Yaradılmış Yüksel Uğur, Ateş Ahmet, Özer Mehmet, Özdemir Erdi, Demirkale İsmail, Altay Murat
Orthopaedics and Traumatology, Keçiören Health Practice and Research Center, Ankara, TUR.
Cureus. 2021 Apr 9;13(4):e14393. doi: 10.7759/cureus.14393.
Background Revision knee arthroplasty (RKA) is associated with low hemoglobin (Hb) levels after surgery, which results mostly from perioperative blood loss. Periprosthetic joint infection (PJI) is one of the common reasons for RKA. This study aimed to determine whether low Hb levels affect the healing process of PJI. Methodology This retrospective study included 69 patients who underwent two-stage revision for PJI between 2013 and 2016. Patients were divided into two groups according to the latest Hb levels (Hb < 10 and Hb > 10 g/dL) during hospitalization for the first-stage revision surgery. Laboratory parameters of infection were measured during the cement spacer retention period: C-reactive protein (CRP), sedimentation rate (SEDIM), and white blood cell (WBC) count. Treatment was evaluated in two periods: cement spacer retention period (between the first surgery and second surgery) and the first normal CRP period (between the first surgery with the first normal CRP level during the cement spacer retention period). Infection parameters in the two time periods and reoperation with cement spacer were compared between the groups. Results The mean patient age was 67.3 ± 7.94 (50-87) years, and the female-to-male ratio was 4:1. No difference was found in the postoperative first control CRP, SEDIM, and WBC between the groups (p = 0.953, p = 0.3341, and p = 0.444, respectively). CRP-SEDIM control curves were observed in parallel, and no significant difference was found. The cement spacer retention period was 60.3 ± 24.8 (17-123) days, and the first normal CRP period was 87.3 ± 28.4 (14-161) days; no statistical difference was found between the groups (p = 0.727, p = 0.754). Conclusions In RKA, as low Hb level was not a negative factor of infection, blood transfusion should be avoided as it has many complications.
翻修膝关节置换术（RKA）术后常伴有低血红蛋白（Hb）水平，这主要是由围手术期失血所致。假体周围关节感染（PJI）是RKA的常见原因之一。本研究旨在确定低Hb水平是否会影响PJI的愈合过程。方法：本回顾性研究纳入了2013年至2016年间因PJI接受两阶段翻修手术的69例患者。根据一期翻修手术住院期间的最新Hb水平（Hb < 10和Hb > 10 g/dL）将患者分为两组。在骨水泥间隔器留置期测量感染的实验室参数：C反应蛋白（CRP）、血沉（SEDIM）和白细胞（WBC）计数。在两个阶段评估治疗情况：骨水泥间隔器留置期（第一次手术和第二次手术之间）和第一个正常CRP期（骨水泥间隔器留置期内第一次手术至第一次出现正常CRP水平之间）。比较两组在这两个时间段的感染参数以及使用骨水泥间隔器的再次手术情况。结果：患者平均年龄为67.3 ± 7.94（50 - 87）岁，男女比例为4:1。两组术后首次复查的CRP、SEDIM和WBC无差异（分别为p = 0.953、p = 0.3341和p = 0.444）。观察到CRP - SEDIM控制曲线呈平行关系，无显著差异。骨水泥间隔器留置期为60.3 ± 24.8（17 - 123）天，第一个正常CRP期为87.3 ± 28.4（14 - 161）天；两组间无统计学差异（p = 0.727，p = 0.754）。结论：在RKA中，由于低Hb水平并非感染的负面因素，且输血有诸多并发症，应避免输血。
