Grzelecki Dariusz, Dudek Piotr, Marczak Dariusz, Sibinski Marcin, Olewnik Łukasz, Kowalczewski Jacek
Orthopedics. 2019 Sep 1;42(5):e472-e476. doi: 10.3928/01477447-20190604-06. Epub 2019 Jun 13.
This study evaluated the success and failure rates as well as the final results following 2-stage revision total knee arthroplasty (TKA) for periprosthetic joint infection (PJI). Particular emphasis was placed on comparing patients with rheumatoid arthritis (RA) and non-RA patients. A total of 140 knees that required 2-stage revision for PJI after TKA were analyzed. Mean patient age at first revision TKA was 67.9 years (range, 43 to 89 years), and mean time from second-stage revision to final follow-up was 53.3 months (range, 26 to 127 months). Thirty-eight of the 140 knees (27.1%) demonstrated recurrence of infection after first 2-stage revision. Of these, 8 required another 2-stage revision, 25 required knee arthrodesis, and 2 required amputation; 3 patients refused further treatment or were lost to follow-up. There was no recurrence of infection. No statistically significant differences were observed between the RA and non-RA groups in terms of success or failure rate (P=.6) according to Diaz-Ledezma and Knee Society Scores (P=.3). These findings indicate reinfection rates and final results were similar in RA and non-RA patients following revision TKA for PJI. [Orthopedics. 2019; 42(5):e472-e476.].
本研究评估了两阶段翻修全膝关节置换术（TKA）治疗假体周围关节感染（PJI）后的成功率、失败率以及最终结果。特别强调了对类风湿关节炎（RA）患者和非RA患者进行比较。共分析了140例TKA术后因PJI需要进行两阶段翻修的膝关节。首次翻修TKA时患者的平均年龄为67.9岁（范围43至89岁），从第二阶段翻修至最终随访的平均时间为53.3个月（范围26至127个月）。140例膝关节中有38例（27.1%）在首次两阶段翻修后出现感染复发。其中，8例需要再次进行两阶段翻修，25例需要膝关节融合术，2例需要截肢；3例患者拒绝进一步治疗或失访。未出现感染复发。根据迪亚兹 - 莱德斯马评分和膝关节协会评分，RA组和非RA组在成功率或失败率方面未观察到统计学显著差异（P = 0.6）（P = 0.3）。这些结果表明，RA患者和非RA患者在TKA翻修治疗PJI后的再感染率和最终结果相似。[《骨科》。2019年；42(5):e472 - e476。]
