German Centre for Orthopaedics
Leading experts in arthroplasty
At the German Centre for Orthopaedics, Dr. Eric Röhner and his team have developed concepts to improve the rate of infection and the surgical outcome in knee arthroplasty.
For many years, the German Centre for Orthopaedics at the Waldkliniken Eisenberg has belonged to the pioneers in the field of arthroplasty and is constantly working on achieving even better results. In the field of knee arthroplasty, the team led by the managing senior physician Dr. Eric Röhner has set new standards.
The treatment strategies applied in Eisenberg are aimed at infection prophylaxis and improvement of the surgical outcome. And the best thing about this: Dr. Eric Röhner and his team have conducted studies to demonstrate that their methods do indeed achieve the desired effects.
In the Knee Department at the German Centre for Orthopaedics, drainage tubes are no longer placed and tourniquets are not applied.
“Operation without a tourniquet shows that we have a better control over bleeding and the patients have fewer complaints in the area of the thigh, where the tourniquet is usually applied,” explains Dr. Röhner.
At less than one percent, the infection rate at the Waldkliniken Eisenberg is already below the national average of one to three percent. In order to further minimise the risk of infection and get it as close as possible to zero, the specialists in Eisenberg place importance on continuous treatment with antibiotics. The patient already receives the first dose 30 minutes before the operation. If the operation lasts more than two hours, a second dose of antibiotics is to be given.
“The most important thing is to adjust the dose to the patient’s weight in order to achieve the desired effect,” says Dr. Röhner. Apart from this, the patient receives medication for blood coagulation before the operation,” so that we can reduce blood loss and postoperative haematoma formation,” explains the managing senior physician.
After the operation, vancomycin is administered. This antibiotic is deposited directly into the joint. “The advantage is that it remains and acts there for a while,” explains Dr. Röhner. “In a study, we were able to show that our already very low infection rate could be reduced even further. It must be noted that this antibiotic cannot be used in the implantation of partial prostheses, as we have demonstrated that it is toxic for cartilage.”
Also in the case of aseptic revision of prostheses, i.e. in patients whose prosthesis has loosened or is no longer stable, treatment with antibiotics for five days produces better results.
The decisive advantage: If a specific bacterium is identified in a tissue sample, the antibiotic can be adjusted according to the antibiogram, and that without any gaps. “The patient has received an antibiotic from the first day onwards, which means that there is a very good chance that the infection can be overcome. This would not be the case if we only started administering the antibiotic after three days, as bacteria produce biofilm from the first day on,” says Röhner.