Orthopaedic Surgery, Elda University Hospital, Elda, Alicante, Spain.
Orthopaedic Surgery, Elda University Hospital, Elda, Alicante, Spain.
Clin Microbiol Infect. 2015 Sep;21(9):851.e11-7. doi: 10.1016/j.cmi.2015.05.028. Epub 2015 Jun 4.
Sixty-four patients with periprosthetic infection within 3 months of index arthroplasty, of whom 39 underwent debridement with prosthesis retention and antibiotherapy (DPRA), and 25 underwent two-stage revision (2SR), were compared regarding control of infection and functional outcomes by use of Knee Society scores. Failure was defined as the need for subsequent surgery to control infection. The failure rate after DPRA was 61.5%, and that after 2SR was 12.0% (p 0.001). The failure risk was not significantly associated with the duration of symptoms (≤4 weeks). The only predictor of failure was isolation of Staphylococcus aureus or Staphylococcus epidermidis. Treatment with 2SR required fewer surgical operations, a shorter duration of hospitalization, and a shorter duration of treatment. All patients who required a second debridement ultimately underwent prosthesis removal. The functional outcome was significantly better for 2SR at the last follow-up.
64 例人工关节置换术后 3 个月内发生假体周围感染的患者，其中 39 例行清创保留假体联合抗生素治疗（DPRA），25 例行二期翻修（2SR），比较两组在感染控制和膝关节学会评分（Knee Society Scores）评估的功能结局方面的差异。失败定义为需要进一步手术控制感染。DPRA 组的失败率为 61.5%，2SR 组的失败率为 12.0%（p 0.001）。症状持续时间（≤4 周）与失败风险无显著相关性。唯一的失败预测因子是金黄色葡萄球菌或表皮葡萄球菌的分离。2SR 治疗需要的手术操作更少，住院时间更短，治疗时间更短。所有需要再次清创的患者最终都进行了假体取出。末次随访时，2SR 的功能结局明显更好。
