Zunarelli Renato, Fiore Michele, Lonardo Gianluca, Pace Andrea, Persiani Valentina, De Paolis Massimiliano, Sambri Andrea
Orthopedic and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
J Clin Med. 2023 Dec 15;12(24):7711. doi: 10.3390/jcm12247711.
Periprosthetic infection (PJI) after TAR is a serious complication, often requiring further surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. This systematic review aims to summarize the current evidence on the management of TAR PJI and provide a comprehensive overview of this topic, especially from an epidemiologic point of view. Three different databases (PubMed, Scopus, and Web of Science) were searched for relevant articles, and further references were obtained by cross-referencing. Seventy-one studies met the inclusion criteria, reporting on cases of TAR PJI. A total of 298 PJIs were retrieved. The mean incidence of PJI was 3.8% (range 0.2-26.1%). Furthermore, 53 (17.8%) were acute PJIs, whereas most of them (156, 52.3%) were late PJIs. Most of the studies were heterogeneous regarding the treatment protocols used, with a two-stage approach performed in most of the cases (107, 35.9%). While the prevalence of ankle PJI remains low, it is potentially one of the most devastating complications of TAR. This review highlights the lack of strong literature regarding TAR infections, thus highlighting a need for multicentric studies with homogeneous data regarding the treatment of ankle PJI to better understand outcomes.
全踝关节置换术（TAR）后假体周围感染（PJI）是一种严重的并发症，常常需要进一步手术，包括关节置换翻修术、转换为踝关节融合术，甚至截肢。本系统评价旨在总结目前关于TAR后PJI治疗的证据，并全面概述这一主题，尤其是从流行病学角度。检索了三个不同的数据库（PubMed、Scopus和Web of Science）以查找相关文章，并通过交叉引用获取更多参考文献。71项研究符合纳入标准，报告了TAR后PJI的病例。共检索到298例PJI。PJI的平均发生率为3.8%（范围0.2 - 26.1%）。此外，53例（17.8%）为急性PJI，而大多数（156例，52.3%）为迟发性PJI。大多数研究在使用的治疗方案方面存在异质性，大多数病例（107例，35.9%）采用两阶段方法。虽然踝关节PJI的患病率仍然较低，但它可能是TAR最具破坏性的并发症之一。本综述强调了关于TAR感染的有力文献的缺乏，从而凸显了开展多中心研究以获取关于踝关节PJI治疗的同质数据以更好了解治疗结果的必要性。
