Triantafyllopoulos Georgios K, Poultsides Lazaros A, Zhang Wei, Sculco Peter K, Ma Yan, Sculco Thomas P
Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
Department of Epidemiology and Biostatistics, The George Washington University.
J Arthroplasty. 2015 Apr;30(4):649-57. doi: 10.1016/j.arth.2014.10.026. Epub 2014 Oct 25.
The role of irrigation and debridement (I&D) in the treatment of periprosthetic joint infections (PJI) of the knee remains controversial. Our purpose was to identify the success rate and factors determining outcome of I&D in those patients. Clinical characteristics of 78 patients with PJI of the knee treated with I&D were retrospectively reviewed. Implant retention at final follow-up was achieved in 43 patients (55.1%). Logistic regression analysis revealed that duration of symptoms >5days and thyroid disease were independent predictors of I&D failure. Patients with methicillin-resistant staphylococcal infections had a success rate of 45.5% and significantly lower odds of success compared to patients with negative cultures. In selected patients, I&D is a reasonable option in the context of acute PJI of the knee.
冲洗清创术（I&D）在膝关节假体周围感染（PJI）治疗中的作用仍存在争议。我们的目的是确定这些患者接受冲洗清创术的成功率及决定其结果的因素。对78例接受冲洗清创术治疗的膝关节假体周围感染患者的临床特征进行了回顾性分析。43例患者（55.1%）在末次随访时实现了植入物保留。逻辑回归分析显示，症状持续时间>5天和甲状腺疾病是冲洗清创术失败的独立预测因素。耐甲氧西林葡萄球菌感染患者的成功率为45.5%，与培养结果为阴性的患者相比，成功几率显著更低。对于部分选定患者，冲洗清创术是膝关节急性假体周围感染情况下的一种合理选择。
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