Department of Orthopedic Surgery, Policlinico G.B. Rossi, Verona University School of Medicine, Piazzale LA Scuro 10, 37134 Verona, Italy.
Int J Infect Dis. 2010 Mar;14(3):e259-61. doi: 10.1016/j.ijid.2009.04.019. Epub 2009 Aug 6.
Preformed spacers have proved to be effective in the two-stage revision of infected total hip replacements. In the treatment of septic arthritis of the hip, the use of a temporary device has occasionally been described, but the implantation of a preformed antibiotic-loaded spacer has not yet been reported. A 71-year-old man with a destructive Staphylococcus aureus septic arthritis of the hip joint was admitted to hospital. Given the persistence of local infection regardless of all antibiotics and the worsening of joint damage, an aggressive surgical treatment including early placement of a preformed temporary spacer loaded with antibiotics was performed. Two months later an uncemented total hip replacement was successfully implanted. Two years after surgery the patient had a complete functional recovery with no signs of recurrence. The advantages of a preformed device include an effective and predictable local release of antibiotics and a mechanically tested resistance that allows early partial weight bearing and immediate joint mobilization.
预制间隔物已被证明在感染性全髋关节翻修的两期手术中有效。在髋关节化脓性关节炎的治疗中,偶尔会使用临时装置,但尚未报道使用预制抗生素载药间隔物。一名 71 岁男性患有破坏性金黄色葡萄球菌髋关节化脓性关节炎,被收入院。尽管使用了所有抗生素,但局部感染仍持续存在,且关节损伤不断恶化,因此采用了积极的手术治疗,包括早期放置载抗生素的预制临时间隔物。两个月后,成功植入了非骨水泥全髋关节置换。手术后两年,患者完全恢复了功能,无复发迹象。预制装置的优点包括抗生素的有效且可预测的局部释放以及经过机械测试的阻力,这可以允许早期部分负重和立即关节活动。