Haubruck Patrick, Schmidmaier Gerhard
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland.
Unfallchirurg. 2017 Feb;120(2):110-115. doi: 10.1007/s00113-016-0300-3.
Despite modern treatment options, implant-associated infections (IAI) remain a severe and challenging complication in the treatment of trauma patients. Almost 30 years after the introduction of implants made of titanium alloy into the treatment of trauma patients, there is still no uniform consensus regarding the clinical benefit of titanium alloy in the context of patients with IAI.
We sought to determine if implants made of titanium alloy have been proven to be less susceptible regarding IAI in contrast to implants made of stainless steel.
A review of the current literature on IAI in association with the utilized implant material was conducted. Relevant articles from the years 1995 to 2016 were searched in the PubMed database. A total of 183 articles were identified and all abstracts were reviewed for relevance. A total of 14 articles met the inclusion criteria and were stratified according to the level of evidence and furthermore evaluated regarding the influence of the implant material on IAI.
Considerable debate remains concerning the influence of the implant material on the susceptibility to IAI; however, the available literature shows that despite slight tendencies, there is no proof of titanium alloy being favorable in the susceptibility to IAI. Furthermore, the literature shows that the design of plates for osteosynthesis might influence IAI. In particular, plates that cause less soft tissue damage and preserve perfusion of the periosteum proved to be beneficial regarding IAI.
尽管有现代治疗方案，但植入物相关感染（IAI）仍是创伤患者治疗中严重且具有挑战性的并发症。在将钛合金植入物引入创伤患者治疗近30年后，关于钛合金在IAI患者中的临床益处仍未达成统一共识。
我们试图确定与不锈钢植入物相比，钛合金植入物是否已被证明对IAI的易感性更低。
对当前关于IAI与所用植入物材料相关的文献进行综述。在PubMed数据库中搜索1995年至2016年的相关文章。共识别出183篇文章，并对所有摘要进行相关性审查。共有14篇文章符合纳入标准，根据证据水平进行分层，并进一步评估植入物材料对IAI的影响。
关于植入物材料对IAI易感性的影响仍存在相当大的争议；然而，现有文献表明，尽管有轻微趋势，但没有证据证明钛合金在IAI易感性方面具有优势。此外，文献表明骨合成钢板的设计可能会影响IAI。特别是，对软组织损伤较小且能保留骨膜血供的钢板在IAI方面被证明是有益的。
