Department of Orthopaedics, University of Texas Health Science Center at San Antonio, 7730 Floyd Curl Drive, San Antonio, TX 78229. E-mail address:
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905.
J Bone Joint Surg Am. 2015 Dec 2;97(23):1962-71. doi: 10.2106/JBJS.O.00170.
➤ Periprosthetic elbow infections rarely involve systemic symptoms such as fever or malaise.➤ Unlike tests for periprosthetic hip and knee infections, the diagnostic utility of blood testing and joint aspiration for periprosthetic elbow infection has not been demonstrated to date.➤ Intraoperative histological analysis has good specificity (93.1%) but very low sensitivity (51.3%) for periprosthetic elbow infection.➤ Emerging diagnostic options such as implant sonication, molecular analysis, and advanced synovial fluid cytokine and protein analysis may reduce diagnostic uncertainty in the future.➤ Recommended surgical treatment options for an infection at the site of an elbow arthroplasty include implant retention and debridement, two-stage revision with or without techniques for restoration of bone stock and triceps continuity, and resection arthroplasty.
➤ 人工肘关节感染很少出现发热或全身不适等全身症状。➤ 与髋关节和膝关节假体周围感染的检测方法不同，目前尚未证实血液检测和关节抽吸术对人工肘关节感染的诊断有帮助。➤ 术中组织学分析对人工肘关节感染具有很好的特异性（93.1%），但敏感性非常低（51.3%）。➤ 植入物超声检查、分子分析以及高级滑液细胞因子和蛋白质分析等新兴诊断方法可能会降低未来的诊断不确定性。➤ 肘关节置换术后感染的推荐手术治疗方法包括保留假体清创术、二期翻修术（包括或不包括骨库存和三头肌连续性重建技术）和关节切除成形术。
