Hashimoto Akira, Sonohata Motoki, Kitajima Masaru, Kawano Shunsuke, Eto Shuichi, Mawatari Masaaki
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan.
Department of Orthopaedic Surgery, Shiroisi Kyouritu Hosptal, Fukuda 1296, Shiroishi-cho, Kishima-gun, Saga 849-1112, Japan.
Int J Surg Case Rep. 2020;77:434-437. doi: 10.1016/j.ijscr.2020.11.032. Epub 2020 Nov 11.
Septic arthritis of the hip joint in adults is a rare and potentially devasting disease. To the best of our knowledge, there have been no reports of two-stage total hip arthroplasty (THA) for the treatment of septic arthritis of the hip joint with a cementless hip implant that has antibacterial properties.
We present a case of two-stage THA with a thermal-sprayed silver oxide-containing hydroxyapatite coating (Ag-HA) implant to treat septic arthritis of the hip joint with hip osteoarthritis in an 80-year-old woman. There was no complication or recurrence at 28 months follow-up after 2nd-stage operation.
Ag-HA implants were found to have antibacterial activity within the subcutaneous tissues and bone, osteoconductive properties, and no adverse reactions in vivo. Moreover, no adverse events due to silver were reported in a clinical or radiographic study.
To further reduce infection after two-staged THA for septic arthritis of the hip joint, antibacterial implants, such as an Ag-HA implant, may be used.
成人髋关节化脓性关节炎是一种罕见且可能造成严重破坏的疾病。据我们所知,尚无关于使用具有抗菌特性的非骨水泥型髋关节植入物进行两阶段全髋关节置换术(THA)治疗髋关节化脓性关节炎的报道。
我们报告一例使用含热喷涂氧化银羟基磷灰石涂层(Ag-HA)植入物的两阶段THA治疗一名80岁女性髋关节化脓性关节炎合并髋骨关节炎的病例。二期手术后28个月随访时无并发症或复发。
发现Ag-HA植入物在皮下组织和骨内具有抗菌活性、骨传导特性,且在体内无不良反应。此外,临床或影像学研究中均未报告因银导致的不良事件。
为进一步降低两阶段THA治疗髋关节化脓性关节炎后的感染率,可使用抗菌植入物,如Ag-HA植入物。