Hill G E, Droller D G
Hip Surgery Section of Orthopaedic Surgery, Holy Cross Hospital, Fort Lauderdale, Florida.
Orthop Rev. 1989 May;18(5):617-23.
Nine hundred thirty-two uncemented total hip replacement arthroplasties were studied. Seven hundred nineteen of these were primary operations with or without bone autograft. Two hundred thirteen were revisions with bone autograft and/or allograft. All were done by a single surgeon in a single operating theater. Prophylaxis included perioperative and postoperative antibiotics using either cefazolin or vancomycin, the use of a laminar flow room, and the use of total body exhaust systems. Aspiration of the hip with culture of the derived joint fluid was carried out preparatory to revision surgery. In each instance, the culture was negative. One acute infection and three subacute infections occurred three months and five months respectively after the index operation. One infection occurred seven months following complex revision surgery with bone allografting and autografting. The overall incidence of deep sepsis (four of 932 total cases) was 0.43%. The incidence of deep sepsis in the primary cases alone (three of 719) was 0.42%. In the revision series, the incidence of deep sepsis (one of 213) was 0.47%. No attempt was made to quantify the incidence of late sepsis. The incidence of acute and subacute postoperative deep sepsis after uncemented hip replacement, including revision surgery with major bone grafting, was comparable to other previously reported results on cemented hips.
对932例非骨水泥型全髋关节置换术进行了研究。其中719例为初次手术，伴有或不伴有自体骨移植。213例为采用自体骨移植和/或同种异体骨移植的翻修手术。所有手术均由一名外科医生在一个手术室完成。预防措施包括围手术期和术后使用头孢唑林或万古霉素进行抗生素治疗、使用层流室以及使用全身排气系统。在翻修手术前对髋关节进行穿刺并对获取的关节液进行培养。在每种情况下，培养结果均为阴性。1例急性感染和3例亚急性感染分别发生在初次手术后3个月和5个月。1例感染发生在进行同种异体骨移植和自体骨移植的复杂翻修手术后7个月。深部脓毒症的总体发生率（932例总病例中的4例）为0.43%。仅初次手术病例中的深部脓毒症发生率（719例中的3例）为0.42%。在翻修系列中，深部脓毒症的发生率（213例中的1例）为0.47%。未尝试对晚期脓毒症的发生率进行量化。非骨水泥型髋关节置换术后，包括进行主要骨移植的翻修手术在内的急性和亚急性术后深部脓毒症的发生率与先前报道的骨水泥型髋关节的其他结果相当。
