Coste J S, Reig S, Trojani C, Berg M, Walch G, Boileau P
Service de Chirugie Orthopédique et Traumatologie du Sport, Hôpital de l'Archet II, Centre Hospitalier Universitaire de Nice, BP 3079, 06202 Nice, France.
J Bone Joint Surg Br. 2004 Jan;86(1):65-9.
The management and outcome of treatment in 42 patients (49 shoulders) with an infected shoulder prosthesis was reviewed in a retrospective multicentre study of 2343 prostheses. The factors which were analysed included the primary diagnosis, the delay between the diagnosis of infection and treatment and the type of treatment. Treatment was considered to be successful in 30 patients (71%). Previous surgery and radiotherapy were identified as risk factors for the development of infection. All patients with an infected prosthesis had pain and limitation of movement and 88% showed radiological loosening. In 50% of the shoulders, the antibiotics chosen and the length of treatment were considered not to be optimal. The mean follow-up was 34 months. Antibiotics or debridement alone were ineffective. In acute infection, immediate revision with excision of all infected tissue and exchange of the prosthesis with appropriate antibiotic therapy gave the best results. Multidisciplinary collaboration is recommended.
在一项对2343个假体进行的回顾性多中心研究中，对42例（49个肩关节）感染性肩关节假体患者的治疗管理及结果进行了评估。分析的因素包括初始诊断、感染诊断与治疗之间的间隔时间以及治疗类型。30例患者（71%）的治疗被认为是成功的。既往手术和放疗被确定为感染发生的危险因素。所有感染假体的患者均有疼痛和活动受限，88%表现为影像学松动。在50%的肩关节中，所选抗生素及治疗时长被认为并非最佳。平均随访时间为34个月。单独使用抗生素或清创术无效。在急性感染中，立即翻修并切除所有感染组织，更换假体并给予适当的抗生素治疗效果最佳。建议进行多学科协作。
