Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico I.R.C.C.S. Galeazzi, Milan, Italy.
J Orthop Traumatol. 2011 Jun;12(2):81-6. doi: 10.1007/s10195-011-0135-1. Epub 2011 May 5.
Isolated reports indicate the efficacy of infrared thermography for monitoring wound healing and septic complications, but no long-term analysis has ever been performed on this, and there are no data on the telethermographic patterns of surgical site healing after uncomplicated total hip prosthesis and after knee prosthesis.
In this prospective, observational, nonrandomized cohort study, two groups with forty consecutive patients each, who were operated on respectively for total hip and for total knee replacements, underwent telethermographic examination of the operated and contralateral joints prior to and at fixed intervals for up to 1 year after uncomplicated surgery. A digital, portable telethermocamera and dedicated software were used for data acquisition and processing.
No thermographic difference was observed preoperatively between the affected side and the contralateral side in both groups. After the intervention, a steep increase in the temperature of the operated joint was recorded after total hip replacement and after knee replacement, with a peak mean differential temperature measured three days postoperatively between the operated and unoperated joint of 3.1 ± 0.8°C after total hip replacement, and 3.4 ± 0.7°C after total knee replacement. Thereafter, the mean differential temperature declined slowly to 0.7 ± 1.1°C and to 0.5 ± 1.3°C at 60 days, and to 0.0 ± 1.0°C and -0.1 ± 1.1°C 90 days post-operatively, respectively. No further changes were observed for up to 1 year after surgery. Results were similar when comparing the average telethermographic values of an elliptical area where the main axis corresponded to the surgical wound.
The surgical sites after uncomplicated total hip or total knee replacement show similar telethermographic patterns for up to 1 year from surgery, and can easily be monitored using a portable, digital, telethermocamera.
有孤立的报告表明，红外热成像技术在监测伤口愈合和感染并发症方面具有疗效，但尚未对此进行长期分析，也没有关于普通全髋关节假体和全膝关节假体置换术后手术部位愈合的远程热成像模式的数据。
在这项前瞻性、观察性、非随机队列研究中，两组各有 40 例连续患者，分别接受全髋关节和全膝关节置换术，在手术前和手术后固定时间间隔内（最长 1 年）对手术关节和对侧关节进行远程热成像检查。使用数字便携式远程热像仪和专用软件进行数据采集和处理。
两组患者在手术前，患侧与对侧之间均无热成像差异。手术后，全髋关节置换术和全膝关节置换术后，手术关节的温度急剧升高，术后 3 天，手术关节与未手术关节之间的平均温差达到 3.1±0.8°C，全髋关节置换术后为 3.4±0.7°C。此后，平均温差缓慢下降至术后 60 天的 0.7±1.1°C 和 0.5±1.3°C，术后 90 天降至 0.0±1.0°C 和-0.1±1.1°C。术后 1 年内未观察到进一步变化。当比较与手术切口主轴线对应的椭圆形区域的平均远程热像图值时，结果相似。
普通全髋关节或全膝关节置换术后，手术部位在术后 1 年内呈现相似的远程热成像模式，使用便携式数字远程热像仪可轻松进行监测。
