Department of Orthopedics, Hospital for Special Surgery, New York, New York 10021, USA.
J Arthroplasty. 2009 Oct;24(7):1051-60. doi: 10.1016/j.arth.2008.07.004. Epub 2008 Oct 9.
Infection is a devastating complication of total hip arthroplasty (THA). This study aimed to determine whether 2-stage reimplantation is still effective for treating contemporary pathogens, including multidrug-resistant organisms. Records of all cases of infected THAs from 1989 to 2003 were reviewed for data on organism, presence of drug resistance, use of an antibiotic-impregnated spacer, type of reimplant, and success of treatment. Of the 87 protocol patients with 2 years of follow-up, 94.3% (82) underwent reimplantation. The original infection was eradicated in 80 of the 84 hips (78/82 patients), a success rate of 95%. All 21 multidrug-resistant infections were eradicated. There were no major differences in eradication rates when the period was split into 3 sections. These results support previous studies from our institution which demonstrated the effectiveness of a 2-stage reimplantation protocol with a standard 1:8 minimal bactericidal titer for treating infections after THA, including those due to methicillin-resistant organisms.
感染是全髋关节置换术（THA）的一种严重并发症。本研究旨在确定 2 期再植入术对于治疗包括耐多药菌在内的当代病原体是否仍然有效。回顾了 1989 年至 2003 年所有感染性 THA 病例的记录，以获取有关病原体、耐药性、抗生素浸渍间隔物使用、再植入类型和治疗成功的数据。在接受了 2 年随访的 87 名协议患者中，94.3%（82 名）进行了再植入。84 髋中有 80 髋（78/82 例患者）消除了原感染，成功率为 95%。所有 21 例耐多药感染均得到消除。将时间段分为 3 个部分时，清除率没有明显差异。这些结果支持了我们机构之前的研究，该研究表明，使用标准的 1:8 最小杀菌浓度的 2 期再植入方案治疗 THA 后感染，包括耐甲氧西林菌引起的感染，是有效的。
