两步法翻修术治疗全膝关节置换术后深部感染

Revision of Infected Total Knee Arthroplasty in Two Stages

目的探讨治疗全膝关节置换术（TKA）术后深部感染的有效措施。方法对自2002年2月-2006年9月收治的12例TKA术后感染患者采用两步法进行翻修，术后记录不同时期的关节功能恢复情况。结果术后随访平均11．2个月（6-36个月）。参照HSS膝关节功能评分．就诊时、第1次术后及第2次术后平均HSS评分分别为（47．50±17．62）分（28-77分）、（68．42±16．95）分（41-90分）及（81．75±12．97）分（56～97分），（P〈0．05）。结论两步法纯骨水泥压模假体技术可以增加关节内的抗生素浓度，有效控制感染；能保持膝关节活动度，是有效的治疗TKA术后感染的方法。

Objective To explore the effective way to deal with the infected total knee arthroplasty （TKA）. Methods From February 2002 to September 2006, 12 cases of infected TKA were treated with the molded articulated cement spacer in two stages. The function of each case on different stage was followed up and documented. Results All the cases were followed up for average 11.2 months （range 6 to 36 months）. According to the hospital for special surgery （HSS） score, the mean HSS score at initial presentation was 47.50±17.62 （range 28 to 77） and was improved to 68.42±16.95 （range 41 to 90） after the first operation. At final review, the mean HSS score was 81.75±12.97 （range 56 to 97 ） ,（P〈0.05）. Conclusion The revision of infected TKA with the molded articulated cement spacer in two stages can improve the concentration of antibiotics in the joint, and prevent the eontracture of the peri-knee soft tissues resulting in restoring the normal function of the knee joint. This technique is the ideal method to deal with the infected TKA.