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人工膝关节感染:十种有效的策略。

Periprosthetic knee infection: ten strategies that work.

作者信息

Parvizi Javad, Cavanaugh Priscilla Ku, Diaz-Ledezma Claudio

机构信息

Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

出版信息

Knee Surg Relat Res. 2013 Dec;25(4):155-64. doi: 10.5792/ksrr.2013.25.4.155. Epub 2013 Nov 29.

Abstract

Periprosthetic joint infection (PJI) is one of the most serious complications following total knee arthroplasty (TKA). The demand for TKA is rapidly increasing, resulting in a subsequent increase in infections involving knee prosthesis. Despite the existence of common management practices, the best approach for several aspects in the management of periprosthetic knee infection remains controversial. This review examines the current understanding in the management of the following aspects of PJI: preoperative risk stratification, preoperative antibiotics, preoperative skin preparation, outpatient diagnosis, assessing for infection in revision cases, improving culture utility, irrigation and debridement, one and two-stage revision, and patient prognostic information. Moreover, ten strategies for the management of periprosthetic knee infection based on available literature, and experience of the authors were reviewed.

摘要

人工关节周围感染(PJI)是全膝关节置换术(TKA)后最严重的并发症之一。TKA的需求正在迅速增加,导致涉及膝关节假体的感染随之增加。尽管存在常见的管理方法,但人工膝关节感染管理中几个方面的最佳方法仍存在争议。本综述探讨了目前对PJI以下方面管理的理解:术前风险分层、术前抗生素、术前皮肤准备、门诊诊断、翻修病例中的感染评估、提高培养效用、冲洗和清创、一期和二期翻修以及患者预后信息。此外,还回顾了基于现有文献和作者经验的人工膝关节感染管理的十种策略。

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