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采用抗菌水凝胶涂层的非骨水泥一期翻修髋关节置换术后感染根除率高。

High rate of infection eradication following cementless one-stage revision hip arthroplasty with an antibacterial hydrogel coating.

作者信息

Pellegrini Antonio, Legnani Claudio

机构信息

IRCCS Istituto Ortopedico Galeazzi, Reconstructive Surgery and Septic Complications Surgery Center, Milan, Italy.

IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally-Invasive Articular Surgery Center, Milan, Italy.

出版信息

Int J Artif Organs. 2022 Jan;45(1):113-117. doi: 10.1177/0391398821995507. Epub 2021 Feb 17.

Abstract

PURPOSE

We conducted a retrospective study to evaluate the outcomes of one-stage revision total hip arthroplasty (THA) following periprosthetic joint infection (PJI) in terms of eradication of the infection, improvement of pain and joint function. We hypothesized that this treatment strategy could lead to satisfying results in selected patients after preoperative microorganism isolation.

METHODS

Ten patients underwent cementless one-stage revision hip arthroplasty with antibacterial hydrogel coating for the treatment of an infected THA. Inclusion criteria were: the presence of a known organism with known sensitivity, patients non-immunocompromised with healthy soft tissues with minimal or moderate bone loss. Mean age at surgery was 69.4 years. Assessment included objective examination, Harris hip score, visual analog scale pain score, standard X-rays.

RESULTS

At a mean follow-up of 3.1 years (range, 2-5 years), none of the patients had clinical or radiographic signs suggesting recurrent infection. Follow-up examination showed significant improvement of all variables compared to pre-operative values ( < 0.05). Radiographs did not show progressive radiolucent lines or change in the position of the implant.

CONCLUSIONS

One-stage revision THA with antibacterial hydrogel coated implants represents a safe and effective procedure providing infection eradication and satisfying subjective functional outcomes in selected patients.

摘要

目的

我们进行了一项回顾性研究,以评估一期翻修全髋关节置换术(THA)治疗假体周围关节感染(PJI)在感染根除、疼痛改善和关节功能方面的效果。我们假设这种治疗策略在术前分离出微生物的特定患者中可产生令人满意的结果。

方法

10例患者接受了带抗菌水凝胶涂层的非骨水泥型一期翻修髋关节置换术,以治疗感染性THA。纳入标准为:存在已知敏感性的已知微生物,患者无免疫功能低下,软组织健康,骨丢失最少或中等。手术时的平均年龄为69.4岁。评估包括客观检查、Harris髋关节评分、视觉模拟量表疼痛评分、标准X线片。

结果

平均随访3.1年(范围2 - 5年),所有患者均无提示感染复发的临床或影像学迹象。随访检查显示,与术前值相比,所有变量均有显著改善(<0.05)。X线片未显示进行性透光线或植入物位置改变。

结论

带抗菌水凝胶涂层植入物的一期翻修THA是一种安全有效的手术方法,在特定患者中可根除感染并提供令人满意的主观功能结果。

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