Harris Orthopedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
J Arthroplasty. 2013 Sep;28(8 Suppl):66-70. doi: 10.1016/j.arth.2013.02.037. Epub 2013 Aug 20.
Eighty three patients of infected total hip arthroplasty (THA) treated by implant removal and staged revision were retrospectively analyzed. Clinical characteristics and treatment outcomes were compared between three groups: 17 one-stage revisions (one-stage group), 44 two-stage revisions with second stage reimplantation (two-stage reimplanted group), and 22 planned two-stage but no reimplantation (two-stage non-reimplanted group). The rate of infection control was 82% (14/17) in the one-stage group, 75% (33/44) in the two-stage reimplanted group, and 68% (15/22) in the two-stage non-reimplanted group (P=0.60). The mean of latest Harris hip score was 77, 60, and 58 (P=0.14), and the UCLA activity score was 4.0, 4.2, and 3.6 (P=0.74) for each group, respectively. Results of this study suggest that one-stage revision arthroplasty can be a treatment option in selected cases of infected THA with a satisfactory infection control rate and functional outcomes comparable to those of two-stage revision.
回顾性分析了 83 例感染性全髋关节置换术(THA)患者,这些患者均接受了假体取出和分期翻修治疗。比较了三组患者的临床特征和治疗结果:17 例一期翻修(一期组),44 例二期翻修二期再植入(二期再植入组)和 22 例计划二期但不进行再植入(二期非再植入组)。一期组的感染控制率为 82%(14/17),二期再植入组为 75%(33/44),二期非再植入组为 68%(15/22)(P=0.60)。每组的最新 Harris 髋关节评分均值分别为 77、60 和 58(P=0.14),UCLA 活动评分分别为 4.0、4.2 和 3.6(P=0.74)。本研究结果表明,对于特定的感染性 THA 病例,一期翻修关节置换术是一种治疗选择,其感染控制率和功能结果令人满意,与二期翻修相当。