Ainscow D A, Denham R A
J Bone Joint Surg Br. 1984 Aug;66(4):580-2. doi: 10.1302/0301-620X.66B4.6430907.
One thousand patients who received 1112 total joint replacements between 1966 and 1980 were followed up prospectively for an average of six years. These patients were not advised to take antibiotics prophylactically to cover subsequent dental or surgical procedures and, so far, only three cases of haematogenous infection at the site of the joint replacement have developed. Two hundred and twenty-four patients did subsequently undergo dental or surgical procedures and 284 patients developed infections in the respiratory tract, urinary tract or at multiple sites; none of these patients developed haematogenous infection. But of 40 patients who suffered recurrent skin ulceration and infection, three (7.5%) developed haematogenous infection of the replaced joint; two of these belonged to a group of 134 patients with rheumatoid arthritis. These results suggest that transient bacteraemia is not likely to infect a replaced joint in otherwise healthy patients. But an infected skin lesion producing chronic bacteraemia, or septicaemia due to a virulent organism, may well do so and patients with rheumatoid arthritis are at greater risk than those with osteoarthritis.
1966年至1980年间接受了1112例全关节置换手术的1000名患者被前瞻性随访了平均六年。这些患者未被建议预防性使用抗生素以应对随后的牙科或外科手术，到目前为止，仅出现了3例关节置换部位的血源性感染病例。随后有224名患者接受了牙科或外科手术，284名患者出现了呼吸道、泌尿道或多部位感染；这些患者均未发生血源性感染。但在40例反复出现皮肤溃疡和感染的患者中，有3例（7.5%）发生了置换关节的血源性感染；其中2例属于134名类风湿关节炎患者。这些结果表明，在其他方面健康的患者中，短暂菌血症不太可能感染置换关节。但产生慢性菌血症的感染性皮肤病变或由强毒力生物体引起的败血症很可能会导致感染，类风湿关节炎患者比骨关节炎患者面临更大的风险。
