Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Expert Rev Med Devices. 2020 Mar;17(3):245-252. doi: 10.1080/17434440.2020.1733971. Epub 2020 Mar 2.
: Periprosthetic joint infection (PJI) remains one of the most dreaded and challenging complications in adult reconstruction. While primary total joint arthroplasty is one of the most successful surgeries in medicine, revisions secondary to infections do not hold as well. As the number of primary procedures increases, so will infections. In North America, two-stage exchange arthroplasty is the standard of care for patients with PJI, especially when the presentation is greater than 4 weeks after the index procedure. However, it is not necessarily the best option for all patients, particularly when compared to one-stage arthroplasty.: The aim of this review is to analyze the indications, safety, and efficacy of two-stage exchange arthroplasty for the treatment of PJI and to compare the results reported 10 years ago with the ones of recent publications and those of one-stage arthroplasty.: Two-stage exchange arthroplasty is a safe and efficacious treatment particularly suited for recalcitrant infections, resistant organisms, and patients with certain host factors that make it more difficult to eradicate infection. However, one-stage arthroplasty might be well suited as well for infections caused by susceptible organisms and patients with minimal or no comorbidities or those unable to undergo two surgeries.
: 人工关节周围感染（PJI）仍然是成人重建中最可怕和最具挑战性的并发症之一。虽然初次全关节置换术是医学上最成功的手术之一，但因感染而进行的翻修效果并不理想。随着初次手术数量的增加，感染的数量也会增加。在北美，二期关节置换术是 PJI 患者的标准治疗方法，特别是在指数手术后 4 周以上出现感染时。然而，对于所有患者来说，它不一定是最佳选择，尤其是与一期关节置换术相比。: 本综述的目的是分析二期关节置换术治疗 PJI 的适应证、安全性和疗效，并将 10 年前的结果与近期出版物的结果以及一期关节置换术的结果进行比较。: 二期关节置换术是一种安全有效的治疗方法，特别适用于难治性感染、耐药菌以及存在某些宿主因素的患者，这些因素使得感染更难根除。然而，一期关节置换术也可能适用于由敏感菌引起的感染以及合并症少或无、或无法接受两次手术的患者。
