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全肘关节置换术后假体周围感染的一期翻修术

Single-stage revision of peri-prosthetic infection following total elbow replacement.

作者信息

Gille J, Ince A, González O, Katzer A, Loehr J F

机构信息

Endoklinik Hamburg, Holstenstrasse 2, D-22767 Hamburg, Germany.

出版信息

J Bone Joint Surg Br. 2006 Oct;88(10):1341-6. doi: 10.1302/0301-620X.88B10.17952.

Abstract

This study reviews the predisposing features, the clinical, and laboratory findings at the time of diagnosis and the results of single-stage revision of prosthetic replacement of the elbow for infection. Deep infection occurred in six of 305 (1.9%) primary total elbow replacements. The mean follow-up after revision was 6.8 years (6 months to 16 years) and the mean age at the time of revision was 62.7 years (56 to 74). All six cases with infection had rheumatoid arthritis and had received steroid therapy. The infective organism was Staphylococcus aureus. Four of the six elbows had a developed radiolucency around one component or the other. Successful single-stage exchange arthroplasty was carried out with antibiotic-loaded cement in five of the six cases. In one, the revision prosthesis had to be removed following recurrence of the infection. The functional result was good in three elbows, fair in one, poor in one and fair in the resection arthroplasty.

摘要

本研究回顾了肘关节假体置换术后感染的易感因素、诊断时的临床及实验室检查结果,以及一期翻修的结果。305例初次全肘关节置换术中,有6例(1.9%)发生深部感染。翻修术后的平均随访时间为6.8年(6个月至16年),翻修时的平均年龄为62.7岁(56至74岁)。所有6例感染患者均患有类风湿关节炎且接受过类固醇治疗。感染病原体为金黄色葡萄球菌。6例肘关节中有4例在一个或另一个假体部件周围出现了透亮区。6例中有5例成功进行了一期抗生素骨水泥型关节置换翻修术。1例患者在感染复发后不得不取出翻修假体。3例肘关节功能结果良好,1例尚可,1例较差,切除成形术的结果为尚可。

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