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采用手工硅胶模具制作含抗生素骨水泥间隔物的两阶段翻修全膝关节置换术在感染病例中的临床结果。

Clinical outcomes of two-stage revision total knee arthroplasty in infected cases with antibiotic-loaded cement spacers produced using a handmade silicone mold.

作者信息

Hoshino Takashi, Watanabe Toshifumi, Nakagawa Yusuke, Katagiri Hiroki, Ozeki Nobutake, Ohara Toshiyuki, Shioda Mikio, Kono Yuji, Sekiya Ichiro, Koga Hideyuki

机构信息

Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

出版信息

Knee Surg Relat Res. 2021 Aug 28;33(1):27. doi: 10.1186/s43019-021-00113-3.

Abstract

PURPOSE

This study assessed the clinical outcomes of periprosthetic joint infection patients who underwent two-stage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold.

MATERIALS AND METHODS

This study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and follow-up period after revision total knee arthroplasty were investigated.

RESULTS

At the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed.

CONCLUSIONS

The clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.

摘要

目的

本研究评估了接受两阶段翻修全膝关节置换术并使用手工硅胶模具制作的含抗生素骨水泥间隔物的人工关节周围感染患者的临床结局。

材料与方法

本研究纳入了2009年至2013年间在我院接受手术的7例患者(平均年龄77岁,平均随访时间54个月)。调查了临床结局,包括末次观察时的膝关节评分、功能评分、膝关节活动范围和步行能力、初次全膝关节置换术至植入物取出的时间、植入物取出至翻修全膝关节置换术的时间以及翻修全膝关节置换术后的随访时间。

结果

末次随访时,平均膝关节活动范围为99°,各阶段无显著差异;平均膝关节和功能评分分别为84分和77分。使用骨水泥间隔物后,5例患者能够使用丁字拐行走。未观察到感染复发。

结论

本病例系列的临床结局显示膝关节功能良好,步行能力得以保留,人工关节周围感染无复发。本研究表明,使用手工硅胶模具可能是全膝关节置换术后人工关节周围感染的一种有效选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a66/8400397/73f1afc912e0/43019_2021_113_Fig1_HTML.jpg

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