European Implant Cohort Study (EICS)
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Purpose
The incidence of postoperative PJI is ranging from 0.5-2.5% for primary interventions and are reported up to 20% for revision procedure. In addition, hematogenous PJI can occur at any time after implantation and the risk of infection remains during the entire prosthesis indwelling time. Prosthetic joint infections (PJI) are associated with significant morbidity and costs to the healthcare system. Evidence for optimal management of PJI with best outcome and lowest expenses is limited and recommendations between countries vary significantly. There is unmet need to standardized diagnostic procedures and definition of infection as well as achieve a consensus for uniform treatment guidelines.The European Implant Cohort Study (EICS) is a multicenter European research project, including patients with PJI in a cohort representative for Europe. The EICS is established jointly by the Orthopedic and Traumatology surgeons, Infectious Diseases specialists and microbiologists of selected university and non-university institutions across Europe. The principal aim of the EICS is to improve the management of PJI and develop consensus guidelines across Europe. By systematic analysis of consecutively included patients with PJI, factors associated with best outcome regarding infection (assessed by the infection-free interval) and joint function (assessed by the degree of pain, mobility, range of motion) will be determined in a longitudinal prospective study with long-term follow-up. This is an investigator-initiated, open, prospective, multicenter observational study. Participating study centers will be university or non-university hospitals across Europe, which fulfill the following study conditions:
- Close collaboration between infectious diseases specialists, microbiologists and orthopedic/trauma surgeons,
- Availability of appropriate microbiological methods (following standard recommendations including sonication of removed prosthesis),
- Availability a dedicated study team (study nurse and/or research fellow) for regular eligibility screenings, patient inclusion procedure, real-time data collection and patient follow-up.
This project may generate important scientific evidence for future guidelines regarding management of PJI, has the potential to initiate new multicenter substudies in an establish network, and may open further collaboration and exchange of skills between institutions across Europe.
| Condition |
|---|
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Bone Diseases |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | European Implant Cohort Study |
- Infection Outcome [ Time Frame: 2 years ] [ Designated as safety issue: No ]This will be determined as the infection-free interval after end of treatment. Infection-free status is defined as absence of clinical (e.g. no fistula), laboratory (e.g. normal C-reactive protein) and radiological signs of infection (e.g. no septic loosening). The expected "cure rate", defined as the infection-free interval at 2 years, is >80%. The treatment outcome of the combined (antimicrobial and surgical) treatment approach will be assessed in a time-dependent manner using the Kaplan-Meier survival method.
- Functional outcome [ Time Frame: The following data will be collected at study inclusion, during hospitalization and during follow-up visits (3, 6, 12 months and thereafter as the usual clinical practice): ] [ Designated as safety issue: No ]The functional assessment will be performed using joint-specific scores involving the range of motion (ROM), patient mobility / independency in daily life and subjective evaluation of pain using a pain scale (1-10 points). The expected functional outcome is that >60% patients return to previous life activities, >75% reduction of pain.
| Estimated Enrollment: | 4000 |
| Study Start Date: | January 2013 |
| Estimated Primary Completion Date: | January 2015 (Final data collection date for primary outcome measure) |
Show Detailed Description Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
All patient with hip, knee and shoulder prosthetic joint infection.
Inclusion Criteria:
- Subject is older than 18 years of age.
- Written Informed consent has been obtained.
Subject has a prosthetic joint infection (PJI) of the hip, knee or shoulder prosthesis defined as presence of at least one of the following criteria:
- visible pus around the prosthesis
- presence of sinus tract (fistula),
- acute inflammation in histopathology of periprosthetic tissue
- positive microbiology of synovial fluid, sonication or periprosthetic tissue
- increased leukocyte count or neutrophil percentage in preoperative synovial fluid aspirate,
- Subject is willing to participate in the study, to follow protocol study treatment regimen, and to comply with all planned follow-up assessments.
Exclusion Criteria:
- Subject has been previously enrolled in the study or is currently enrolled in another investigational study, which deviates from the treatment algorithm.
- Inability to read and understand the participant's information.
Contacts and Locations| Contact: Andrej Trampuz, MD | 0041 213143992 | Andrej.Trampuz@chuv.ch |
| Switzerland | |
| Centre Hospitalier Universitaire Vaudois (CHUV) | Not yet recruiting |
| Lausanne, Vaud, Switzerland, 1011 | |
| Principal Investigator: | Andrej Trampuz, MD | Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne |
| Principal Investigator: | Olivier Borens, MD | Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne |
More Information
Additional Information:
Publications:
| Responsible Party: | Andrej Trampuz, Medical Doctor, Centre Hospitalier Universitaire Vaudois |
| ClinicalTrials.gov Identifier: | NCT01633619 History of Changes |
| Other Study ID Numbers: | CHUV0005 |
| Study First Received: | July 2, 2012 |
| Last Updated: | July 3, 2012 |
| Health Authority: | European Union: European Medicines Agency |
Keywords provided by Centre Hospitalier Universitaire Vaudois:
|
Prosthetic Joint Infection |
Additional relevant MeSH terms:
|
Bone Diseases Musculoskeletal Diseases |
ClinicalTrials.gov processed this record on May 19, 2013