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两阶段翻修治疗人工关节感染的长期疗效

Long-term outcome of prosthetic joint infections treated with two-stage revision.

作者信息

Carrega Giuliana, Casalino-Finocchio Giorgetta, Cavagnaro Luca, Felli Lamberto, Riccio Giovanni, Burastero Giorgio

出版信息

Acta Orthop Belg. 2020 Mar;86(1):10-16.

Abstract

Long-term evaluation of prosthetic joint infection treated with two-stage revision. Retrospective analysis of 102 periprosthetic infections treated with two-stage revision from 2010 to 2012 in Albenga hospital, Italy. During the second stage, samples for microbiological tests were collected. Failure was defined as a persistence of infection during the second stage or as a relapse during follow-up. 102 cases (55 hip, 47 knee) were analyzed. Patients were evaluated for a median of 44 months. 8/102 (8%) had positive cultures at replacement. These patients were treated with long-term antibiotic treatment and in 3/8 (38%) infection was cured. 9 patients were loss to follow-up or died, 6 patients (6%) had a relapse a median of 16,3 months from replanting. Risk factors significantly related to failures were diabetes and infection due to methicillin-resistant staphylococci. Two stage revision requires continued follow up. Screening for infection at replacement suggests prolonged antibiotic treatment.

摘要

两阶段翻修治疗人工关节感染的长期评估。对2010年至2012年在意大利阿尔本加医院接受两阶段翻修治疗的102例人工关节周围感染进行回顾性分析。在第二阶段,采集微生物检测样本。失败定义为第二阶段感染持续存在或随访期间复发。分析了102例病例(55例髋关节,47例膝关节)。患者的中位评估时间为44个月。8/102(8%)在置换时培养结果呈阳性。这些患者接受了长期抗生素治疗,其中3/8(38%)感染得到治愈。9例患者失访或死亡,6例患者(6%)复发,距再植的中位时间为16.3个月。与失败显著相关的危险因素是糖尿病和耐甲氧西林葡萄球菌感染。两阶段翻修需要持续随访。置换时筛查感染提示需延长抗生素治疗时间。

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