Articles | Volume 11, issue 3
https://doi.org/10.5194/jbji-11-323-2026
https://doi.org/10.5194/jbji-11-323-2026
Original full-length article
 | 
04 Jun 2026
Original full-length article |  | 04 Jun 2026

High intra- and inter-observer reliability of the PJI-TNM classification in acute and chronic periprosthetic hip joint infection

Dominic Simon, Jonas Tumler, Lennart M. Schroeder, Florian Pachmann, Eduardo Suero, Boris M. Holzapfel, Gautier Beckers, and Kathrin Pfahl

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Cited articles

Aftab, M. H. S., Joseph, T., Almeida, R., Sikhauli, N., and Pietrzak, J. R. T.: Periprosthetic Joint Infection: A Multifaceted Burden Undermining Arthroplasty Success, Orthop. Rev. (Pavia), 22, 138205, https://doi.org/10.52965/001c.138205, 2025. 
Alt, V., Rupp, M., Langer, M., Baumann, F., and Trampuz, A.: Can the oncology classification system be used for prosthetic joint infection?: The PJI-TNM system, Bone Joint Res., 9, 79–81, 2020. 
Alt, V., Walter, N., Rupp, M., and Baertl, S.: Comment on Lunz et al. Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections. J. Clin. Med. 2023, 12, 1262, J. Clin. Med., 12, 6073, https://doi.org/10.3390/jcm12186073, 2023. 
Baertl, S., Rupp, M., Kerschbaum, M., Morgenstern, M., Baumann, F., Pfeifer, C., Worlicek, M., Popp, D., Amanatullah, D. F., and Alt, V.: The PJI-TNM classification for periprosthetic joint infections, Bone Joint Res., 13, 19–27, https://doi.org/10.1302/2046-3758.131.BJR-2023-0012.R2, 2024. 
Bakalakos, M., Ampadiotaki, M. M., Vlachos, C., Sipsas, N., Pneumaticos, S., and Vlamis, J.: Molecular Mechanisms of Biofilm Formation on Orthopaedic Implants: Review of the Literature, Maedica (Bucur), 19, 129–136, https://doi.org/10.26574/maedica.2024.19.1.129, 2024. 
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Short summary
This study assessed the reliability of the tumor, node, and metastasis (TNM) classification for periprosthetic joint infection (PJI) in patients with acute and chronic infections after hip replacement. Using a large clinical cohort, we found that clinicians with different levels of experience applied the system consistently. These findings support its use for describing disease severity, improving communication, and supporting future research and treatment planning.
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