可旋转绞链膝假体二期翻修治疗人工膝关节置换术后感染

Treatment of Infection after Total Knee Arthroplasty by Rotational Hinged Knee Prosthesis in Second-Stage Revision

目的总结采用可旋转绞链膝假体二期翻修方法治疗人工膝关节置换(TKA)术后感染的体会。方法对1999年10月～2003年10月收治的12例(14膝)TKA术后感染患者,采用一期清创加自制含抗生素骨水泥植入,可旋转绞链膝假体二期翻修方法治疗。结果全部病例获6～36个月随访,平均随访时间24个月。其中10例12膝治愈,1例再次行二期置换后治愈,1例因软组织条件太差致感染无法控制截肢。结论对膝关节置换术后感染采用二期翻修方法治疗,效果确切,采用可旋转绞链膝假体翻修术后膝关节功能恢复满意。

Objective To summary the treatment of infection after total knee arthroplasty （TKA） by rotational hinged knee prosthesis in second- stage revision. Methods From Oct. 1999 to Oct. 2003, 12 cases （14 knees） of infection after TKA were treated. Debridement and the self- made antibiotic PMMA were used in the first stage treatment and rotational hinged knee prosthesis was used in the second- stage revision. Results The patients were followed up from 6 to 36 months with an average of 24 months. Ten cases （12 knees） were healed well. One case was healed after a repeative treatment mentioned above. One case was amputated because the infec- tion was out of control. Conclusion Infection after TKA could be well treated by second - stage revision, and the knee function could be improved by the usage of rational hinged knee prosthesis than other prosthesis.