Woo Young Ha, Jeong Ju Seon, Kim Ok Geol, Lee In Seung
Department of Orthopedic Surgery, Busan Bumin Hospital, Busan, Korea.
Knee Surg Relat Res. 2018 Jun 1;30(2):142-146. doi: 10.5792/ksrr.17.054.
Taurolidine is an antimicrobial agent that was originally used in the local treatment of peritonitis. The aim of this study was to evaluate the efficacy of taurolidine irrigation in primary total knee arthroplasty (TKA).
All patients who underwent TKA at our institute from January 2015 to March 2017 were eligible. There were 300 patients in the taurolidine irrigation group and 300 patients in the control group. The patients in the taurolidine irrigation group were irrigated after implantation with a mix of 250 mL of taurolidine and 750 mL of normal saline. The patients in the control group were not irrigated after implantation. We compared postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and infection rate between groups.
The taurolidine irrigation group had a significantly lower CRP (5.39 mg/dL vs. 7.55 mg/dL; p<0.001) and ESR (53.21 mm/hr vs. 58.74 mm/hr; p=0.003) on postoperative day 3 after TKA, as compared with the control group. However, there was no difference between the two groups on postoperative days 6, 13, and 20. Periprosthetic joint infection occurred in one patient in the taurolidine irrigation group.
We believe that it is not necessary to use taurolidine for patients who undergo primary TKA.
陶罗利定是一种抗菌剂,最初用于腹膜炎的局部治疗。本研究的目的是评估陶罗利定冲洗在初次全膝关节置换术(TKA)中的疗效。
2015年1月至2017年3月在我院接受TKA的所有患者均符合条件。陶罗利定冲洗组有300例患者,对照组有300例患者。陶罗利定冲洗组患者在植入后用250 mL陶罗利定和750 mL生理盐水的混合液冲洗。对照组患者在植入后不进行冲洗。我们比较了两组术后的C反应蛋白(CRP)、红细胞沉降率(ESR)和感染率。
与对照组相比,TKA术后第3天,陶罗利定冲洗组的CRP(5.39 mg/dL对7.55 mg/dL;p<0.001)和ESR(53.21 mm/hr对58.74 mm/hr;p = 0.003)显著更低。然而,两组在术后第6、13和20天没有差异。陶罗利定冲洗组有1例患者发生假体周围关节感染。
我们认为,对于接受初次TKA的患者,没有必要使用陶罗利定。