Wakabayashi Hiroki, Hasegawa Masahiro, Naito Yohei, Tone Shine, Sudo Akihiro
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan.
J Clin Med. 2024 Dec 8;13(23):7469. doi: 10.3390/jcm13237469.
: This study explores the long-term clinical outcomes of antibiotic-impregnated calcium hydroxyapatite (CHA) as an antibiotic delivery system in treating periprosthetic joint infection (PJI) following total hip arthroplasty (THA). : We conducted a retrospective analysis of 12 patients (13 hips) who were treated with antibiotic-impregnated CHA for PJI after THA and followed for more than 10 years at our institution between 1999 and 2011. The study group comprised six men (seven hips) and six women, with a mean age of 61.4 years. : The mean follow-up duration was 13.8 years. After irrigation and debridement with modular component exchange, seven hips in six patients underwent revision surgery; however, PJI relapsed in two hips of two patients with a history of diabetes. Two-stage revision surgery was performed on the two relapsed hips and six scheduled hips with antibiotic-impregnated CHA used to treat all cases of PJI. Infection control (100% rate) was achieved in all joints, and revision surgeries were completed. Two patients died 12 years after the initial procedure, and one died 14 years after the first procedure due to unrelated internal diseases; no infection recurrence was observed. No complications related to antibiotic-impregnated CHA were observed. : Our results indicate that antibiotic-impregnated CHA is associated with high success rates in treating PJI after THA, even in cases with advanced disease, and yields satisfactory functional outcomes postoperatively.
本研究探讨了载抗生素的羟基磷灰石(CHA)作为一种抗生素递送系统在治疗全髋关节置换术(THA)后假体周围关节感染(PJI)方面的长期临床结果。我们对1999年至2011年间在本机构接受载抗生素CHA治疗THA后PJI并随访超过10年的12例患者(13髋)进行了回顾性分析。研究组包括6名男性(7髋)和6名女性,平均年龄为61.4岁。平均随访时间为13.8年。在进行模块化组件置换的冲洗和清创术后,6例患者中的7髋接受了翻修手术;然而,2例有糖尿病史的患者的2髋出现了PJI复发。对2例复发髋和6例计划翻修的髋进行了两阶段翻修手术,所有PJI病例均使用载抗生素CHA进行治疗。所有关节均实现了感染控制(100%),并完成了翻修手术。2例患者在初次手术后12年死亡,1例在初次手术后14年因无关的内科疾病死亡;未观察到感染复发。未观察到与载抗生素CHA相关的并发症。我们的结果表明,载抗生素CHA在治疗THA后PJI方面成功率高,即使在疾病晚期的病例中也是如此,并且术后功能结果令人满意。