Kim Manyoung, Ha Chul-Won, Jang Jae Won, Park Yong-Beom
Department of Orthopedic Surgery, Gangnam Nanoori Hospital, 731 Eonju-ro, Gangnam-gu, Seoul 06048, South Korea.
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea; Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea.
Knee. 2017 Aug;24(4):869-875. doi: 10.1016/j.knee.2017.04.015. Epub 2017 May 24.
Non-tuberculous mycobacteria (NTM) cause prosthetic knee joint infections in rare cases. Infections with rapidly growing non-tuberculous mycobacteria (RGNTM) are difficult to treat due to their aggressive clinical behavior and resistance to antibiotics. Infections of a prosthetic knee joint by RGNTM have rarely been reported. A standard of treatment has not yet been established because of the rarity of the condition. In previous reports, diagnoses of RGNTM infections in prosthetic knee joints took a long time to reach because the condition was not suspected, due to its rarity. In addition, it is difficult to identify RGNTM in the lab because special identification tests are needed. In previous reports, after treatment for RGNTM prosthetic infections, knee prostheses could not be re-implanted in all cases but one, resulting in arthrodesis or resection arthroplasty; this was most likely due to the aggressiveness of these organisms. In the present report, two cases of prosthetic knee joint infection caused by RGNTM (Mycobacterium abscessus) are described that were successfully treated, and in which prosthetic joints were finally reimplanted in two-stage revision surgery.
非结核分枝杆菌（NTM）在罕见情况下会导致人工膝关节感染。快速生长的非结核分枝杆菌（RGNTM）感染因其侵袭性的临床行为和对抗生素的耐药性而难以治疗。RGNTM引起的人工膝关节感染鲜有报道。由于这种情况罕见，尚未确立治疗标准。在以往的报告中，由于RGNTM感染罕见，未被怀疑，所以人工膝关节RGNTM感染的诊断耗时良久。此外，由于需要特殊的鉴定试验，在实验室中很难鉴定RGNTM。在以往的报告中，在治疗RGNTM人工感染后，除1例之外，所有病例的膝关节假体均无法再次植入，导致关节融合或切除关节成形术；这很可能是由于这些微生物的侵袭性所致。在本报告中，描述了2例由RGNTM（脓肿分枝杆菌）引起的人工膝关节感染病例，这些病例得到了成功治疗，并且在二期翻修手术中最终重新植入了人工关节。
