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[人工膝关节周围感染中动态与静态骨水泥间隔器的Meta分析]

[Dynamic versus static cement spacer in periprosthetic knee infection: A meta-analysis].

作者信息

Citak Mustafa, Citak Musa, Kendoff Daniel

机构信息

Orthopädische Chirurgie, Helios ENDO-Klinik Hamburg, Holstenstraße 2, 22767, Hamburg, Deutschland,

出版信息

Orthopade. 2015 Aug;44(8):599-606. doi: 10.1007/s00132-015-3091-2.

Abstract

BACKGROUND

The standard of care for treatment of periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is two-stage revision arthroplasty. The cement spacer in the interim period can be classified as either a static/non-articulating spacers (e.g., traditionally simple cement blocks) or a mobile/articulating spacer.

OBJECTIVES

The goal of the present meta-analysis is to analyze the outcomes with regard to infection control between dynamic and static knee spacers in the treatment of infected TKA with a minimum 3-year follow-up.

MATERIALS AND METHODS

We systematically reviewed the literature for potentially relevant articles addressing two-stage revision of an infected TKA using the MEDLINE computerized literature databases. Only 25 articles studies with a minimum follow-up examination of 36 months met the inclusion criteria and were analyzed with regard to infection control after reimplantation between static (318 cases) and dynamic group (700 cases).

RESULTS

At latest follow-up, the eradication rate in the dynamic group was 89.7% (range 63-100%; SD 9.1) and in the static group 84.8% (range 67-92.4%; SD 7.8; p = 0.32). We are unable to comment on the Hospital for Special Surgery (HSS) Score and complication rates between static and dynamic spacers because the majority of the studies did not report on this.

CONCLUSION

The data show that there are no differences regarding infection control between static and dynamic spacers in the treatment of infected TKA.

摘要

背景

全膝关节置换术(TKA)后假体周围关节感染(PJI)的标准治疗方法是两阶段翻修关节成形术。在此期间使用的骨水泥间隔物可分为静态/非关节型间隔物(例如,传统的简单骨水泥块)或动态/关节型间隔物。

目的

本荟萃分析的目的是分析在至少3年随访的感染性TKA治疗中,动态和静态膝关节间隔物在感染控制方面的结果。

材料与方法

我们使用MEDLINE计算机文献数据库系统回顾了关于感染性TKA两阶段翻修的潜在相关文章。只有25项至少36个月随访检查的研究符合纳入标准,并对静态组(318例)和动态组(700例)再植入后的感染控制情况进行了分析。

结果

在最新随访时,动态组的根除率为89.7%(范围63 - 100%;标准差9.1),静态组为84.8%(范围67 - 92.4%;标准差7.8;p = 0.32)。我们无法对静态和动态间隔物之间的特殊外科医院(HSS)评分及并发症发生率进行评论,因为大多数研究未报告这方面内容。

结论

数据表明,在感染性TKA治疗中,静态和动态间隔物在感染控制方面没有差异。

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