Internistic Ultrasound Service, "Campus Bio-Medico" University, Rome, Italy.
Upper and Lower Limb Surgery Unit, University Campus Bio-Medico, Rome, Italy.
J Infect Public Health. 2020 Dec;13(12):1888-1891. doi: 10.1016/j.jiph.2020.09.006. Epub 2020 Oct 21.
Prosthetic joint infection (PJI) is a common complication of the knee and hip arthroplasty and represents a huge challenge for physicians. PJI raises serious social, economic and clinical concerns in the public health that need a comprehensive approach to better focus on proven strategies for disease prevention and treatment. History and clinical signs on joint site are useful means for suspecting PJI that need to be confirmed through major and minor diagnostic criteria. The pathogen isolation and the resulting antibiogram are crucial to guide the correct antibiotic strategy and together with surgical treatment (prosthesis revision and spacer implantation) represent the cornerstones to eradicate the infection before attempting a new arthroplasty. External fixator with removal of the spacer may be an option before performing a new arthroplasty when the infection does not heal. Arthrodesis may also be considered if the arthroplasty is contraindicated. Limb amputation is the last chance when pathogen eradication failed and might lead to life-threatening situations.
人工关节感染（PJI）是膝关节和髋关节置换术的常见并发症，对医生来说是一个巨大的挑战。PJI 在公共卫生方面引起了严重的社会、经济和临床问题，需要采取综合方法，更好地关注预防和治疗疾病的既定策略。关节部位的病史和临床体征是怀疑 PJI 的有用手段，需要通过主要和次要诊断标准来确认。病原体分离和由此产生的药敏试验对于指导正确的抗生素策略至关重要，与手术治疗（假体翻修和间隔器植入）一起，是在尝试新的关节置换之前根除感染的基石。当感染未愈合时，在进行新的关节置换之前，移除间隔器的外固定器可能是一种选择。如果关节置换术有禁忌，也可以考虑关节融合术。当病原体清除失败且可能导致危及生命的情况时，截肢是最后的机会。
