Boelch Sebastian Philipp, Jakuscheit Axel, Luedemann Martin, Heilig Philipp, Kamawal Yama, Arnholdt Joerg, Rudert Maximilian
Julius-Maximilians-University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, D-97074, Wuerzburg, Germany.
Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Germany.
J Orthop. 2020 Dec 31;23:41-45. doi: 10.1016/j.jor.2020.12.022. eCollection 2021 Jan-Feb.
The aim of this study was to investigate the reinfection rate and risk factors for septic failure after two-stage exchange for chronic periprosthetic joint infections of primary total knee arthroplasties. Reinfections should be classified as new infection or as infection recurrence after two-stage exchange.
We performed a retrospective study of 60 knees with chronic periprosthetic joint infections. Follow-up information was extracted from the departments electronic database.
The reinfection rate after a mean follow-up of 35.6 months (1-135) was 20.0%. The only significant risk factor for reinfection was spacer exchange during two-stage exchange (OR = 10.42; p = 0.001). Of the 12 cases with reinfection 6 cases were classified as new infection and 2 as infection recurrence.
Patient specific factors for reinfection remain furtive. If a spacer exchange is preformed, the risk of reinfection increases. Culture results indicate that the benefit of spacer exchanges during two-stage exchange is highly questionable, particularly because reinfection is an issue of new infection rather than of infection recurrence.
本研究旨在调查初次全膝关节置换术后慢性假体周围关节感染二期翻修术后的再感染率及脓毒症性失败的危险因素。再感染应分为新感染或二期翻修术后的感染复发。
我们对60例慢性假体周围关节感染的膝关节进行了回顾性研究。随访信息从科室电子数据库中提取。
平均随访35.6个月（1 - 135个月）后的再感染率为20.0%。再感染的唯一显著危险因素是二期翻修术中的间隔物更换（比值比=10.42；p = 0.001）。在12例再感染病例中，6例被分类为新感染，2例为感染复发。
再感染的个体特异性因素仍不明确。如果进行间隔物更换，再感染风险会增加。培养结果表明，二期翻修术中间隔物更换的益处非常值得怀疑，特别是因为再感染是新感染问题而非感染复发问题。
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