Klinik für Orthopädie und Orthopädische Chirurgie, Universitätskliniken des Saarlandes, Homburg/Saar, Germany.
J Arthroplasty. 2012 Feb;27(2):293-8. doi: 10.1016/j.arth.2011.04.044. Epub 2011 Jul 12.
Fungal periprosthetic joint infections are a rare entity in orthopedic surgery, and there exist no guidelines according to which these infections can be successfully managed. Between 2004 and 2009, 7 patients with fungal periprosthetic joint infections (4 total hip arthroplasties and 3 total knee arthroplasties) have been treated with a 2-stage protocol and implantation of antibiotic-loaded cement spacers. Most of the infection was caused by Candida species. Systemic antifungal agents were administered for 6 weeks in 6 cases and 6 months in 1 case. The mean spacer implantation time was 12 weeks. At a mean follow-up of 28 months (5-70 months), no persistence of infection or reinfection could be observed. A 2-stage treatment protocol with implantation of an antibiotic-loaded cement spacer is an efficient option in the treatment of fungal periprosthetic infections.
真菌性假体周围关节感染在骨科手术中较为罕见,目前尚无针对此类感染的成功管理指南。2004 年至 2009 年间,采用 2 期清创术联合抗生素骨水泥占位器植入术治疗 7 例真菌性假体周围关节感染患者(4 例全髋关节置换术,3 例全膝关节置换术)。感染大多由念珠菌属引起。6 例患者接受了 6 周的全身抗真菌药物治疗,1 例患者接受了 6 个月的治疗。平均占位器植入时间为 12 周。平均随访 28 个月(5-70 个月),未观察到感染持续或再感染。2 期清创术联合抗生素骨水泥占位器植入术是治疗真菌性假体周围感染的有效方法。