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两阶段骨水泥间隔器与全髋关节置换术治疗髋关节化脓性关节炎结局的中期分析

A Midterm Analysis of Outcomes of Septic Arthritis of Hip Treated With Two Stage Cement Spacer and Total Hip Arthroplasty.

作者信息

Sharma Anmol, Gupta Sandeep, Sethi Anisha, Singh Jagseer

机构信息

Fortis Hospital, Mohali, Punjab, India.

Max Superspecialty Hospital, Mohali, Punjab, India.

出版信息

Arch Bone Jt Surg. 2024;12(10):690-694. doi: 10.22038/ABJS.2024.67176.3193.

Abstract

OBJECTIVES

Septic arthritis of the hip, if not managed early and adequately, leads to degenerative arthritis with pain and debility. Various treatment options have been recommended, but no guidelines for the same have been established. Aim of the study is to evaluate the efficacy of our protocol for timing of staging using serological markers, rate of periprosthetic joint infection, midterm implant survivorship and functional outcomes.

METHODS

Thirteen patients aged 25 years and above, suffering from degenerative hip arthritis secondary to septic hip, were treated with 2 stage total hip replacement according to our protocol and serological markers were assessed for the timing of stages and follow up of infection control. Outcome of success of two stage total hip arthroplasty was assessed using modified Delphi criteria.

RESULTS

Both the acetabulum and femur head were involved in all cases. Two patients had a history of previous hip surgery. The most common micro-organism detected in intraoperative cultures was Staphylococcus aureus. The mean Harris Hip Score at the final follow-up was 82.33. The outcome was deemed excellent in 84.6 % and good in 15.4 % of cases.

CONCLUSION

Septic arthritis of the hip leading to end stage degenerative joint disease can be effectively managed with two stage total hip arthroplasty with good to excellent clinical and functional results.

摘要

目的

髋关节化脓性关节炎若不及早且充分治疗,会导致退行性关节炎,引发疼痛和功能障碍。虽已推荐多种治疗方案,但尚未制定相关指南。本研究旨在评估我们使用血清学标志物进行分期的方案的疗效、假体周围关节感染率、中期植入物存活率及功能结果。

方法

13例年龄25岁及以上、因化脓性髋关节继发退行性髋关节炎的患者,按照我们的方案接受两期全髋关节置换治疗,并评估血清学标志物以确定分期时间及感染控制情况。采用改良德尔菲标准评估两期全髋关节置换术的成功结果。

结果

所有病例髋臼和股骨头均受累。2例患者有髋关节既往手术史。术中培养检测出的最常见微生物为金黄色葡萄球菌。末次随访时Harris髋关节评分平均为82.33。84.6%的病例结果为优,15.4%为良。

结论

两期全髋关节置换术可有效治疗导致终末期退行性关节病的髋关节化脓性关节炎,临床和功能结果良好至优秀。

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本文引用的文献

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Active septic arthritis of the hip in adults: what's new in the treatment? A systematic review.
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