Sanzén L, Carlsson A S, Josefsson G, Lindberg L T
Department of Orthopedic Surgery, Malmö General Hospital, Sweden.
Clin Orthop Relat Res. 1988 Apr(229):165-72.
One hundred two of 110 infected hip arthroplasties revised with the protection of gentamicin-loaded cement were followed for a minimum of two years. In 77 of 102 hips the infection healed after one revision operation and in five of eight hips after a second revision operation, representing a final healing rate of 80%. No significant difference in healing rate could be demonstrated with regard to individual bacterial species. However, in infections with a mixed flora, the healing rate was only 27% (p less than .01). After an average of six years, 33 of 82 healed hips had signs of roentgenographic loosening, nine of which had been revised. The modified Merle d'Aubigne and Postel score averaged 5.3 for pain, 3.7 for walking ability, and 4.0 for range of motion (ROM) in patients with healed infections.
110例采用含庆大霉素骨水泥进行翻修的感染性髋关节置换术中,102例患者接受了至少两年的随访。102例髋关节中,77例在一次翻修手术后感染治愈,8例中的5例在二次翻修手术后感染治愈,最终治愈率为80%。就单个细菌种类而言,治愈率无显著差异。然而,在混合菌群感染中,治愈率仅为27%(p<0.01)。平均6年后,82例治愈的髋关节中有33例出现影像学松动迹象,其中9例进行了翻修。感染治愈患者的改良Merle d'Aubigne和Postel评分平均为:疼痛5.3分,行走能力3.7分,活动范围(ROM)4.0分。