Southwood R T, Rice J L, McDonald P J, Hakendorf P H, Rozenbilds M A
Flinders Medical Centre, Bedford Park, Adelaide, South Australia.
Clin Orthop Relat Res. 1987 Nov(224):33-6.
Experimental bacterial infection following implant arthroplasties was investigated in rabbits. Bone cement and a stainless steel head and stem prosthesis were inserted after reaming of the femoral neck and shaft. Measured doses of Staphylococcus aureus were injected either into the femoral medullary cavity or intravenously. Intravenous challenge required high inocula to establish arthroplasty infection, whereas infection around the prosthesis was consistently established after inoculation of 10(3) bacteria into the femoral medulla. The erythrocyte sedimentation rate (ESR) proved the most reliable clinical test of infection. Hematogenous infection was difficult to reproduce. Three weeks after operation, the arthroplasty was as resistant as the normal hip. Antibiotics were administered in doses equivalent to doses used in the treatment of infections in humans. When gentamicin-impregnated cement was used, 60 times the number of organisms were required to establish infection. Flucloxacillin and Imipenem gave similar protection. Rifampicin gave protection to a level exceeding the lethal dose of organisms for the model.
在兔子身上研究了人工关节置换术后的实验性细菌感染情况。在股骨颈和股骨干扩髓后，植入骨水泥以及一个不锈钢股骨头和股骨柄假体。将测量好剂量的金黄色葡萄球菌注入股骨髓腔或静脉内。静脉内感染需要高接种量才能引发人工关节感染，而在股骨髓腔内接种10³个细菌后，假体周围始终会发生感染。红细胞沉降率（ESR）被证明是最可靠的感染临床检测指标。血源性感染难以重现。术后三周，人工关节与正常髋关节一样具有抵抗力。使用了与人类治疗感染所用剂量相当的抗生素。当使用含庆大霉素的骨水泥时，需要60倍数量的微生物才能引发感染。氟氯西林和亚胺培南提供了类似的保护作用。利福平提供的保护作用达到了超过该模型中微生物致死剂量的水平。
