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[植入物相关关节感染]

[Implant-associated joint infections].

作者信息

Mühlhofer Heinrich M L, Feihl Susanne, Suren Christian, Banke In Go J, Pohlig Florian, von Eisenhart-Rothe Rüdiger

机构信息

Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.

Institut für medizinische Mikrobiologie, Immunologie und Hygiene der Technischen Universität München, Trogerstr. 30, 81675, München, Deutschland.

出版信息

Orthopade. 2020 Mar;49(3):277-286. doi: 10.1007/s00132-020-03877-w.

Abstract

Due to the increasing number of endoprosthetic joint replacement operations in older patients as well as in patients with severe primary diseases and comorbidities, the number of revision operations is continuously increasing due to infections. The infection of an endoprosthesis represents a complex clinical picture. This article provides a detailed overview of the treatment of periprosthetic infections with a focus on the diagnostic approach and treatment decision-making. A differentiation is made in periprosthetic infections between infections with a mature or immature biofilm on the surface of the implant. Depending on this, different treatment concepts are available. Highly acute infections represent an orthopedic/surgical emergency in artificial as well as in native joints. Low-grade infections play a role particularly in the area of exchange endoprosthetics. The greatest possible success is achieved only by the interplay of a timely diagnosis, sufficient surgical approach and individualized anti-infective treatment.

摘要

由于老年患者以及患有严重原发性疾病和合并症的患者接受关节置换手术的数量不断增加,因感染导致的翻修手术数量也在持续上升。人工关节假体感染呈现出复杂的临床症状。本文详细概述了人工关节周围感染的治疗方法,重点是诊断方法和治疗决策。人工关节周围感染可分为植入物表面生物膜成熟或不成熟的感染。据此,有不同的治疗理念。高度急性感染在人工关节和天然关节中均代表骨科/外科急症。低度感染尤其在翻修人工关节领域发挥作用。只有通过及时诊断、充分的手术方法和个体化抗感染治疗的相互配合,才能取得最大可能的成功。

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