关节镜下前交叉韧带重建术后关节感染的临床表现及治疗转归

Clinical Manifestation and Treatment Outcome of Joint Infection after Arthroscopic Anterior Cruciate Ligament Reconstruction

目的探讨关节镜下前交叉韧带重建术后关节感染的临床表现及治疗转归。方法选取2015年7月至2018年7月我院收治的20例关节镜下前交叉韧带重建术后关节感染患者,观察其症状体征、实验室检验结果、治疗转归,分析关节镜下前交叉韧带重建术后关节感染的临床表现及治疗转归。结果与治疗前比较,患者治疗后的ESR、 CRP、体温明显下降(P <0.05);2例病例未能保留住重建韧带,2例出现术后关节僵硬,其余16例Lysholm评分为(93.2±2.4)分,膝关节活动度120°~135°,Lachman试验、前抽屉试验均阴性。结论及时发现并使用足量敏感抗生素抗感染治疗以及积极的关节镜下滑膜清理术、置管引流冲洗,对于大多数关节镜下前交叉韧带重建术后关节感染患者可取得较好的治疗效果和预后。

Objective To explore the clinical manifestation and treatment outcome of joint infection after arthroscopic anterior cruciate ligament reconstruction. Methods 30 patients with joint infection after arthroscopic anterior cruciate ligament reconstruction admitted to our hospital from July 2015 to July 2018 were selected. Their symptoms and signs, laboratory examination results, treatment outcome were observed. The clinical manifestation and treatment outcome of joint infection after arthroscopic anterior cruciate ligament reconstruction was analyzed. Results Compared with those before treatment, the ESR, CRP and body temperature of patients after treatment decreased significantly(P <0.05). 2 cases failed to retain the reconstructed ligament, and 2 cases had postoperative joint stiffness. Among the rest 16 cases, the Lysholm score was(93.2 ± 2.4) points, the knee joint mobility was 120° to 135°, and the Lachman test and front drawer test were negative. Conclusions Timely detection, use of sufficient sensitive antibiotics anti-infection treatment, and active arthroscopic synovium cleaning, drainage and flushing can achieve better treatment effect and prognosis for the most patients with joint infection after arthroscopic anterior cruciate ligament reconstruction.