title: [Experience in establishing a certified endoprosthesis center].
abstract: BACKGROUND
  It is well known that morbidity rates of arthroplasties are inversely related to procedure volume. In the department of orthopaedics at a German medical school, a performance of certification of high-volume center for total hip and knee arthroplasties, called the EndoCert(®) Initiative, was started. This project was initiated by the German society of orthopaedic surgery (DGOOC) to secure the quality of total knee and hip arthroplasties.
  
  
  OBJECTIVE
  The aim of this study is to evaluate effects of certification, pathwaycontrolled therapy and quality indicators on outcome in arthroplasty three years after implentation.
  
  
  METHODS
  Arthroplasties performed in this certified center for total hip and knee arthroplasties were evaluated. Outcome was evaluated after the implementation of quality indicators and clinical pathways.
  
  
  RESULTS
  After establishment of certification in the center for total hip and knee arthroplasties morbidity rates decreased as quality increased.
  
  
  CONCLUSIONS
  The implementation of pathway-controlled therapy and quality indicators in a high-volume center for total joint arthroplasties shows better clinical results. Capital investment and efforts are legitimated.
authors.affiliation: ENDOCmax der Orthopädische Klinik, Medizinische Hochschule Hannover im Annastift, Anna-von-Borries-Straße 1-7, 30625, Hannover, Deutschland, Gabriela.Lewinski@ddh-gruppe.de.
authors.forename: G
authors.initials: G
authors.lastname: von Lewinski
authors.forename: T
authors.initials: T
authors.lastname: Floerkemeier
authors.forename: S
authors.initials: S
authors.lastname: Budde
authors.forename: U
authors.initials: U
authors.lastname: Fuhrmann
authors.forename: M
authors.initials: M
authors.lastname: Schwarze
authors.forename: H
authors.initials: H
authors.lastname: Windhagen
authors.forename: K
authors.initials: K
authors.lastname: Radtke
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000592:standards*; D019645:Arthroplasty, Replacement, Knee / Q000592:standards*; D002568:Certification / Q000592:standards*; D019091:Critical Pathways / Q000592:standards*; D005858:Germany; D006801:Humans; D009985:Orthopedics / Q000592:standards*; D011785:Quality Assurance, Health Care; D012955:Societies, Medical / Q000592:standards; D016896:Treatment Outcome