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[使用含抗生素骨水泥假体进行感染性全髋关节置换术的二期翻修]

[The second stage revision for infected total hip arthroplasty using antibiotic-loaded cement prosthesis].

作者信息

Wei Wei, Kou Bo-Long, Ju Rong-Sen, Lü Hou-Shan

机构信息

Arthritis Clinic and Research Center, Beijing University People's Hospital, Beijing 100044, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Feb 15;45(4):246-8.

Abstract

OBJECTIVE

To investigate the effect of two-stage revision for infected total hip arthroplasty (THA) using antibiotic-loaded cement prosthesis.

METHODS

From June 1999 to October 2004, 14 patients who admitted for infected primary total hip arthroplasty surgeries were performed revision surgery with antibiotic-loaded cement prosthesis in two-stage. The mean Harris score of pre-operation was 23. In the first stage operation, the following steps were performed, complete debridement, removal of infected prosthesis, implantation of cement spacer with antibiotics, treatment involved concomitant administration of 3 weeks of intravenous (IV) and 1 month of oral. After 6 months, antibiotic-loaded prosthesis was implanted in the second stage.

RESULTS

The mean follow-up was 18 months (7 - 26 months), no recurrent infection occurred in all 14 patients. The mean post-operation Harris score was 70.

CONCLUSIONS

The success of the protocol to control the delayed infection after THA are complete debridement, enough interval and using antibiotic-loaded cement prosthesis in two stage revision.

摘要

目的

探讨使用含抗生素骨水泥假体进行两阶段翻修术治疗感染性全髋关节置换术(THA)的效果。

方法

1999年6月至2004年10月,对14例因初次全髋关节置换术感染而入院的患者采用含抗生素骨水泥假体进行两阶段翻修手术。术前平均Harris评分为23分。在第一阶段手术中,进行以下步骤:彻底清创、取出感染的假体、植入含抗生素的骨水泥间隔物,治疗包括静脉注射3周及口服1个月。6个月后,在第二阶段植入含抗生素的假体。

结果

平均随访18个月(7 - 26个月),14例患者均未发生反复感染。术后平均Harris评分为70分。

结论

THA术后控制延迟感染方案的成功在于彻底清创、足够的间隔时间以及在两阶段翻修中使用含抗生素骨水泥假体。

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