ArticleDer Orthopade2021
[PJI-TNM as new classification system for periprosthetic joint infections : An evaluation of 20 cases].
Article in Der Orthopade, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.
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12 citing papers in PubMed, 11 citations in OpenAlex.
- High intra- and inter-observer reliability of the PJI-TNM classification in acute and chronic periprosthetic hip joint infection.Journal of bone and joint infection · 2026Article
- A Novel Approach for Tissue Analysis in Joint Infections Using the Scattered Light Integrating Collector (SLIC).Biosensors · 2025Article
- Microbiological Profiles of Patients with Acute Periprosthetic Joint Infection Undergoing Debridement, Antibiotics, Irrigation and Implant Retention (DAIR).Antibiotics (Basel, Switzerland) · 2025Article
- The PJI-TNM Classification as Predictor for Revision-Free Implant Survival Rates in Patients with Periprosthetic Joint Infection of the Hip or Knee Joint.Infectious disease reports · 2025Article
- Assessing the TNM Classification for Periprosthetic Joint Infections of the Knee: Predictive Validity for Functional and Subjective Outcomes.Journal of personalized medicine · 2025Article
- [Structured approach for infected prosthesis].Zeitschrift fur Rheumatologie · 2023Review
- Reply to Alt et al. Comment on "Lunz et al. Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections.Journal of clinical medicine · 2023Article
- Comment on Lunz et al. Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections.Journal of clinical medicine · 2023Article
- Preoperative Decolonization Appears to Reduce the Risk of Infection in High-Risk Groups Undergoing Total Hip Arthroplasty.Antibiotics (Basel, Switzerland) · 2023Article
- Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections.Journal of clinical medicine · 2023Article
- Predicting the Exception-CRP and Primary Hip Arthroplasty.Journal of clinical medicine · 2021Article
- [Comparison of DRG revenues between fast and slow-track procedures for a two-stage replacement of prostheses for periprosthetic hip infections in the aG-DRG system 2020].Der Orthopade · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent classifications for periprosthetic joint infections (PJIs) often lack a detailed description of the overall underlying situation of a patient. The PJI-TNM classification uses the principles of the TNM classification from oncology for the description of critical parameters in PJIs: affected joint, type of implant and implant stability, soft tissue conditions, maturity of biofilm formation, causative microorganism, comorbidities of the patient and recurrence of infection. The aim of the current work is to evaluate the feasibility of this new PJI-TNM classification in clinical practice.
methodsThe PJI-TNM classification was used in 20 patients with hip, knee and shoulder PJIs. Based on a retrospective chart review, the respective parameters T (tissue and implants), N (non-eukaryotic cells and fungi), M (morbidity) and r (reinfection) were classified for each case.
resultsAll 20 cases (12 male, 8 female, average age 72.2 (40-88 years)) with 13 hip, 6 knee and 1 shoulder PJIs were to be classified with the new TNM-PJI classification system. There was a considerable heterogeneity among the cases: 12 protheses were fixed (T0), 6 were loosened (T1) and 2 were associated with a soft tissue defect (T2). Biofilm formation was considered immature in 7 cases (N0). Out of the PJIs, 13 were considered to be associated with mature biofilm formation. Out of the patients, 9 were systemically not or only mildly compromised (M0), 7 patients moderately (M1) and 3 patients (M2) severely compromised. One patient refused surgical treatment (M3a). Recurrent infections (r) were diagnosed in three cases.
conclusionsThe principles of the TNM classification from oncology can also be used for the classification of PJIs. Despite the limited number of cases in this study, a considerable heterogeneity of the evaluated PJIs is shown, which is a phenomenon that is also known from clinical practice. This heterogeneity can be adequately addressed by this new classification, which might be beneficial in decision-making in the future.
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