摘要
目的对全髋关节置换术后感染行二期翻修术治疗的患者进行中期的随访,并进行疗效评估。方法自2004年1月~2007年12月,本组采用二期翻修术治疗人工髋关节术后感染22例(22髋)。一期手术彻底清创,取出感染假体,置入抗生素骨水泥间隔器;二期手术植入骨水泥型或非骨水泥型假体。以感染复发率、疼痛评分(VAS评分)、髋关节功能评分(Harris评分)评估术后疗效。结果平均随访周期为(6.6±1.8)年(5~8年),22例患者均未发现感染复发、假体松动和脱位等。治疗前VAS评分平均为7.2分(5~9.1分),一期手术后VAS评分平均为3.8分(1.2~5.3分),最后一次随访时VAS评分平均为1.2分(0~3.2分)。治疗前Harris评分平均为36.4分(20~49分),一期手术后Harris评分平均为56.3分(40~66分),最后随访时Harris评分平均为84.2分(72~93分)。结论使用抗生素骨水泥间隔器二期翻修术中期随访控制感染效果显著,为全髋置换术后感染提供了有效治疗途径。
Objective To discuss the medium-term results of two-staged revision surgery for the treatment of infected total hip arthroplasty. Methods 22 patients (22 hips) were enrolled in this study between January, 2004 and December, 2007. The treatment protocol consisted of a two-stage surgery with removal of infected components, insertion of an antibiotic impregnated cement spacer and re-implantation of an uncemented or cemented prosthesis. Patients were assessed for infection recurrence, pain ( visual analog scale [ VAS] ) and hip joint function (Harris Hip score). Results The average duration of follow-up was (6. 6 ± 1. 8) (range, 5-8) years; all 22 hips were successfully converted to prosthesis in an average time of 4. 2 months after spacer implantation. There was no case of recurrent prosthetic infection. No patient had required revision for aseptic loosening or dislocation on the femoral side. The mean VAS pain score improved from 7. 2 (range, 5 - 9. 1 ) pre-operatively to 3.8 ( range, 1.2 - 5.3 ) before to spacer removal and to 1.2 ( range, 0 - 3.2) at the last follow-up assessment after prosthesis implantation. The average Harris Hip score improved from 36. 4 (range, 20 - 49) before surgery, to 56. 3 ( range, 40 - 66) between the two stages, and 84. 2 ( range, 72 - 93 ) at the final follow-up assessment. Conclusions Two-stage total hip revision with antibiotic impregnated cement spacer could provid reliable solution in the medium- term follow-up for septic arthritis of the hip and may be offered to patients as a valuable treatment option.
出处
《中华关节外科杂志(电子版)》
CAS
2012年第6期5-8,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
髋
感染
翻修
二期
Arthroplasty, replacement, hip
Infection
Revision
Two-stage