Ochsner P E, Brunazzi M G, Picard C M
Orthopädische Klinik, Kantonsspitals Liestal.
Orthopade. 1995 Aug;24(4):353-9.
Thirteen patients were analyzed who suffered from chronic infection after total hip replacement. Some of them had had severe soft tissue defects or multiple fistulae for years. Some showed acute, sometimes life-threatening infection after long-standing loosening of the prosthesis. Therapy consisted of radical debridement, installation of a closed suction-irrigation drainage system and if another total hip prosthesis was implanted of a specific antibiotic management, including rifampin. In one case treatment was limited to the achievement of a permanent fistula. The average follow-up time was 4.3 years. With or without total hip reimplantation infections were healed as a rule and the decrease in pain was marked. There was only a partial increase in walking ability. In these severely damaged patients treatment can result in marked amelioration of the quality of life but only exceptionally in normalization.
对13例全髋关节置换术后发生慢性感染的患者进行了分析。他们中的一些人多年来一直存在严重的软组织缺损或多处瘘管。一些患者在假体长期松动后出现急性感染,有时甚至危及生命。治疗包括彻底清创、安装封闭式负压冲洗引流系统,如果植入了另一枚全髋关节假体,则进行特定的抗生素治疗,包括利福平。有1例患者的治疗仅限于形成永久性瘘管。平均随访时间为4.3年。无论是否进行全髋关节再次植入,感染通常都能治愈,疼痛明显减轻。行走能力仅部分提高。在这些严重受损的患者中,治疗可显著改善生活质量,但很少能使其恢复正常。