Wilke Benjamin, Wagner Eric, Trousdale Robert
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty. 2015 May;30(5):808-12. doi: 10.1016/j.arth.2014.10.037. Epub 2014 Nov 11.
Revision total knee arthroplasty (TKA) in prosthetic joint infections (PJI) is a challenging problem. We evaluated our institutional experience with a semi-constrained implant placed in a PJI setting. Seventy-eight TKAs in 75 patients with a history of a PJI were identified. The average follow-up was 7.5 years. Twenty-three (29%) underwent repeat revision surgery. Five and 10 year survivals were 71% and 64%, respectively. The most common reason for repeat revision surgery was recurrent infection (78%). Smoking and elevated BMI increased the risk of repeat revision surgery. Significant improvements were maintained long term in pain and range of motion (P < 0.01 and P = 0.02). In the absence of repeat infection, long term pain relief and improved function may be expected with the semi-constrained implant.
假体关节感染（PJI）患者的全膝关节置换翻修术（TKA）是一个具有挑战性的问题。我们评估了在PJI情况下植入半限制性假体的机构经验。确定了75例有PJI病史患者的78例TKA。平均随访时间为7.5年。23例（29%）接受了再次翻修手术。5年和10年生存率分别为71%和64%。再次翻修手术最常见的原因是反复感染（78%）。吸烟和BMI升高会增加再次翻修手术的风险。疼痛和活动范围长期保持显著改善（P<0.01和P = 0.02）。在没有反复感染的情况下，半限制性假体有望实现长期疼痛缓解和功能改善。
