soft tissue defect (T2). Biofilm formation was considered immature in 7 cases (N0). Out of the PJIs, 13 were considered to be associated with mature biofilm formation. Out of the patients, 9 were systemically not or only mildly compromised (M0), 7 patients moderately (M1) and 3 patients (M2) severely compromised. One patient refused surgical treatment (M3a). Recurrent infections (r) were diagnosed in three cases. Conclusions The principles of the TNM classification from oncology can also be used for the classification of PJIs. Despite the limited number of cases in this study, a considerable heterogeneity of the evaluated PJIs is shown, which is a phenomenon that is also known from clinical practice. This heterogeneity can be adequately addressed by this new classification, which might be beneficial in decision-making in the future.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftOrthopäde
Verlag:Springer
Ort der Veröffentlichung:NEW YORK
Band:50
Seitenbereich:S. 198-206
Datum2021
InstitutionenMedizin > Lehrstuhl für Unfallchirurgie
Identifikationsnummer
WertTyp
10.1007/s00132-020-03933-5DOI
Stichwörter / KeywordsKNEE ARTHROPLASTY; HIP; Biofilms; Arthroplasty; Periprosthetic joint infections; Retrospective studies; TNM classification
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenZum Teil
URN der UB Regensburgurn:nbn:de:bvb:355-epub-451978
Dokumenten-ID45197

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