Harris Orthopedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, GRJ-1126, Boston, MA 02114, USA.
Int Orthop. 2012 Apr;36(4):723-9. doi: 10.1007/s00264-011-1324-5. Epub 2011 Jul 27.
The purpose of this study was to compare infection control rates between implant retention and two-stage revision and assess the effectiveness of retention treatment in THA.
Twenty-eight debridements with implant retention (retention group) and 65 staged revisions (removal group) were retrospectively analysed and risk factors that can contribute to failure of infection control were explored.
For the retention and removal groups, infection control rates were 50% and 78% after initial treatment, and 68% and 82% at latest follow-up, respectively. There were no significant differences in the number of additional operative procedures, total length of hospital stay, and duration of treatment between groups. Infection of revision THA, polybacterial and S. aureus infection were identified as risk factors for infection control.
Retention treatment can be considered an initial treatment option in selected cases of primary THA, with a single organism, non-S. aureus infection with 50% chance of infection control and no disadvantages in terms of additional procedure, hospital stay, and treatment duration.
本研究旨在比较保留种植体与二期翻修治疗在全髋关节置换术(THA)中治疗感染的效果,并比较两种方法的感染控制率。
回顾性分析 28 例保留种植体清创术(保留组)和 65 例分期翻修术(去除组),并探讨可能导致感染控制失败的危险因素。
保留组和去除组初次治疗后的感染控制率分别为 50%和 78%,末次随访时分别为 68%和 82%。两组之间的附加手术次数、总住院时间和治疗时间无显著差异。翻修 THA 感染、多细菌和金黄色葡萄球菌感染被确定为感染控制的危险因素。
对于特定病例,保留种植体治疗可作为初次治疗的选择,对于初发 THA 中单一生物体、非金黄色葡萄球菌感染,保留种植体治疗有 50%的感染控制机会,且在附加手术、住院时间和治疗时间方面没有劣势。