Sendi P, Zumstein M A, Zimmerli W
Medizinische Universitätsklinik, Kantonsspital Liestal und Universitätsklinik für Infektiologie, Inselspital, Universitätsspital Bern.
Praxis (Bern 1994). 2011 Jun 22;100(13):787-92. doi: 10.1024/1661-8157/a000560.
The number of prosthetic joint implantation is continuously increasing. Periprosthetic joint infection is a rare but serious complication. The correct diagnosis is essential for successful treatment. It requires the close collaboration between general practitioners, orthopaedic surgeons and infectious disease specialists. A delayed diagnosis sets hurdles to the medical and surgical treatment. Also, antimicrobial treatment without proper microbiological sampling must be avoided. Swabs from wounds are not helpful, because the results represent the skin flora, but not the causative pathogen of infection. The general practitioner is the first physician that patients contact and has, therefore, a central role in diagnosing and managing periprosthetic joint infections. In this review, classification, diagnostic means and treatment concepts of periprosthetic joint infections are presented.
人工关节置换的数量在持续增加。人工关节周围感染是一种罕见但严重的并发症。正确的诊断对于成功治疗至关重要。这需要全科医生、骨科医生和传染病专家之间密切协作。延迟诊断会给药物和手术治疗带来障碍。此外,必须避免在没有进行适当微生物采样的情况下进行抗菌治疗。伤口拭子检查并无帮助,因为其结果代表的是皮肤菌群,而非感染的致病病原体。全科医生是患者首先接触的医生,因此在人工关节周围感染的诊断和管理中起着核心作用。在本综述中,将介绍人工关节周围感染的分类、诊断方法和治疗理念。