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髋关节和膝关节置换术中的细菌感染与植入物松动:209例病例评估

Bacterial Infection and Implant Loosening in Hip and Knee Arthroplasty: Evaluation of 209 Cases.

作者信息

Dapunt Ulrike, Radzuweit-Mihaljevic Stephanie, Lehner Burkhard, Haensch Gertrud Maria, Ewerbeck Volker

机构信息

Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, Heidelberg 69118, Germany.

Institute for Immunology, Heidelberg University, Im Neuenheimer Feld 305, Heidelberg 69120, Germany.

出版信息

Materials (Basel). 2016 Oct 26;9(11):871. doi: 10.3390/ma9110871.

Abstract

The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients ( = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention. Coagulase-negative spp. were most frequently detected, followed by Differences in CRP concentration were detected among various bacteria species. Osteolysis was not associated with one causative agent in particular. Patients who had undergone previous revision surgery had a higher probability of implant loosening. Coagulase-negative spp. are the most common causative agents of prosthetic joint infection and show no significant differences with regard to implant loosening or the time-course when compared to Infections with spp. seem to develop faster than with other bacteria species. The risk of implant loosening increases with revision surgery, in particular in the hip joint.

摘要

本研究的目的是评估在一家单一专业中心接受髋膝关节假体感染治疗的大量患者中检测到的细菌种类。此外,还对最常检测到的细菌种类,以时间依赖性方式研究了植入物松动率。对209例接受髋膝关节假体感染治疗的患者进行了回顾性分析。评估了以下参数:C反应蛋白(CRP)浓度、组织样本的微生物学评估、植入物松动情况、初次假体关节置换术后经过的时间以及上次手术干预后的持续时间。凝固酶阴性葡萄球菌最常被检测到,其次是金黄色葡萄球菌。不同细菌种类之间检测到CRP浓度存在差异。骨溶解并非与某一种特定病原体相关。既往接受过翻修手术的患者植入物松动的可能性更高。凝固酶阴性葡萄球菌是假体关节感染最常见的病原体,与金黄色葡萄球菌相比,在植入物松动或病程方面无显著差异。与其他细菌种类相比,金黄色葡萄球菌感染似乎发展得更快。植入物松动的风险随着翻修手术而增加,尤其是在髋关节。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4e6/5457256/47759a496cb1/materials-09-00871-g001a.jpg

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