Choong Peter F M, Dowsey Michelle M, Carr Derek, Daffy John, Stanley Peter
Department of Orthopaedics, University of Melbourne, and Infectious Diseases Unit, St. Vincent's Hospital, Australia.
Acta Orthop. 2007 Dec;78(6):755-65. doi: 10.1080/17453670710014527.
Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy.
Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months.
There was a correlation between having a body mass index (BMI) of >or=30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit.
Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implantation was included, 13 of 14 patients had a mobile prosthetic joint without further infection.
急性人工关节感染是一个严重问题。我们报告与急性感染发生率相关的因素以及联合关节清创术和基于利福平的延长抗生素治疗的结果。
1998年至2004年间，819例初次髋关节置换术后发生14例急性感染。分析了患者相关因素和手术因素与感染风险之间的关联。感染采用多次关节灌洗、清创、2周抗生素治疗，然后口服抗生素至少6个月。
体重指数（BMI）≥30且合并症超过2种与感染风险增加相关。糖尿病是一个潜在风险因素。按照我们的治疗方案，14例患者中有11例保留了假体。3例需要行关节切除成形术的患者中有2例成功进行了分期翻修，而第3例患者因身体状况不佳未进行进一步手术。
14例患者中有11例成功保留了初次关节置换。若将成功再次植入计算在内，14例患者中有13例拥有可活动的人工关节且无进一步感染。
