Michiels I, Schmitz B, Stridde E
Orthopädische Universitätsklinik, Johannes Gutenberg-Universität Mainz.
Unfallchirurg. 1993 Oct;96(10):508-16.
Following irrigation-suction drainage and synovectomy in 68 knee joints for empyema between 1971 and 1987, all were available for clinical and radiological follow-up. Since in 24 cases the empyema occurred after total knee arthroplasty, this group of patients was evaluated separately. The mean follow-up time in the no-prosthesis group was 8.3 and that in the prosthesis group, 5.3 years. In particular the aetiological factors, the bacterial pathogens and the effect of infection on radiological signs of degeneration were studied. The clinical results, including subjective findings, were assessed with the aid of HSS score. Our late results show that the prognosis for knee joint empyema can be rated as good if it is diagnosed early and treated aggressively. The poor outcome in a few cases was rather the result of underlying local disease and concomitant factors, and seemed not to be an immediate consequence of the infection itself. The relatively poor results in prosthesis group have to be referred predominantly to cases dating from the early years of total arthroplasty, with implants of the metal-on-metal type.
1971年至1987年间,对68例膝关节积脓患者进行了冲洗吸引引流和滑膜切除术,所有患者均接受了临床和放射学随访。由于24例积脓发生在全膝关节置换术后,因此对这组患者进行了单独评估。无假体组的平均随访时间为8.3年,假体组为5.3年。特别对病因、细菌病原体以及感染对退变放射学征象的影响进行了研究。临床结果,包括主观症状,借助HSS评分进行评估。我们的后期结果表明,如果膝关节积脓能早期诊断并积极治疗,其预后可评为良好。少数病例预后不佳主要是由于潜在的局部疾病和伴随因素,似乎并非感染本身的直接后果。假体组相对较差的结果主要归因于全关节置换术早期使用金属对金属型植入物的病例。