Fink B, Schäfer P, Frommelt L
Klinik für Endoprothetik, Allgemeine und Rheumaorthopädie, Orthopädische Klinik Markgröningen, Kurt-Lindemann-Weg 10, 71706 Markgröningen, Deutschland.
Orthopade. 2012 Jan;41(1):15-9. doi: 10.1007/s00132-011-1836-0.
Preoperative diagnosis of periprosthetic infections is particularly important before revision of knee and hip arthroplasties because of the therapeutic consequences. Therefore, periprosthetic infections should be ruled out before any revision surgery is performed. Of the different diagnostic methods direct techniques which allow the direct detection of microorganisms with testing of antibiotic sensitivity are recommended. This allows microorganism-specific systemic and local antibiotic therapies and helps to reduce the risk of development of resistance. In our studies it could be shown that the time for incubation to detect microorganisms should be 14 days and that biopsy of periprosthetic tissues is superior to aspiration alone because it combines several diagnostic methods (microbiological and histological). It is preferable to repeating an aspiration when data are unclear, i.e. in cases of potentially false positives or negatives results of aspiration.
由于治疗后果，膝关节和髋关节置换翻修术前假体周围感染的术前诊断尤为重要。因此，在进行任何翻修手术之前，都应排除假体周围感染。在不同的诊断方法中，推荐采用直接检测微生物并测试抗生素敏感性的直接技术。这有助于进行针对微生物的全身和局部抗生素治疗，并有助于降低耐药性产生的风险。我们的研究表明，检测微生物的培养时间应为14天，假体周围组织活检优于单纯抽吸，因为它结合了多种诊断方法（微生物学和组织学）。当数据不明确时，即在抽吸结果可能为假阳性或假阴性的情况下，重复抽吸是更好的选择。
