Li Sen, Xu Xiuping
Hand Surgery Two, Gansu Provincial Hospital of TCM, Qilihe District, Lanzhou City, Gansu Province, China.
Hand Surgery Two, Gansu Provincial Hospital of TCM, 418 Guazhou Road, Qilihe District, Lanzhou City, Gansu Province, 730000, China.
Arch Orthop Trauma Surg. 2024 Dec 12;145(1):26. doi: 10.1007/s00402-024-05679-7.
There is a lack of effective and innovative treatment for patients with prosthesis exposure and deep joint infection following total knee arthroplasty. This study explores the application of the medial head of the gastrocnemius myocutaneous flap transfer in these conditions, offering new therapeutic strategies for clinical practice.
Clinical data of 68 patients with prosthesis exposure and deep joint infection following total knee arthroplasty were included and retrospectively analyzed. Patients were divided into one study group (n = 35, received medial head of the gastrocnemius myocutaneous flap transfer and vacuum sealing drainage) and one control group (n = 33, received vacuum sealing drainage). The total effective rates, visual analogue scale (VAS), Hospital for Special Surgery score (HSS), knee joint function, activity, inflammatory reactions, safety, and recurrence rate were compared between the two groups.
The total effective rate in the study group was higher than that in the control group. VAS scores in the study group were lower at 3 and 7 days after treatment. HSS scores were higher in the study group after treatment. The study group showed lower levels of hs-CRP and IL-6 after treatment. At 1 month and 3 months after treatment, the study group exhibited higher knee joint activity. There was no difference in the incidence of adverse reactions between the two groups, and the study group had a lower recurrence rate.
Medial head of the gastrocnemius myocutaneous flap transfer effectively improves knee joint function and activity, reduces pain, alleviates inflammatory reactions, and has fewer adverse reactions and a lower recurrence rate.
全膝关节置换术后假体暴露及深部关节感染的患者缺乏有效且创新的治疗方法。本研究探讨腓肠肌内侧头肌皮瓣转移术在这些情况下的应用,为临床实践提供新的治疗策略。
纳入并回顾性分析68例全膝关节置换术后假体暴露及深部关节感染患者的临床资料。患者分为一个研究组(n = 35,接受腓肠肌内侧头肌皮瓣转移术及封闭式负压引流)和一个对照组(n = 33,接受封闭式负压引流)。比较两组的总有效率、视觉模拟评分(VAS)、特种外科医院评分(HSS)、膝关节功能、活动度、炎症反应、安全性及复发率。
研究组的总有效率高于对照组。研究组治疗后3天和7天的VAS评分较低。治疗后研究组的HSS评分较高。治疗后研究组的hs-CRP和IL-6水平较低。治疗后1个月和3个月,研究组的膝关节活动度较高。两组不良反应发生率无差异,且研究组的复发率较低。
腓肠肌内侧头肌皮瓣转移术可有效改善膝关节功能和活动度,减轻疼痛,缓解炎症反应,不良反应较少且复发率较低。