Abstract:
INTRODUCTION:The German national nosocomial infections surveillance system (KISS) has been collecting surveillance data from hip and knee prosthesis operations since 1997. The purpose of this article is to investigate whether surveillance and feedback of surgical site infection (SSI) information to the physicians and nurses of participating hospitals lead to reduced SSI rates or not. MATERIALS AND METHODS:Only information from hospitals previously participating for at least 3 years was used for the analysis. Monthly SSI rates were pooled over the 36-month period, beginning in each clinic's case with its first month of participation, the rates then being compared for 12-month periods. Relative risks were calculated for comparison of the SSI rates in the first and third years of participation. A multiple logistic regression analysis with stepwise variable selection was performed to identify significant risk factors, including the year of surveillance after starting surveillance activities. RESULTS:The overall SSI rates were 1.4% for hip prosthesis and 1.0% for knee prosthesis. Fourteen clinics participated in KISS for at least 3 years continuously with HIP prostheses and 21 with knee prostheses. It was possible to include a total of 15,457 hip and 9,011 knee procedures for this analysis. A comparison of data from the first and the third years show a significant SSI reduction with hip procedures, with a relative risk of 0.54 (CI95 0.38-0.77), and a trend towards reduced SSI rates for knee procedures. The multiple logistic regression analysis confirmed that the SSI rate for hip prosthesis was significantly lower in the third year than in the first year of surveillance (OR = 0.57; CI95 0.42-0.78), though for knee prosthesis the level of significance was not achieved. CONCLUSION:A reduction of SSIs following hip and knee prosthesis operations through the introduction of ongoing surveillance and the possibility of using benchmark data for comparison does seem to be possible in many institutions.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Gastmeier P,Sohr D,Brandt C,Eckmanns T,Behnke M,Rüden Hdoi
10.1007/s00402-005-0036-ysubject
Has Abstractpub_date
2005-10-01 00:00:00pages
526-30issue
8eissn
0936-8051issn
1434-3916journal_volume
125pub_type
杂志文章abstract:INTRODUCTION:There is a great deal of controversy about the effect of tourniquets on development of deep vein thrombosis (DVT) after total knee arthroplasty (TKA). PATIENTS AND METHODS:We investigated the incidence of postoperative DVT after TKA with or without the use of a tourniquet. The patients were 48 consecutive...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-006-0244-0
更新日期:2007-10-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to evaluate the results of a contoured focal articular femoral condyle resurfacing prosthetic in the treatment of full-thickness cartilage and osteochondral defects at the medial femoral condyle of the knee beyond 5 years. METHODS:In a multicenter case series, preoperative an...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00402-011-1323-4
更新日期:2011-08-01 00:00:00
abstract:AIM:Rounding surface of the sacral dome and wedging deformity of the vertebral body are commonly observed in patients with isthmic spondylolisthesis. Recently, an animal study showed that the deformity can be caused by the growth plate involvement in the immature pediatric vertebral body after biomechanical alteration ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1257-2
更新日期:2011-09-01 00:00:00
abstract:INTRODUCTION:The treatment of proximal tibial fractures is often challenging, and internal fixation is occasionally associated with problems in wound healing due to frequently co-existing soft tissue injuries. External fixation of these fractures have yielded satisfactory results, but some studies have reported problem...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0931-8
更新日期:2010-07-01 00:00:00
abstract::A number of complications are associated with shoulder arthroscopic surgery. However rare, respiratory complications such as pneumomediastinum and related tension pneumothorax as well as spontaneous pneumothorax in patients undergoing shoulder arthroscopy by endotracheal intubation have been reported in the literature...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0593-y
更新日期:2009-03-01 00:00:00
abstract::Conclusions on results after resection arthroplasty were made by analyzing patient records with regard to completed questionnaires. Sixty-four patients were followed up for 2.1-15.9 years postoperatively. The indications for explanation were septic or aseptic loosening with extensive bony destruction. The average age ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00932314
更新日期:1989-01-01 00:00:00
abstract::The presence of large and massive segmental defects of the diaphyseal bone following tumor resection is a significant problem for orthopedic surgeons. Double or folded free vascularized fibula graft (FVFG) is used in massive femur defects and is considered to be a reliable reconstructive procedure. However, folded or ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0615-9
更新日期:2008-09-01 00:00:00
abstract::The purpose of our study was to evaluate the value of MRI for preoperative arthroscopical planning in patients with osteochondritis dissecans. Based on the experience from 136 patients with osteochondritis dissecans of the knee or the ankle who were arthroscopically operated by retrograde drilling a follow-up study wa...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050235
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:Superior capsule reconstruction (SCR) has been used for the tendon grafting of massive rotator cuff tears when primary repair is difficult. We examined the postoperative outcomes of SCR for massive rotator cuff tears and the risk factors for postoperative retear. MATERIALS AND METHODS:Through this retrosp...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03316-2
更新日期:2020-10-01 00:00:00
abstract::Hydatid disease of the muscle is very rare and represents approximately 3% of all patients with hydatidosis. Since the infection closely resembles a soft-tissue tumor on clinical examination, the preoperative radiologic diagnosis is very important to avoid biopsy. We report an unusual case of primary intramuscular hyd...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/pl00013775
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION:Drilling of bones in orthopaedic and trauma surgery is a common procedure. There are yet no recommendations about which drill bits/coating should be preferred and when to change a used drill bit. MATERIALS AND METHODS:In preliminary studies typical "drilling patterns" of surgeons concerning used spindle s...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2338-z
更新日期:2015-12-01 00:00:00
abstract::Extended thromboprophylaxis is vital in patients undergoing total hip arthroplasty (THA) because of the prolonged risk of venous thromboembolism (VTE). Despite evidence that extended prophylaxis can reduce the incidence of symptomatic VTE in this high-risk patient population and the evidence-based guideline recommenda...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0930-9
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:The cementless, hydroxyapatite-coated Anatomique Benoist Giraud-I (ABG-I) hip endoprosthesis represented a modern implant in the 1990s. The aim of the current retrospective study was to evaluate the clinical and radiological results of this prosthesis. In addition, an analysis of the complications and retr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-006-0168-8
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Only few procedures for Lisfranc ligaments reconstruction to treat subtle injury of the Lisfranc joint have been reported. We have developed a novel technique for Lisfranc ligaments reconstruction, which was applied to treat chronic symptomatic subtle injuries that had failed to respond to initial treatmen...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2250-6
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:Rotator cuff tears are increasing with age. Does osteopenic bone have an influence on the pullout strength of suture anchors? MATERIALS AND METHODS:SPIRALOK 5.0 mm (DePuy Mitek), Super Revo 5 mm and UltraSorb (both ConMed Linvatec) suture anchors were tested in six osteopenic and six healthy human cadaver...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0689-4
更新日期:2009-03-01 00:00:00
abstract::Intramuscular hemangiomas are rare benign tumors, making up 0.8% of all hemangiomas. They are of interest to the surgeon because their location may present considerable therapeutic challenge since radiographic work-up of the soft- tissue mass by magnetic resonance imaging (MRI) may be suspicious for malignancy. The de...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/pl00013761
更新日期:2000-01-01 00:00:00
abstract::Fractures of the distal radius are extremely common injuries, which are steadily becoming a public health issue. One of the most common complications following distal radius fractures is still malunion of the distal radius. This review of the literature surrounding distal radius malunion covers the biomechanics of dis...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-012-1466-y
更新日期:2012-05-01 00:00:00
abstract:INTRODUCTION:While numerous classifications of hip arthritis have been proposed, none considered the magnitude and direction of femoral head translation relative to the native acetabulum. A more precise classification of architectural hip deformities is necessary to improve preoperative templating and anticipate surgic...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03298-1
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Retrospective analysis of the clinical efficacy and feasibility of patients with thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage. METHOD:A total of 18 patients with thorac...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1722-9
更新日期:2013-06-01 00:00:00
abstract::The reasons are discussed for differences in functional results of the pelvic osteotomy after Chiari, regardless of the fact that the CE and AC angles were equal in all patients. When lateralization and distal displacement of the greater trochanter were performed in addition to the pelvic osteotomy, the functional res...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00932167
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:Lateral retinacular release (LRR) is a common procedure during total knee arthroplasty (TKA), especially if patellar maltracking is observed intraoperatively. The impact of LRR on patellofemoral kinematics is well-examined, but the influence on femorotibial kinematics requires more elucidation. Therefore, ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2843-3
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Injury of the tarsometatarsal (TMT) joint complex, known as Lisfranc injury, covers a wide range of injuries from subtle ligamentous injuries to severely displaced crush injuries. Although it is known that these injuries are commonly missed, the literature on the accuracy of the diagnostics is limited. The d...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03391-w
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:In the proximal femoral metaphysis, hematopoietic marrow is predominant during the adult stage of life. The conversion of hematopoietic marrow to fatty marrow in the proximal femoral metaphysis has been suggested as an etiologic factor of ischemia in the pathogenesis of femoral head osteonecrosis. To deter...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0824-4
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2439-3
更新日期:2016-05-01 00:00:00
abstract::From 1985 to 1995, 417 patients with dislocated medial femoral neck fractures (Garden III-IV) were treated with hemiarthroplasty using a Biolox ceramic head. The average patient age at the time of operation was 81.5 years. A total of 140 survivors was available for follow-up examination with a mean prosthesis longevit...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050469
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:The purpose of the current study was to clinically evaluate the technique of longer pull-out suture as a transmission suture for early active motion after flexor tendon repair in the proximal zone-2. METHOD:Eleven patients (eight adult male, two adult female and one child) with 19 proximal zone II flexor te...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1238-5
更新日期:2011-04-01 00:00:00
abstract::Proximal tibiofibular ganglion is a rare disorder. It may settle down in the subcutaneous tissue or may develop along the peroneal muscles and nerve. Common clinical findings are various sizes of mass, pain and hypoesthesis due to compression neuropathy. We report three cases of proximal tibiofibular ganglion and revi...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-005-0084-3
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:The purpose of this investigation was to compare clinical outcome, component loosening, polyethylene cup wear and periprosthetic bone mineral density between "cup first" navigated and conventional cementless total hip arthroplasty (THA) 5-7 years after surgery. MATERIALS AND METHODS:Fifty patients who rec...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2201-2
更新日期:2015-05-01 00:00:00
abstract::The treatment of open distal tibia fractures remains challenging, particularly when the fracture is infected and involves segmental bone loss. We report the case of a 38-year-old man who sustained an open distal tibiofibular fracture with segmental bone loss and a closed proximal tibial fracture. The fractures were in...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1523-6
更新日期:2012-08-01 00:00:00
abstract:PURPOSE:Radial neuropathy represents a devastating complication in a posterior approach to the distal humerus. This study aimed to propose "safe zones" regarding the radial nerve (RN) location at the posterior aspect of the humerus to minimize the risk of iatrogenic injury. METHODS:In 100 embalmed specimens, the dista...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2300-0
更新日期:2015-11-01 00:00:00