Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Mod Rheumatol. 2021 Sep;31(5):1073-1077. doi: 10.1080/14397595.2020.1868663. Epub 2021 Jan 25.
Antibiotic-impregnated hydroxyapatite (HA) is an emerging drug delivery system for the treatment of periprosthetic joint infection (PJI) of the knee. The aim of this study was to evaluate the clinical results of this treatment in patients with PJI following total knee arthroplasty (TKA).
Participants comprised 14 consecutive patients with PJI of the knee who were scheduled to undergo two-stage knee revision. In the first stage, all components were removed with thorough debridement, and antibiotic-impregnated HA was inserted in the bone and joint space. In the second stage, revision TKA was performed after the eradication of infection. The mean period from the removal of all components and treatment with antibiotic-impregnated HA to revision TKA was 3.4 months. Clinical and radiographic evaluations were performed after a mean follow-up of 6.1 years following revision TKA. Predictors of reinfection were evaluated.
Eleven patients had no recurrent infection, whereas 3 patients showed recurrent infection. Knee Society knee score and function score, as well as flexion angles, improved significantly postoperatively. No knees showed osteolysis or loosening after revision TKA. The present study identified no predictors of reinfection.
Antibiotic-impregnated HA could be effective in treating knee PJI.
载抗生素羟基磷灰石（HA）是一种新兴的药物输送系统，可用于治疗膝关节假体周围关节感染（PJI）。本研究旨在评估该治疗方法在全膝关节置换术后（TKA）发生 PJI 的患者中的临床效果。
参与者包括 14 例计划接受二期膝关节翻修的膝关节 PJI 连续患者。在第一阶段，彻底清创后取出所有假体，并在骨和关节间隙中插入载抗生素 HA。在第二期，感染消除后进行 TKA 翻修。从取出所有假体并用载抗生素 HA 治疗到 TKA 翻修的平均时间为 3.4 个月。TKA 翻修后平均随访 6.1 年进行临床和影像学评估。评估了再感染的预测因素。
11 例患者无复发感染，3 例患者出现复发感染。膝关节学会膝关节评分和功能评分以及膝关节屈曲角度在手术后显著改善。TKA 翻修后无膝关节出现骨溶解或松动。本研究未发现再感染的预测因素。
载抗生素 HA 可有效治疗膝关节 PJI。
