Golgelioglu Fatih, Oguzkaya Sinan, Misir Abdulhamit, Guney Ahmet
Department of Orthopaedics and Traumatology, Tunceli State Hospital, Cumhuriyet Mah., Tunceli-Elazığ karayolu Merkez, 62000 Tunceli, Turkey.
Department of Orthopaedics and Traumatology, Sarkısla State Hospital, Yıldırım Mahallesi No: 27, Şarkışla, 58400 Sivas, Turkey.
Indian J Orthop. 2020 Sep 2;54(6):824-830. doi: 10.1007/s43465-020-00247-8. eCollection 2020 Nov.
The present study aimed to evaluate the effect of a longer interval between the first and second stages of infected total knee arthroplasty (TKA) revision on the clinical and functional outcome.
This study included a total of 56 patients who underwent two-stage revision TKA with a dynamic spacer with a minimum of 2 years of follow-up. Patients were categorized into two groups according to time with the spacer: < 3 months (Group 1, 31 patients) or > 3 months (Group 2, 25 patients). Clinical outcome and quality of life were assessed by knee range of motion (ROM), Knee Society Score for Knee (KSS-K), Knee Society Score for Function (KSS-F) and Short Form 36 (SF-36).
The mean follow-up period was 48 ± 19.1 months (range, 24-84 months). The KSS-K, KSS-F, and ROM values were significantly higher in Group 1 than in Group 2 ( < 0.05). The SF-36 scores for general health, physical function, and bodily pain were significantly higher in Group 1 ( < 0.05). Re-infection occurred in 10 patients (17.8%). Time with spacer was not associated with re-infection development (Group 1, = 6, 19% vs. Group 2, = 4, 16%; > 0.05).
Increased duration with a spacer is associated with poorer clinical and functional outcomes as well as higher treatment costs in two-stage revision knee arthroplasty. Surgeons can attempt to reduce the time patients spend in a spacer to obtain better postoperative functional outcomes, as well as a better quality of life.
本研究旨在评估感染性全膝关节置换术（TKA）翻修术第一阶段和第二阶段之间较长间隔时间对临床和功能结局的影响。
本研究共纳入56例行两阶段翻修TKA并使用动态间隔器且随访至少2年的患者。根据使用间隔器的时间将患者分为两组：<3个月（第1组，31例患者）或>3个月（第2组，25例患者）。通过膝关节活动范围（ROM）、膝关节协会膝关节评分（KSS-K）、膝关节协会功能评分（KSS-F）和简明健康状况调查量表（SF-36）评估临床结局和生活质量。
平均随访期为48±19.1个月（范围24 - 84个月）。第1组的KSS-K、KSS-F和ROM值显著高于第2组（<0.05）。第1组的SF-36总体健康、身体功能和身体疼痛评分显著更高（<0.05）。10例患者（17.8%）发生再次感染。使用间隔器的时间与再次感染的发生无关（第1组，=6，19% vs.第2组，=4，16%；>0.05）。
在两阶段翻修膝关节置换术中，延长使用间隔器的时间与较差的临床和功能结局以及更高的治疗成本相关。外科医生可尝试减少患者使用间隔器的时间，以获得更好的术后功能结局和更高的生活质量。
3级。
