膝关节假肢关节感染的微生物学及其对持久感染的影响
Sven E Putnis1,2,3, Antonio Klasan1,4,5, Brendan Bott1
1Sydney Orthopaedic Research Institute, Chatswood, Sydney, Australia.
The journal of knee surgery
|June 3, 2024
概括
在全膝关节整形术后周围假肢关节感染是常见的,凝结酶阴性葡萄球菌和多微生物感染是关键风险. 手术后3-5年的年龄和表现较小,增加了重复手术的需要.
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
- 流行病学 流行病学
背景情况:
- 在全膝关节整形术 (TKA) 后的周围假肢关节感染 (PJI) 是一个严重的并发症和患者负担.
- 了解导致持续感染的致病微生物和风险因素对于改善患者的治疗结果至关重要.
- 目前TKA PJI的管理策略各不相同,需要对其有效性和相关风险进行评估.
研究的目的:
- 确定涉及TKA PJI的微生物的流行病学.
- 评估需要进一步手术干预的持续感染率.
- 确定与持续的TKA PJI相关的风险因素以及修复手术的需要.
主要方法:
- 在2002年6月至2017年3月期间,对修订TKA程序中的微生物标本进行了回顾性分析.
- 通过国家联合替代注册表从五个区域医院网站收集的数据.
- 包括患者人口统计数据,手术间的时间,修订策略和后续数据 (至少2年).
主要成果:
- 50例 (29%) 患有持续性感染,需要至少一次额外的手术;13例需要三次或更多手术.
- 凝聚酶阴性葡萄球菌种 (CNS) 和多微生物感染与手术失败有显著的关联.
- 在初级TKA12个月内进行修复时,观察到最佳的手术成功;风险在3-5年之间达到顶峰. 年龄较小是进一步手术的重要风险因素.
结论:
- 这项研究确定了TKA PJI中常见的病原体,并强调了经过修订后持续感染的高率.
- 持续感染和重复手术的关键风险因素包括多微生物和中枢神经系统感染,TKA后3-5年的表现,以及年轻的患者年龄.
- 这些发现强调了需要有针对性的研究,以减轻与TKA PJI相关的多次手术的负担.
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