Z Orthop Unfall 2021; 159(04): 397-405
DOI: 10.1055/a-1107-3398
Original Article/Originalarbeit

Retrospective Comparative Study of the Influence on Quality of Primary Total Hip Arthroplasty by the EndoCert-Certification System in a Communal Hospital

Article in several languages: English | deutsch
Philipp Bergschmidt
1   Department for Orthopaedic Surgery, Trauma Surgery and Hand Surgery, Rostock Suedstadt Hospital
2   Orthopaedic Clinic and Outpatient Department, University Medical Centre Rostock
,
Jan Pawel Maruniewicz
1   Department for Orthopaedic Surgery, Trauma Surgery and Hand Surgery, Rostock Suedstadt Hospital
,
Thomas Westphal
1   Department for Orthopaedic Surgery, Trauma Surgery and Hand Surgery, Rostock Suedstadt Hospital
,
Annett Klinder
2   Orthopaedic Clinic and Outpatient Department, University Medical Centre Rostock
,
Wolfram Mittelmeier
2   Orthopaedic Clinic and Outpatient Department, University Medical Centre Rostock
› Author Affiliations

Abstract

The EndoCert®-Initiative system sets specific requirements for the structural, process and result quality in certified Arthroplasty Centers in Germany. However, it remains unclear to what extent the certification process can increase the quality in total hip and knee arthroplasty. Aim of the comparative retrospective study is to analyse the change in quality of total hip arthroplasty in a communal hospital before and after the certification process. All primary total hip arthroplasties (n = 366) between 2013 and 2016 were included in the study retrospectively and grouped by treatment period. Treatment was performed in group 1 without clinical pathways, in group 2 pathway-controlled without a valid certificate and in group 3 pathway-controlled after final completion of the certification process. Outcome quality was analysed using quality indicators defined by the EndoCert-Initiative and further predefined indicators. Results show quality improvement under certified pathway-controlled treatment, e.g. time of surgery, cup and stem positioning, blood transfusion rate, periprosthetic fractures. However, improvements were not significantly in all cases and limitations must be recognized. Positive effects of the certification process legitimate capital investment and efforts. Further quality indicators may be implemented in the certification process to improve quality of treatment in arthroplasty.



Publication History

Article published online:
04 March 2020

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