抗生素骨水泥与人工关节置换后的翻修

Antibiotic bone cement and renovation after artificial joint replacement

背景:抗生素骨水泥是预防和治疗人工关节置换以及翻修后感染的重要方法。目的:综述抗生素骨水泥的研究进展以及人工关节置换后翻修。方法:通过计算机检索Pubmed数据库、中国知网数据库、中国生物医学文献数据库、维普期刊全文数据库、万方数据库,时间范围在1978年至2012年,中文检索词"骨水泥"、"抗生素骨水泥"、"感染"、"关节置换";英文检索词"bone cement"、"antibiotic bone cement"、"infection"、"joint replacement"。结果与结论:共检索到相关文献335篇。通过阅读标题、摘要以及全文进行初步筛选,最后保留29篇文献进行深入的分析。抗生素骨水泥目前已广泛应用于人工关节置换以及翻修后感染的治疗,可以降低初次关节置换和翻修后感染的风险。适量的抗生素与骨水泥混合后其材料特性和力学性能不会发生改变。不同抗生素在骨水泥中的释放率也存在不同,与骨水泥的孔隙率有着密切的关系,在骨水泥中加入能够增加孔隙率的添加剂,可以达到最终增加抗生素释放的目的。

BACKGROUND：Antibiotic bone cement is the important method for the prevention and treatment of infection after artificial hip replacement and renovation. OBJECTIVE：To review the research progress of antibiotic bone cement. METHODS：A computer-based online search was performed in PubMed database, CNKI database, Chinese Biomedical Literature database, VIP database and Wanfang database for the literatures from 1978 to 2012. The key words were“bone cement, antibiotic bone cement, infection, joint replacement”in English and Chinese. RESUTLS AND CONCLUSION：A total of 335 literatures were screened out. Final y, 29 literatures were included for in-depth analysis after the primary screen through reading the title, abstract and ful-text. Antibiotic bone cement has been widely used in the treatment of infection after artificial joint replacement and renovation as it can reduce the risk of infection after initial joint replacement and renovation. The material properties and mechanical properties wil not change after bone cement mixed with appropriate amount of antibiotic. Different antibiotics in the bone cement have different release rates, which were closely related with the porosity of bone cement. Adding the additive that used for increasing the porosity of bone cement can increase the antibiotic release.