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Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections

The comprehensive “PJI-TNM classification” for the description of periprosthetic joint infections (PJI) was introduced in 2020. Its structure is based on the well-known oncological TNM classification to appreciate the complexity, severity, and diversity of PJIs. The main goal of this study is to imp...

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Autores principales: Lunz, Andre, Lehner, Burkhard, Voss, Moritz N., Knappe, Kevin, Jaeger, Sebastian, Innmann, Moritz M., Renkawitz, Tobias, Omlor, Georg W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967834/
https://www.ncbi.nlm.nih.gov/pubmed/36835798
http://dx.doi.org/10.3390/jcm12041262
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author Lunz, Andre
Lehner, Burkhard
Voss, Moritz N.
Knappe, Kevin
Jaeger, Sebastian
Innmann, Moritz M.
Renkawitz, Tobias
Omlor, Georg W.
author_facet Lunz, Andre
Lehner, Burkhard
Voss, Moritz N.
Knappe, Kevin
Jaeger, Sebastian
Innmann, Moritz M.
Renkawitz, Tobias
Omlor, Georg W.
author_sort Lunz, Andre
collection PubMed
description The comprehensive “PJI-TNM classification” for the description of periprosthetic joint infections (PJI) was introduced in 2020. Its structure is based on the well-known oncological TNM classification to appreciate the complexity, severity, and diversity of PJIs. The main goal of this study is to implement the new PJI-TNM classification into the clinical setting to determine its therapeutic and prognostic value and suggest modifications to further improve the classification for clinical routine use. A retrospective cohort study was conducted at our institution between 2017 and 2020. A total of 80 consecutive patients treated with a two-stage revision for periprosthetic knee joint infection were included. We retrospectively assessed correlations between patients’ preoperative PJI-TNM classification and their therapy and outcome and identified several statistically significant correlations for both classifications, the original and our modified version. We have demonstrated that both classifications provide reliable predictions already at the time of diagnosis regarding the invasiveness of surgery (duration of surgery, blood and bone loss during surgery), likelihood of reimplantation, and patient mortality during the first 12 months after diagnosis. Orthopedic surgeons can use the classification system preoperatively as an objective and comprehensive tool for therapeutic decisions and patient information (informed consent). In the future, comparisons between different treatment options for truly similar preoperative baseline situations can be obtained for the first time. Clinicians and researchers should be familiar with the new PJI-TNM classification and start implementing it into their routine practice. Our adjusted and simplified version (“PJI-pTNM”) might be a more convenient alternative for the clinical setting.
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spelling pubmed-99678342023-02-27 Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections Lunz, Andre Lehner, Burkhard Voss, Moritz N. Knappe, Kevin Jaeger, Sebastian Innmann, Moritz M. Renkawitz, Tobias Omlor, Georg W. J Clin Med Article The comprehensive “PJI-TNM classification” for the description of periprosthetic joint infections (PJI) was introduced in 2020. Its structure is based on the well-known oncological TNM classification to appreciate the complexity, severity, and diversity of PJIs. The main goal of this study is to implement the new PJI-TNM classification into the clinical setting to determine its therapeutic and prognostic value and suggest modifications to further improve the classification for clinical routine use. A retrospective cohort study was conducted at our institution between 2017 and 2020. A total of 80 consecutive patients treated with a two-stage revision for periprosthetic knee joint infection were included. We retrospectively assessed correlations between patients’ preoperative PJI-TNM classification and their therapy and outcome and identified several statistically significant correlations for both classifications, the original and our modified version. We have demonstrated that both classifications provide reliable predictions already at the time of diagnosis regarding the invasiveness of surgery (duration of surgery, blood and bone loss during surgery), likelihood of reimplantation, and patient mortality during the first 12 months after diagnosis. Orthopedic surgeons can use the classification system preoperatively as an objective and comprehensive tool for therapeutic decisions and patient information (informed consent). In the future, comparisons between different treatment options for truly similar preoperative baseline situations can be obtained for the first time. Clinicians and researchers should be familiar with the new PJI-TNM classification and start implementing it into their routine practice. Our adjusted and simplified version (“PJI-pTNM”) might be a more convenient alternative for the clinical setting. MDPI 2023-02-05 /pmc/articles/PMC9967834/ /pubmed/36835798 http://dx.doi.org/10.3390/jcm12041262 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lunz, Andre
Lehner, Burkhard
Voss, Moritz N.
Knappe, Kevin
Jaeger, Sebastian
Innmann, Moritz M.
Renkawitz, Tobias
Omlor, Georg W.
Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title_full Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title_fullStr Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title_full_unstemmed Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title_short Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections
title_sort impact and modification of the new pji-tnm classification for periprosthetic joint infections
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967834/
https://www.ncbi.nlm.nih.gov/pubmed/36835798
http://dx.doi.org/10.3390/jcm12041262
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