Romanò C L, Logoluso N, Dell'Oro F, Elia A, Drago L
Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4-20161, Milano, Italy.
Knee. 2012 Jun;19(3):193-7. doi: 10.1016/j.knee.2011.02.012. Epub 2011 Mar 26.
Thermal imaging with infrared thermography is a noninvasive approach to monitoring surgical site healing and detecting septic complications. The aim of this study was to set reference values for telethermographic patterns of wound healing after total knee replacement (TKR) not complicated by infection and to compare them against thermograms from patients with knee prosthesis infection. Forty consecutive patients operated for TKR underwent telethermography of the operated and the contralateral knee before and up to 12 months after uncomplicated surgery. The imaging data sets were then compared against those obtained starting 8 months after TKR in 15 other patients with diagnosed periprosthetic infection. Presurgical assessment thermograms showed no difference between the affected and the healthy knees. At assessment 3 days postoperative, the temperature of the operated knee had increased markedly, with a peak differential temperature (operated minus non-operated knee joint temperature) of 3.4±0.7°C; measurement at 90 days after surgery showed a return to baseline knee joint temperature in the patients with uncomplicated surgery. In the patients with septic complications, the mean differential temperature was 1.6±0.6°C (range, 1.1-2.5°C). Thermal imaging showed a measurable, reproducible telethermographic pattern of surgical site healing in patients with uncomplicated TKR and an elevated mean differential temperature >1.0°C in those with persistent prosthesis infection.
红外热成像技术进行热成像是一种监测手术部位愈合情况及检测败血症并发症的非侵入性方法。本研究的目的是设定全膝关节置换术（TKR）后未发生感染的伤口愈合远程热成像模式的参考值，并将其与膝关节假体感染患者的热成像图进行比较。40例接受TKR手术的连续患者在未发生并发症的手术后，于术前及术后长达12个月对手术侧膝关节和对侧膝关节进行了远程热成像检查。然后将这些成像数据集与另外15例诊断为假体周围感染的患者在TKR术后8个月开始获得的数据集进行比较。术前评估热成像图显示患侧膝关节与健康膝关节之间无差异。术后3天评估时，手术侧膝关节温度明显升高，最高温差（手术侧膝关节温度减去非手术侧膝关节温度）为3.4±0.7°C；未发生并发症的患者在术后90天测量时膝关节温度恢复至基线水平。在发生败血症并发症的患者中，平均温差为1.6±0.6°C（范围为1.1 - 2.5°C）。热成像显示，未发生并发症的TKR患者手术部位愈合具有可测量、可重复的远程热成像模式，而持续存在假体感染的患者平均温差升高>1.0°C。
