Härle A
Orthopädische Universitätsklinik, Westfälische Wilhelms-Universität Münster, Federal Republic of Germany.
Arch Orthop Trauma Surg. 1989;108(2):63-71. doi: 10.1007/BF00932159.
Early diagnosis and determined management of infection after hip replacement are the prerequisites for good end results. Infections that manifest themselves during the first 6 weeks after a prosthetic implant can be mastered by local debridement. The implant can thus be saved, and the functional performance as well. Infections that appear after this 6-week period may require temporary removal of the implant in order to control the infection. When the clinical aspects and laboratory data indicate the infection is under control, the hip endoprosthesis can be reimplanted with a very low rate of recurrence. The method applied for removal of implants and bone cement is of utmost importance for the final results, and a extremely diligent surgical technique is the basis for long-term management of infection and good functional performance. Resection arthroplasty is not the treatment of choice anymore for infected hip prostheses and should be restricted to special cases.
髋关节置换术后感染的早期诊断和确定的处理方法是取得良好最终效果的前提条件。在假体植入后的前6周内出现的感染，可以通过局部清创来控制。这样可以挽救植入物，以及其功能表现。在这6周之后出现的感染可能需要暂时取出植入物以控制感染。当临床症状和实验室数据表明感染得到控制时，可以重新植入髋关节假体，复发率很低。用于取出植入物和骨水泥的方法对最终结果至关重要，极其严谨的手术技术是感染的长期管理和良好功能表现的基础。对于感染的髋关节假体，切除关节成形术不再是首选治疗方法，应仅限于特殊情况。
