Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
J Arthroplasty. 2019 Nov;34(11):2770-2773. doi: 10.1016/j.arth.2019.06.030. Epub 2019 Jun 20.
It is considered the gold standard treatment for infected hip arthroplasty to remove and reimplant the corresponding whole set of implant components before and after infection control, but it usually causes substantial bone loss to remove the well-fixed cup or stem, which may increase the difficulty in reconstruction. We would like to determine whether infected hip arthroplasty can be treated without removal of a well-fixed cup or stem.
Patients with infected hip arthroplasty and a radiographically well-fixed, cementless cup or stem were selected. During the first surgical stage, we retained the stem or cup if these cannot be removed using a stem or cup extractor. We performed the reimplantation surgery after control of infection.
From January 2008 to December 2016, 26 patients underwent partial component-retained 2-stage reconstruction. All the patients were free of infection with a mean follow-up time of 43.85 months.
Partial component-retained 2-stage reconstruction may be a treatment option for infected total hip arthroplasty with a well-fixed component in patients.
在感染性髋关节置换术的治疗中,在感染控制前后将整套植入物组件取出并重新植入被认为是金标准治疗方法,但通常会因取出固定良好的杯或柄而导致大量骨质丢失,这可能会增加重建的难度。我们想确定对于固定良好的杯或柄是否可以不取出而治疗感染性髋关节置换术。
选择患有感染性髋关节置换术且影像学上固定良好、非骨水泥杯或柄的患者。在第一阶段手术中,如果无法使用柄或杯取出器取出柄或杯,则保留柄或杯。在感染得到控制后进行再植入手术。
2008 年 1 月至 2016 年 12 月,26 例患者接受了部分保留组件的两期重建。所有患者均无感染,平均随访时间为 43.85 个月。
对于固定良好的组件的感染性全髋关节置换术患者,部分保留组件的两期重建可能是一种治疗选择。