Fang Xinyu, Wang Qiaojie, Yang Xurong, Zhang Feiyang, Huang Changyu, Huang Zida, Shen Hao, Zhang Wenming
Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai, China.
Bone Joint Res. 2021 Dec;10(12):790-796. doi: 10.1302/2046-3758.1012.BJR-2021-0225.R1.
To explore the effect of different durations of antibiotics after stage II reimplantation on the prognosis of two-stage revision for chronic periprosthetic joint infection (PJI).
This study involved a retrospective collection of patients who underwent two-stage revision for chronic PJI and continued to use extended antibiotic prophylaxis in two regional medical centres from January 2010 to June 2018. The patients were divided into a short (≤ one month) or a long (> one month) course of treatment based on the duration of antibiotics following stage II reimplantation. The difference in the infection control rate between the two groups was compared, and prognostic factors for recurrence were analyzed.
A total of 105 patients with chronic PJI were enrolled: 64 patients in the short course group and 41 patients in the long course group. For 99 of the patients, the infection was under control during a follow-up period of at least 24 months after two-stage revision. For the short course group, the mean duration of antibiotic prophylaxis after stage II reimplantation was 20.17 days (SD 5.30) and the infection control rate was 95.3%; for the long course group these were 45.02 days (SD 15.03) and 92.7%, respectively. There was no significant difference in infection control rates between the two groups (p = 0.676). Cox regression analysis found that methicillin-resistant staphylococcus infection (p = 0.015) was an independent prognostic factor for recurrence.
After stage II reimplantation surgery of two-stage revision for chronic PJI, extended antibiotic prophylaxis for less than one month can achieve good infection control rate. Cite this article: 2021;10(12):790-796.
探讨二期再植入术后不同抗生素使用时长对慢性人工关节周围感染（PJI）两阶段翻修预后的影响。
本研究回顾性收集了2010年1月至2018年6月期间在两个地区医疗中心接受慢性PJI两阶段翻修并持续使用延长抗生素预防治疗的患者。根据二期再植入术后抗生素使用时长，将患者分为短期（≤1个月）或长期（>1个月）治疗组。比较两组感染控制率的差异，并分析复发的预后因素。
共纳入105例慢性PJI患者：短期治疗组64例，长期治疗组41例。其中99例患者在两阶段翻修术后至少24个月的随访期内感染得到控制。短期治疗组二期再植入术后抗生素预防的平均时长为20.17天（标准差5.30），感染控制率为95.3%；长期治疗组分别为45.02天（标准差15.03）和92.7%。两组感染控制率无显著差异（p = 0.676）。Cox回归分析发现耐甲氧西林葡萄球菌感染（p = 0.015）是复发的独立预后因素。
慢性PJI两阶段翻修二期再植入术后，延长抗生素预防治疗少于1个月可取得良好的感染控制率。引用本文：2021;10(12):790-796。
