采用可活动性间隔物治疗髋关节假体周围感染的转归

Medium term outcomes of treatment using antibiotic articulating cement spacers for prosthetic hip infection

目的探讨采用活动性抗生素骨水泥治疗全髋关节置换术后假体周围感染,患者感染的控制与转归情况。方法回顾性分析上海六院关节外科2011年1月至2016年12月全髋置换术后假体周围感染行活动性抗生素骨水泥间隔器患者,排除浅表感染和深部髋关节假体周围感染患者、一期翻修患者及化脓性关节炎患者,记录并统计患者微生物学培养结果,感染的转归以及其他并发症情况。结果髋关节假体周围感染,行二期翻修或仅行活动性抗生素骨水泥间隔器共32例,平均随访时间(39±24)月。其中,2例患者感染复发,感染治愈率93.8%,无感染5年累积生存率91.8%;除感染外并发症,观察到1例患者出现骨水泥间隔器脱位,再翻修后假体脱位患者1例,骨水泥间隔器断裂患者1例。结论采用活动性抗生素骨水泥治疗全髋关节置换术后假体周围感染有较好的疗效。

Objective To observe the medium term outcomes of the treatment of the prosthetic infection using antibiotic articulating cement spacers. Methods All the patients with periprosthetic hip infection from 2011 through April 2016 were reviewed at Shanghai 6th People＇s Hospital. Following a PJI control protocol,those patients who underwent articulating antibiotic spacer revision were analyzed. The patients with superficial/deep surgical site infection or patients undergoing one-stage revision or septic arthritis patients were excluded. Information such as microbiology,clinical outcome and other complications were recorded. Results All the 32 cases were enrolled and followed up. The mean follow-up duration was（ 39 ± 24） months. The infection control rate was 93. 8% after hip spacer revision. The 5-year survival rate was 91. 8%. Other complications were observed,dislocation of spacer occurred in one case,dislocation of re-implanted prosthesis occurred in one case, spacer fracture occurred in one case. Conclusion Articulating antibiotic spacer revision presents a high success rate for eradication of periprosthetic hip infection.