化脓性膝关节炎伴有邻近骨髓炎的治疗

Treatment of adjacent osteomyelitis with acute septic knee arthritis

目的:探讨化脓性膝关节炎伴有邻近骨骨髓炎的的治疗。方法:对2000年9月至2006年3月诊断为化脓性膝关节炎的52例患者进行回顾分析,其中9例磁共振(MR)显示伴有临近骨髓炎。采用清创、负压引流等方法治疗。结果:9例感染均得到控制,膝关节功能评分:优33例,良44例,满意11例,差11例。结论:难治性化脓性膝关节炎患者应考虑伴有邻近骨骨髓炎的可能,MR应作为常规检查,此类患者感染的关节及骨髓应同时进行清创。

Objective：To explore the diagnostic and therapeutic method for adjacent osteomyelitis with acute septic knee arthritis and to evaluate its treatment efficacy. Methods： A total of 52 cases with acute septic knee arthritis from MAR, 2000 to AUG, 2006 were reviewed, adjacent osteomyelitis was identified in 9 patients by magnetic resonance imaging （MR） and treated with debridement and drainage. Results ：Infections in all 9 cases were controlled. Function evaluation ： 3 cases were excellent, 4 cases good, 1 case satisfied, 1 case bad. Conclusion：Refractory response to management of septic knee arthrifts should raise suspicion of adjacent osteomyelitis and MR may be necessary for confirmation. The surgical debridement procedure should include the involved bone and arthrosis.