Anderson John A, Sculco Peter K, Heitkemper Sven, Mayman David J, Bostrom Mathias P, Sculco Thomas P
Hospital for Special Surgery, New York, New York 10021, USA.
J Arthroplasty. 2009 Jun;24(4):631-5. doi: 10.1016/j.arth.2008.04.003. Epub 2008 May 14.
This retrospective study analyzed 25 consecutive patients (25 knees) with chronic deep TKA infection. During 1997-2004, patients underwent two-stage articulating spacer surgery. The original femoral component was removed, autoclaved and replaced and a new polyethylene was utilized. The second- stage procedure occurred at a mean of 11 weeks (range: 4 to 39 weeks) after spacer insertion. Mobilization was encouraged between stages. All patients were assessed at a minimum of two years (mean 54 months; range: 24-108 months) post re-implantation, and Modified Hospital for Special Surgery (HSS) knee scores were calculated. Only one patient (4%) had re-infection. Average ROM before re-implantation was 5 degrees to 112 degrees , and 3 degrees to 115 degrees at latest follow-up. HSS scores averaged 91 (Range: 65-100) at latest follow-up. Two-stage re-implantation with an articulating spacer for infected TKA effectively treats infection and gives excellent knee motion between stages, and at mid- to long-term follow-up.
这项回顾性研究分析了25例连续性慢性全膝关节置换术（TKA）深部感染患者（25个膝关节）。在1997年至2004年期间，患者接受了两阶段的可活动间隔物手术。移除原有的股骨部件，进行高压灭菌后再替换，并使用新的聚乙烯材料。第二阶段手术在间隔物植入后平均11周（范围：4至39周）进行。两阶段之间鼓励患者活动。所有患者在重新植入后至少两年（平均54个月；范围：24至108个月）接受评估，并计算改良的特种外科医院（HSS）膝关节评分。只有1例患者（4%）发生再次感染。重新植入前的平均活动范围为5度至112度，最近一次随访时为3度至115度。最近一次随访时HSS评分平均为91分（范围：65至100）。采用可活动间隔物的两阶段重新植入术治疗感染性TKA能有效治疗感染，在两阶段之间以及中长期随访时能实现出色的膝关节活动度。
