Xie Chengxin, Pan Wenjun, Wang Shouli, Yan Xueli, Luo Hua
Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
EFORT Open Rev. 2024 Jun 3;9(6):479-487. doi: 10.1530/EOR-23-0147.
Knee arthroplasty is an effective treatment for severe knee degeneration; however, periprosthetic joint infection (PJI) is one of its serious complications. Single- and two-stage revision are common treatments, but few studies have compared single- and two-stage revision for PJI after knee arthroplasty. This study aimed to compare the reinfection and reoperation rates of single- and two-stage revision through meta-analysis.
The review process was conducted according to the PRISMA guidelines. We searched the PubMed, Medline, Embase and Cochrane Central Register of Controlled Trials databases for trials comparing single- and two-stage revision for PJI after knee arthroplasty from the respective inception dates to April 2023. Two researchers individually screened the studies, performed the literature quality evaluation and data extraction and used Stata 17 software for data analysis.
The meta-analysis showed that the reinfection rate was significantly lower in the single-stage revision group than in the two-stage revision group. While the reoperation rates demonstrated no statistically significant difference between the two groups. We presented descriptive results because the discrepancies in the knee function scores and data reported in the studies meant that these data could not be combined in the meta-analysis.
Based on the available research, single-stage revision is a reliable option for PJI after knee arthroplasty. However, when developing the best treatment strategy, it is still necessary to consider the individual circumstances and needs of the patient, as well as the risks of postoperative rehabilitation and complications.
膝关节置换术是治疗严重膝关节退变的有效方法；然而，假体周围关节感染（PJI）是其严重并发症之一。单阶段和两阶段翻修是常见的治疗方法，但很少有研究比较膝关节置换术后PJI的单阶段和两阶段翻修。本研究旨在通过荟萃分析比较单阶段和两阶段翻修的再感染率和再次手术率。
按照PRISMA指南进行文献检索。我们在PubMed、Medline、Embase和Cochrane对照试验中央注册库数据库中检索了从各数据库建库至2023年4月比较膝关节置换术后PJI单阶段和两阶段翻修的试验。两名研究人员分别筛选研究、进行文献质量评估和数据提取，并使用Stata 17软件进行数据分析。
荟萃分析表明，单阶段翻修组的再感染率显著低于两阶段翻修组。而两组的再次手术率无统计学显著差异。我们给出了描述性结果，因为研究中报告的膝关节功能评分和数据存在差异，这意味着这些数据无法纳入荟萃分析。
基于现有研究，单阶段翻修是膝关节置换术后PJI的可靠选择。然而，在制定最佳治疗策略时，仍有必要考虑患者的个体情况和需求，以及术后康复和并发症的风险。
