Savvidou Olga D, Kaspiris Angelos, Goumenos Stavros, Trikoupis Ioannis, Melissaridou Dimitra, Kalogeropoulos Athanasios, Serenidis Dimitris, Georgoulis Jim-Dimitris, Lianou Ioanna, Koulouvaris Panagiotis, Papagelopoulos Panayiotis J
Medical School, First Department of Orthopedics, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Laboratory of Molecular Pharmacology, School of Health Sciences, University of Patras, 26504 Patras, Greece.
J Clin Med. 2023 May 22;12(10):3600. doi: 10.3390/jcm12103600.
Knee arthrodesis is a limb salvage intervention for persistent periprosthetic joint infection (PJI) when revision total knee arthroplasty fails. Conventional arthrodesis techniques are associated with the increased rate of complications, especially in patients with extensive bone loss and extensor tendon deficiency.
Eight patients with a modular silver-coated arthrodesis implant after failed exchange arthroplasty for infection, were retrospectively reviewed. All patients had significant bone loss, while 5 displayed extensor tendon deficiency. Survivorship, complications, leg length discrepancy, median Visual Analogue Scale (VAS) and Oxford Knee score (OKS) were evaluated.
The median follow up was 32 months (range 24-59 months). The survivorship rate of the prosthesis was 86% during the minimum time of follow up of 24 months. In one patient recurrence of the infection was observed and above-knee amputation was performed. The median postoperative leg length discrepancy was 2.07 ± 0.67 cm. Patients were able to ambulate with mild or no pain. The median VAS and OKS was 2.14 ± 0.9 and 34.7 ± 9.3, respectively.
The results of our study demonstrated that knee arthrodesis with a silver coated arthrodesis implant, performed for persistent PJI in patients with significant bone loss and extensor tendon deficit, provided a stable construct, allowed eradication of infection and was associated with good functional outcome.
当全膝关节置换翻修失败时，膝关节融合术是一种用于挽救持续性假体周围关节感染（PJI）肢体的干预措施。传统的融合技术并发症发生率较高，尤其是在有广泛骨丢失和伸肌腱缺损的患者中。
回顾性分析了8例因感染行关节置换翻修失败后使用模块化银涂层融合植入物的患者。所有患者均有明显的骨丢失，其中5例存在伸肌腱缺损。评估了生存率、并发症、肢体长度差异、视觉模拟量表（VAS）中位数和牛津膝关节评分（OKS）。
中位随访时间为32个月（范围24 - 59个月）。在至少24个月的随访期内，假体的生存率为86%。观察到1例患者感染复发并进行了膝上截肢。术后肢体长度差异中位数为2.07±0.67 cm。患者能够在轻度疼痛或无痛的情况下行走。VAS和OKS中位数分别为2.14±0.9和34.7±9.3。
我们的研究结果表明，对于有明显骨丢失和伸肌腱缺损的持续性PJI患者，采用银涂层融合植入物进行膝关节融合术可提供稳定的结构，能够根除感染，并具有良好的功能结果。
