Norden C, Nelson J D, Mader J T, Calandra G B
Medical Research Division, Lederle Laboratories, Pearl River, New York 10965.
Clin Infect Dis. 1992 Nov;15 Suppl 1:S177-81. doi: 10.1093/clind/15.supplement_1.s177.
Infections of a prosthetic hip are of three types: acute contiguous, chronic contiguous, and hematogenous. Acute contiguous infections result from contamination of the operative field at the time of surgery; clinical manifestations of infection become apparent within 6 months. Chronic contiguous infections are diagnosed 6-24 months postoperatively and are believed to be caused by intraoperative contamination. Hematogenous seeding of prosthetic joints accounts for infections that develop > or = 2 years after surgery. Fever and pain or dysfunction of the joint may be the only signs or symptoms of prosthetic hip joint infection. Definitive diagnosis is established by culture of a needle aspirate from the joint space or by intraoperative culture. Prospective, randomized, double-blind or evaluator-blinded, active-control comparative studies are preferable to open trials. Success rates 10-14 weeks after completion of a 4- to 6-week course of antimicrobial therapy should be > or = 90%.
急性邻近性感染、慢性邻近性感染和血源性感染。急性邻近性感染是手术时手术区域受到污染所致；感染的临床表现会在6个月内显现出来。慢性邻近性感染在术后6至24个月被诊断出来，据信是由术中污染引起的。人工关节血源性播散导致的感染发生在手术2年或更久之后。发热以及关节疼痛或功能障碍可能是人工髋关节感染的唯一体征或症状。通过对关节腔穿刺液进行培养或术中培养来确诊。前瞻性、随机、双盲或评估者盲法、活性对照比较研究优于开放性试验。在完成4至6周抗菌治疗疗程10至14周后的成功率应≥90%。
