髋关节感染二期翻修手术中应用骨水泥型假体占位器

Clinical progress of cemented prosthesis as spacer inserted in two-stage revision for periprosthetic joint infection following total hip arthroplasty

假体周围感染(PJI)是全髋关节置换术后灾难性的并发症,目前二期翻修手术对于髋关节PJI仍是最为有效的治疗方法。传统的抗生素骨水泥关节型占位器的植入是二期翻修间隔期控制感染复发的关键,但既往研究中患者于间隔期髋关节功能及生活质量均处于较低水平。骨水泥型假体是较为新颖的二期翻修占位器设计,以PROSTALAC系统为代表的骨水泥型假体占位器在近年数篇临床研究中均报道了较为满意的结果,但目前在国内外仍未广泛开展。本综述旨在筛选既有骨水泥型假体占位器的相关文献,总结其设计理念、感染控制率、间隔期功能及生活质量等方面的相关数据,探讨长期占位器留存的可能性,为骨水泥型占位器的研究开展提供参考。

Periprosthetic joint infection(PJI)is a disastrous complication after total hip arthroplasty(THA),while two-stage revision remains the most effective solution among all the therapeutic treatments of PJI.The insertion of traditional articulating antibiotic-loaded cement spacer reaches high eradication rate and provides improved range of movement of hip.However,patients still report poor hip function、health quality and satisfaction during the interim phase.The cemented prosthesis spacer coated with antibiotic-loaded cement such as PROSTALAC system is an evolutionary technique,which has been reported satisfied clinical outcome in recent researches but not widely used worldwide.This review aimed to summarize the data of design、eradication rate、function and health quality during interim phase of the cemented prosthesis spacer from previous literature,explore the possibility of the long-term spacer insertion without second surgery,and provide reference for the prospective studies of the cemented prosthesis in the future.