先前患有踝关节感染性关节炎的患者在接受全踝关节置换术（TAA）时，最佳的处理方法是什么？

What Is the Optimal Management of Patients With Prior Septic Arthritis of the Ankle Who Are Undergoing Total Ankle Arthroplasty (TAA)?

机构信息

1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

2 Codivilla-Putti Institutes and Italian National Department of the Bone Infections, Bologna, Italy.

出版信息

Foot Ankle Int. 2019 Jul;40(1_suppl):9S-10S. doi: 10.1177/1071100719859326.

DOI:10.1177/1071100719859326

PMID:31322938

Abstract

RECOMMENDATION

There is a paucity of data regarding total ankle arthroplasty (TAA) in patients with prior infection involving the ankle, whether it be septic arthritis, osteomyelitis, or infection of the surrounding soft tissues. We recommend that patients with prior infections in the affected ankle be worked up for infection, including a thorough history and physical examination, as well as ordering serologic tests and possible aspiration of the joint. During ankle arthroplasty in patients with prior infection, antibiotics should be added to the cement (if used), and the joint should be thoroughly cleansed. Intraoperative cultures of bone and soft tissue should also be obtained.

LEVEL OF EVIDENCE

Consensus.

DELEGATE VOTE

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).

摘要

建议

对于先前累及踝关节的感染（包括化脓性关节炎、骨髓炎或周围软组织感染）的患者，目前有关全踝关节置换术（TAA）的数据较少。我们建议对有既往感染的患踝进行感染检查，包括详细的病史和体格检查，以及血清学检查和可能的关节抽吸。对于有既往感染的踝关节置换术患者，应在骨水泥（如果使用）中添加抗生素，并彻底清洗关节。还应获取骨和软组织的术中培养物。