|本期目录/Table of Contents|

[1]郭建斌,王亚康,王旭,等.分体式抗生素骨水泥占位器在治疗人工全髋关节感染中的应用[J].国际骨科学杂志,2020,05:303-307.
　GUO Jianbin,WANG Yakang,WANG Xu,et al.Application of articulating antibiotic cement spacer in the treatment of periprosthetic joint infection after total hip arthroplasty[J].International Journal of Orthopaedics,2020,05:303-307.
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分体式抗生素骨水泥占位器在治疗人工全髋关节感染中的应用(PDF)

《国际骨科学杂志》[ISSN:1673-7083/CN:31-1952/R]

期数:
2020年05期
页码:
303-307
栏目:
临床研究
出版日期:
2020-10-20

文章信息/Info

Title:
Application of articulating antibiotic cement spacer in the treatment of periprosthetic joint infection after total hip arthroplasty
作者:
郭建斌; 王亚康; 王旭; 王蕾; 马涛; 徐亚勇; 张育民; 宋伟
710054, 西安交通大学附属红会医院关节病医院髋关节病区(郭建斌、王亚康、王蕾、马涛、徐亚勇、张育民、宋伟); 628000, 广元市中心医院骨科(王旭)
Author(s):
GUO Jianbin1;  WANG Yakang1;  WANG Xu2;  WANG Lei1;  MA Tao1;  XU Yayong1;  ZHANG Yumin1;  SONG Wei1.
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine1, Xi'an 710054, China; Department of orthopedics, Guang yuan Central Hospital2, Guang yuan 628000, China
关键词:
人工全髋关节置换术;  二期翻修;  关节假体周围感染;  抗生素骨水泥占位器;  万古霉素
Keywords:
Total hip arthroplasty;  Two-stage tevision;  Periprosthetic joint infection;  Antibiotic cement spacer;  Vancomycin
分类号:
-
DOI:
10.3969/j.issn.1673-7083.2020.05.011
文献标识码:
A
摘要:
目的 研究分体式抗生素骨水泥占位器在治疗人工全髋关节置换(THA)术后感染中的应用。方法 根据纳入和排除标准,共纳入21例THA术后关节假体周围感染的患者,根据使用的占位器不同,分为试验组11例(分体式占位器)和对照组10例(单体式占位器),记录每组患者的一般资料、手术时间、术中出血量、术后引流量、住院天数,疼痛视觉模拟评分(VAS)、髋关节Harris评分(HHS)和欧洲生活质量评分(EQ-5D)等,比较两组间的差异。结果 两组患者均无占位器脱位,断裂等并发症发生。试验组旷置手术时间为(132.09±16.02)min,长于对照组[(109.90±16.34)min,t=2.886,P=0.009]。试验组翻修手术前HHS评分为(82.67±7.30)分,高于对照组[(67.80±10.43)分,t=3.806,P=0.001]; 试验组翻修手术前EQ-5D评分为(0.74±0.22)分,高于对照组[(0.50±0.11)分,t=3.070,P=0.006]。试验组翻修手术中出血量为(407.27±116.02)mL,少于对照组[(617.00±208.38)mL,t=2.811,P=0.014]。但两组的VAS评分没有明显差异(P>0.05)。结论 采用分体式占位器,可以明显改善患者感染治疗期髋关节功能,提高患者满意度,临床应用价值更高。
Abstract:
Objective To investigate the clinical efficacy of articulating antibiotic cement spacer in the treatment of periprosthetic joint infection after total hip arthroplasty.Methods According to the inclusion and exclusion criteria, a total of 21 patients with

参考文献/References

[1] Corró S, Vicente M, Rodríguez-Pardo D, et al. Vancomycin-gentamicin prefabricated Spacers in 2-stage revision arthroplasty for chronic hip and knee periprosthetic joint infection: insights into reimplantation microbiology and outcomes[J]. J Arthroplasty, 2020, 35(1): 247-254.
[2] McAlister IP, Perry KI, Mara KC, et al. Two-stage revision of total hip arthroplasty for infection is associated with a high rate of dislocation[J]. J Bone Joint Surg Am, 2019, 101(4): 322-329.
[3] Boelch SP, Weissenberger M, Spohn F, et al. Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with Spacers[J]. J Orthop Surg Res, 2018, 13(1): 7.
[4] Rowan FE, Donaldson MJ, Pietrzak JR, et al. The role of one-stage exchange for prosthetic joint infection[J]. Curr Rev Musculoskelet Med, 2018, 11(3): 370-379.
[5] Staats K, Sevelda F, Kaider A, et al. The influence of antibiotic-loaded cement Spacers on the risk of reinfection after septic two-stage hip revision surgery[J]. Infection, 2017, 45(6): 885-891.
[6] Jones CW, Selemon N, Nocon A, et al. The influence of spacer design on the rate of complications in two-stage revision hip arthroplasty[J]. J Arthroplasty, 2019, 34(6): 1201-1206.
[7] Lausmann C, Citak M, Hessling U, et al. Preliminary results of a novel Spacer technique in the management of septic revision hip arthroplasty[J]. Arch Orthop Trauma Surg, 2018, 138(11): 1617-1622.
[8] Aali Rezaie A, Goswami K, Shohat N, et al. Time to reimplantation: waiting longer confers no added benefit[J]. J Arthroplasty, 2018, 33(6): 1850-1854.
[9] Chalmers BP, Mabry TM, Abdel MP, et al. Two-stage revision total hip arthroplasty with a specific articulating antibiotic spacer design: reliable periprosthetic joint infection eradication and functional improvement[J]. J Arthroplasty, 2018, 33(12): 3746-3753.
[10] Anagnostakos K, Duchow L, Koch K. Two-stage protocol and Spacer implantation in the treatment of destructive septic arthritis of the hip joint[J]. Arch Orthop Trauma Surg, 2016, 136(7): 899-906.
[11] Houston BL, Uminski K, Mutter T, et al. Efficacy and safety of tranexamic acid in major non-cardiac surgeries at high risk for transfusion: a systematic review and meta-analysis[J]. Transfus Med Rev, 2020, 34(1): 51-62.
[12] Shi X, Yang J, Zhou Z, et al. Partial implant retention in two-stage exchange for chronic infected total hip arthroplasty[J]. Int Orthop, 2020, 44(3): 461-469.
[13] Garceau S, Warschawski Y, Sanders E, et al. Impact of hip antibiotic spacer dislocation on final implant position and outcomes[J]. J Arthroplasty, 2019, 34(9): 2107-2110.
[14] Yang FS, Lu YD, Wu CT, et al. Mechanical failure of articulating polymethylmethacrylate(PMMA)Spacers in two-stage revision hip arthroplasty: the risk factors and the impact on interim function[J]. BMC Musculoskelet Disord, 2019, 20(1): 372.
[15] Mayes W, Edwards PK, Mears SC. Management of severe proximal femur bone loss with a modular articulating antibiotic spacer[J]. Geriatr Orthop Surg Rehabil, 2019, 10: 2151459319847399.

备注/Memo

备注/Memo:
基金项目: 陕西省自然科学基础研究计划(2019JM-493)、西安市科技局科研项目(2016YFJH2-12)、西安市卫生局科研项目(J2014032)
通信作者: 宋伟 E-mail: songweibone@163.com
更新日期/Last Update: 2020-10-20