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Der m\u00f6glichst sichere Ausschluss oder die Best\u00e4tigung einer periprothetischen Infektion ist die Voraussetzung f\u00fcr jede Revisionsoperation und kann f\u00fcr den behandelnden Orthop\u00e4den und Unfallchirurgen eine gro\u00dfe Herausforderung darstellen. Eine sichere evidenzbasierte pr\u00e4operative Diagnostik ist im Sinne des Patienten notwendig, um einerseits eine periprothetische Infektion zu erkennen sowie die entsprechende chirurgische und antibiotische Therapie zu planen und andererseits unn\u00f6tige zweizeitige Wechsel zu vermeiden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit<\/jats:title>\n                    <jats:p>Ziel ist es, ein evidenzbasiertes problem- und priorit\u00e4tenbasiertes Vorgehen zu entwickeln und dies in einem transparenten und standardisierten Algorithmus zusammenzufassen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methode<\/jats:title>\n                    <jats:p>Durch systematische Literaturrecherche wurden relevante Arbeiten identifiziert und im Rahmen von Expertenrunden bewertet. Nach Extraktion der Daten erfolgte die Berechnung von Sensitivit\u00e4t, Spezifit\u00e4t, positiver und negativer Likelihood-Ratio sowie positiver und negativer pr\u00e4diktiver Werte. Im Rahmen von 4\u00a0Treffen wurden die entsprechenden Studien der Arbeitsgruppe f\u00fcr implantatassoziierte Infektionen pr\u00e4sentiert und analog zu Standard-Delphi-Runden durch die einzelnen Experten bearbeitet und bewertet. Gem\u00e4\u00df der Priorit\u00e4tenliste der Expertenrunde erfolgte die Entwicklung eines zur ISO (International Organization for Standardisation) konformen Algorithmus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Der entwickelte Algorithmus ist eine Abfolge von evidenzbasierten Prozessen gem\u00e4\u00df der verwendeten ISO-Norm. Gem\u00e4\u00df der durch die Expertenrunde priorisierten Haupt- und Nebenkriterien erfolgte die Entwicklung logisch strukturiert und problemorientiert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Der Ausschluss einer periprothetischen Infektion ist von enormer Bedeutung vor einer Revisionsoperation und entscheidet in vielen F\u00e4llen \u00fcber den Erfolg und die Invasivit\u00e4t der Operation. Die Diagnose \u201eperiprothetische Infektion\u201c erfordert eine substanzielle Ver\u00e4nderung der therapeutischen Strategie. Der durch die Arbeitsgruppe entwickelte Algorithmus fasst Positionen aus der aktuellen Literatur und spezielle Expertenmeinungen zusammen, dies erm\u00f6glicht einen transparenten diagnostischen Ansatz im Sinne einer Standard Operation Procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00132-020-03940-6","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T07:03:40Z","timestamp":1594710220000},"page":"312-325","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Diagnostik der periprothetischen Infektion","Diagnosis of periprosthetic joint infection"],"prefix":"10.1007","volume":"50","author":[{"given":"H.","family":"M\u00fchlhofer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Renz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Zahar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"L\u00fcdemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rudert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Frommelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Ascherl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Perka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"von Eisenhart-Rothe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,14]]},"reference":[{"key":"3940_CR1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.arth.2005.05.027","volume":"21","author":"F Ali","year":"2006","unstructured":"Ali F, Wilkinson JM, Cooper JR, Kerry RM, Hamer AJ, Norman P, Stockley I (2006) Accuracy of Joint Aspiration for the Preoperative Diagnosis of Infection in Total Hip Arthroplasty. 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Waldemar Link & Co KG \u2013 Referent auf Honorarbasis, Fa. Heraeus Medical \u2013 Referent auf Honorarbasis. C.\u00a0Perka: keine in Bezug auf diese Arbeit (Consultant f\u00fcr Zimmer\/Smith&Nephew, Link und DePuy\/Synthes). L.\u00a0Frommelt: Fa. Zimmer, Referent auf Honorarbasis. H.\u00a0M\u00fchlhofer, N.\u00a0Renz, M.\u00a0L\u00fcdemann, M.\u00a0Rudert, R.\u00a0Hube, R.\u00a0Ascherl und R.\u00a0von Eisenhart-Rothe geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"Es wurden keine Studien an Tier oder Mensch durchgef\u00fchrt.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}