Di Benedetto Paolo, Di Benedetto Enrico Daniele, Buttironi Michele Mario, De Franceschi D, Beltrame Alessandro, Gissoni Renato, Cainero Vanni, Causero Araldo
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Acta Biomed. 2017 Jun 7;88(2S):92-97. doi: 10.23750/abm.v88i2-S.6519.
Periprosthetic knee infection is a complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5,6% in revisions; incidence is increasing over the years. Two-stage revision is the technique used in chronic infection. Aim of the work is to check success rate in our data. Methods. We analyzed retrospectively data of patients who undergone two stage revision surgery between 01/01/2010 to 31/12/2015. We made a clinical and radiological control after 1, 3, 6, 12, 24 months and we evaluate the outcome in December 2016. Results. Between 2010 and 2015 we treated 45 patients with two-stage revision. Mean follow-up was 3,4 years. Success rate is 89,9%. We had failure in 5 patients: everyone had knee surgery before first knee arthroplasty and Charlson Comorbidity Score was greater then 4 in 4 cases. Conclusions. Two stage revision can be considered a successful treatment in chronic periprosthetic knee infection. It has an optimal success rate, but it has some disadvantages as joint stiffness and pain in the interval between stages. This is a technique with two major surgery procedure with associated morbidity, discomfort, cost and prolonged stay in hospital.
人工膝关节周围感染是一种与假体失败相关的并发症；在初次全膝关节置换中发生率为0.4%-2%，翻修手术中为5.6%；近年来发生率呈上升趋势。两阶段翻修是用于慢性感染的技术。本研究的目的是在我们的数据中检验成功率。方法。我们回顾性分析了2010年1月1日至2015年12月31日期间接受两阶段翻修手术的患者数据。在术后1、3、6、12、24个月进行临床和影像学检查，并于2016年12月评估结果。结果。2010年至2015年期间，我们对45例患者进行了两阶段翻修。平均随访3.4年。成功率为89.9%。我们有5例失败病例：所有患者在首次膝关节置换术前均接受过膝关节手术，4例患者的Charlson合并症评分大于4分。结论。两阶段翻修可被认为是治疗慢性人工膝关节周围感染的一种成功方法。它有最佳的成功率，但也有一些缺点，如关节僵硬和两阶段之间的疼痛。这是一种涉及两次主要手术的技术，伴有发病率、不适、费用和住院时间延长等问题。
