Morrey B F, Bryan R S
J Bone Joint Surg Am. 1983 Mar;65(3):330-8.
Deep sepsis occurred after fourteen (9 per cent) of 156 elbow-replacement procedures in 140 patients. This high frequency of infection was attributed to several factors. First, the patients were drawn from a population that was at high risk of infection, because rheumatoid arthritis and post-traumatic arthritis were the indications for arthroplasty. Second, many of the patients had had prior surgery, which significantly (p less than 0.02) increased the risk of sepsis in those with rheumatoid arthritis. Third, some patients had surgery after the arthroplasty, which also seemed to predispose to deep infection (p less than 0.05). In one patient the elbow was salvaged by early débridement, and in two others reimplantation of a total joint replacement was successful after removal of the first prosthesis and control of the infection. Resection arthroplasty was required to arrest the infection in ten patients, eight of whom had a satisfactory result. The high incidence of this significant complication attests to the hazardous nature of the elbow-replacement procedure and should warn orthopaedic surgeons to be cautious when recommending this form of treatment.
140例患者接受了156次肘关节置换手术，其中14例（9%）发生了严重脓毒症。这种高感染率归因于几个因素。首先，患者来自感染风险较高的人群，因为类风湿性关节炎和创伤后关节炎是关节成形术的适应症。其次，许多患者曾接受过先前的手术，这显著（p<0.02）增加了类风湿性关节炎患者发生脓毒症的风险。第三，一些患者在关节成形术后又进行了手术，这似乎也易引发深部感染（p<0.05）。1例患者通过早期清创保住了肘关节，另外2例在取出首个假体并控制感染后，全关节置换再植入成功。10例患者需要行切除关节成形术来控制感染，其中8例效果满意。这种严重并发症的高发生率证明了肘关节置换手术的危险性，应提醒骨科医生在推荐这种治疗方式时要谨慎。
