[Certification and its influence on the work in certified arthroplasty centers].

backgroundThe certification of an arthroplasty center (EndoCert System) is a process that requires a lot of time, effort, and money. Clear evidence of better clinical results and an improved quality of arthroplasty surgeries is still missing and is also difficult to provide on the basis of fundamental considerations. Nevertheless, working in a certified arthroplasty center offers various benefits. REQUIREMENTS: The catalog of requirements provides the center with clear structures, and the implementation of clinical pathways requires a close collaboration of different professional groups. This is elaborate but timesaving in the long run. The appointment of EndoCert-registered surgeons performing a minimum number of operations is, on the one hand, a crucial contribution to the quality, because they do an experienced job. On the other hand, registered surgeons play an important role in the education of residents. Key data and quality indicators help the centers to recognize strengths, weaknesses, opportunities, and risks. ASSESSMENT: The EndoCert system integrates other quality assurance in its assessment, such as the EPRD (Endoprothesenregister Deutschland), allowing benchmarking with other hospitals. An issue to be discussed in this context is a missing risk stratification, which may possibly lead to contorted results. The claim of quality should also include the management of complex situations and problems.