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在全关节置换术中诊断和管理感染

Markus Walther¹, Veit Krenn², Kathrin Pfahl³

¹Department of Foot and Ankle Surgery, Schön Klinik München Harlaching - FIFA Medical Centre, Harlachinger Straße 51, Munich 81547, Germany; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, München 81377, Germany; Department of Orthopedic Surgery, University of Wuerzburg, Brettreichstrasse 11, Würzburg 97074, Germany; Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria.

Foot and ankle clinics

|February 3, 2024

概括

治疗早期全关节置换 (TAR) 感染包括除bridement和内嵌交换. 晚期或低级感染往往需要用抗生素水泥进行两阶段的修订,可能随后进行融合.

科学领域:

整形外科手术整形外科手术
传染性疾病传染性疾病
生物材料是一种生物材料.

背景情况:

周围假肢关节感染 (PJIs) 是完全关节置换 (TAR) 后的一个重要并发症.
管理策略在早期和晚期发病的感染之间有很大差异.
低级感染可能被低诊断和治疗,可能导致更差的结果.

研究的目的:

概述全面关节置换 (TAR) 后发生的感染的有效管理方案.
为了比较早期和晚期TAR感染的不同治疗方法的疗效.
突出针对持久性或轻度感染的两阶段修订协议的好处.

主要方法:

对患有全脚置换 (TAR) 感染的患者治疗结果的综述.
对早期感染的分析,通过除菌,灌和聚乙烯内嵌交换来管理.
评估两阶段修订协议,涉及晚期或低级感染的含抗生素的骨质水泥隔离器.

主要成果:

早期感染 (4周内) 显示通过除菌,灌和内置交换成功管理.
晚期感染通常需要切除植入物.
使用抗生素水泥间隔器进行双阶段修改,与针对持久性感染的单阶段修改相比,显示出更好的结果.

结论:

迅速的外科干预和适当的抗生素治疗对于管理早期的TAR感染至关重要.
晚期发病和低度感染构成了重大挑战,通常需要切除植入物或分阶段修改.
12周的抗生素疗程与两阶段的修订相结合,然后进行融合或修订TAR,为复杂病例提供了可行的治疗途径.

关键词:

感染感染感染修订修订修订整体关节置换整体关节置换

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