Department of Orthopaedics, Second Affiliated Hospital, Air Force Medical University, 1 Xinsi Rd, Xi'an, 710038, Shaanxi, China.
Department of Ultrasound, Xijing Hospital, Air Force Medical University, 169 Changlexi Rd, Xi'an, 710032, Shaanxi, China.
Int Orthop. 2023 May;47(5):1171-1179. doi: 10.1007/s00264-023-05727-8. Epub 2023 Mar 2.
This study aimed to investigate the clinical efficacy of antibiotic bone cement-coated implants compared with external fixations for treating infected bone defects.
We retrospectively enrolled 119 patients with infected bone defects in our hospital from January 2010 to June 2021, of which 56 were treated with antibiotic bone cement-coated implants and 63 were with external fixation.
The pre-operative and post-operative haematological indexes were tested to assess the infection control; the post-operative CRP level in the internal fixation group was lower than that in the external fixation group. No statistical significance was found in the rate of infection recurrence, loosening and rupture of the fixation, and amputation between the two groups. Twelve patients in the external fixation group had pin tract infection. In the evaluation of the Paley score scale, bone healing aspect revealed no significant difference between the two groups, while in the limb function aspect, antibiotic cement-coated implant group showed a much better score than the external fixation group (P = 0.002). The anxiety evaluation scale result also showed lower score in the antibiotic cement implant group (P < 0.001).
Compared with external fixation, antibiotic bone cement-coated implant had the same effect on controlling infection and was more effective in recovering limb function and mental health in the first-stage treatment of infected bone defects after debridement.
本研究旨在探讨抗生素骨水泥涂层植入物与外固定治疗感染性骨缺损的临床疗效。
我们回顾性纳入了 2010 年 1 月至 2021 年 6 月我院收治的 119 例感染性骨缺损患者,其中 56 例采用抗生素骨水泥涂层植入物治疗,63 例采用外固定治疗。
检测术前和术后的血液学指标以评估感染控制情况;内固定组术后 CRP 水平低于外固定组。两组间感染复发率、固定松动和断裂、截肢率无统计学差异。外固定组 12 例患者出现针道感染。在 Paley 评分量表评估中,两组在骨愈合方面无显著差异,而在肢体功能方面,抗生素水泥涂层植入组的评分明显优于外固定组(P=0.002)。焦虑评估量表结果也显示抗生素水泥植入组的评分较低(P<0.001)。
与外固定相比,抗生素骨水泥涂层植入物在清创后一期治疗感染性骨缺损时控制感染的效果相同,但在恢复肢体功能和心理健康方面更有效。