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Register als Werkzeug für mehr Endoprothesensicherheit

Erfahrungen aus anderen Ländern und dem Aufbau des Endoprothesenregisters Deutschland

Registries as a tool for optimizing safety of endoprostheses

Experiences from other countries and the setup of the German arthroplasty register

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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Bis heute fehlt eine strukturierte Langzeitdokumentation der Ergebnisse von Hüft- und Knieendoprothesenoperationen in Deutschland. Im vorliegenden Beitrag werden die Zielsetzung, Struktur und Datenflüsse des neu aufgebauten Endoprothesenregisters Deutschland (EPRD) beschrieben. Das EPRD ist als gemeinnützige GmbH und 100%ige Tochter der wissenschaftlichen Fachgesellschaft Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie (DGOOC) ausschließlich wissenschaftlichen Grundsätzen verpflichtet. Der bürokratische Aufwand wird durch Nutzung von Abrechnungsdaten und durch die Barcode-Identifikation der Prothesen anhand einer neu entwickelten Implantatdatenbank so gering wie möglich gehalten. Das EPRD dokumentiert die Standzeit der Kunstgelenke vom Einbau bis zum ggf. notwendigen Wechsel. Die Ursachen für den Misserfolg einer Implantation werden aufgeschlüsselt und zeigen, ob die verwendeten Implantate, das operative Vorgehen oder auch patientenspezifische Merkmale für eine erneute Operation verantwortlich sind. Die Daten bilden eine entscheidende Grundlage für die Versorgungsforschung im Bereich der Endoprothetik und können nach den Erfahrungen bereits existierender Register im Ausland wesentlich dazu beitragen, die Revisionsfrequenz von Endoprothesen zu verringern. Unter Beachtung aufwendiger Datenschutzvorgaben ist bei Serienschäden eine Re-Identifikation der betroffenen Patienten möglich.

Abstract

There has previously been no structured long-term documentation of the results of hip and knee prosthesis operations in Germany. This article presents the objectives, structure and data flow of the newly established German arthroplasty registry (EPRD). The EPRD is run as a subdivision of the German Society for Orthopedics and Orthopedic Surgery (Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie, DGOOC). It is dedicated to scientific principles and guarantees independency and immediate feedback to surgeons. The cooperation between insurance funds, hospitals, industry and scientific society is the key to success. Additional data acquisition and bureaucratic formalities are limited to a minimum and in particular there is no use of paper. Involving the health insurance funds provides access to relevant routine data. The implant documentation is facilitated by means of an implant library and barcode scanning in the operating room. The EPRD documents the survival of implants including the reasons for revision. Although the highest level of patient data protection is guaranteed, individual patients can be identified in case of implant recalls.

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Notes

  1. „Burden of revision“: Quotient zwischen Revisionsoperationen und der Summe aus Revisionsoperationen und Primärimplantationen.

  2. Diese Ergebnisse wurden im Juli 1997 in einem orthopädischen Journal veröffentlicht [13].

  3. Finnland: 4,06 Revisionen pro 100 Komponentenjahre; Schweden: 0,72 Revisionen pro 100 Komponentenjahre.

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Authors and Affiliations

  1. Klinik für Orthopädie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Michaelisstraße 1, 24105, Kiel, Deutschland

    Joachim Hassenpflug &  Thoralf R. Liebs

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  1. Joachim Hassenpflug
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  2. Thoralf R. Liebs
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Correspondence to Joachim Hassenpflug.

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J. Hassenpflug und T.R. Liebs geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Hassenpflug, J., Liebs, T. Register als Werkzeug für mehr Endoprothesensicherheit. Bundesgesundheitsbl. 57, 1376–1383 (2014). https://doi.org/10.1007/s00103-014-2057-6

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