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使用预制抗生素负载骨水泥间隔物的两阶段手术治疗髋关节感染的临床结果及并发症

Clinical results and complications of a two-stage procedure in hip infection using preformed antibiotic-loaded cement spacers.

作者信息

Garcia-Oltra Ester, Garcia Sebastian, Bosch Jordi, Combalia Andreu, Soriano Alex, Bori Guillem

出版信息

Acta Orthop Belg. 2019 Dec;85(4):516-524.

Abstract

Antibiotic-loaded cement spacers are used in two- stage hip replacement. The aim of our study was to compare our results using a Spacer-G with previous results reported in the literature. From June 2002 to April 2010, all patients treated with a two-stage revision were retrospectively reviewed. On the basis of the results of the first-stage procedure, 52 patients underwent the second stage, six developed a dislocation, in eight the spacer was maintained, and five patients developed an acute infection of the spacer or the infection was not resolved. With regard to the second-stage procedure the revision was successful in 44 patients, a re-infection developed in four patients and the definitive prosthesis presented a mechanical complication in four more. The literature results reported that 97.5% of the spacers were reimplanted, although 12.09% of them developed a dislocation. Surgeons must assess several aspects so as to avoid mechanical complications like dislocation and re- infections during the two stages of the procedure.

摘要

载抗生素骨水泥间隔物用于两期髋关节置换术。我们研究的目的是将使用Spacer-G的结果与文献中先前报道的结果进行比较。对2002年6月至2010年4月期间所有接受两期翻修手术的患者进行回顾性研究。根据一期手术结果,52例患者接受了二期手术,6例发生脱位,8例保留间隔物,5例发生间隔物急性感染或感染未得到解决。关于二期手术,44例患者翻修成功,4例患者再次感染,另有4例患者的最终假体出现机械并发症。文献结果报告称,97.5%的间隔物被重新植入,尽管其中12.09%发生了脱位。外科医生必须评估几个方面,以避免在手术的两个阶段出现诸如脱位和再次感染等机械并发症。

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