感染的整体肘部关节整形术的管理
1Division of Shoulder and Elbow Surgery, Mayo Clinic, Rochester, Minnesota, USA.
The bone & joint journal
|October 31, 2024
概括
周围假肢关节感染是全面肘部置换后的一个严重并发症. 现有战略可以降低感染率,一些治疗方法取得了中等成功,但需要进一步开发.
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 (PJI) 是全肘关节整形手术后的一个重要并发症,感染率超过5%.
- 在肘部关节整形术后管理PJI带来了独特的挑战,往往导致复杂的手术干预和潜在的不良结果.
- 现有的治疗选择具有可变的成功率,强调需要改进的管理策略.
研究的目的:
- 审查当前预防和管理在全肘关节整形手术后围围假肢关节感染的策略.
- 评估不同手术方法的疗效,包括带有抗生素保留和分阶段再植入的脱bridement.
- 确定在肘部PJI的管理中未来研究和开发的领域.
主要方法:
- 关于全肘关节整形手术中周围假肢关节感染的当前文献的综述.
- 对抗生素保留脱bridement,分阶段再植入,和其他手术选择的治疗结果的分析.
- 讨论与复杂的重建和延伸机制缺陷有关的挑战.
主要成果:
- 在急性感染中,与抗生素保留一起的脱皮显示出有限的成功 (不到三分之一).
- 阶段性保留和两阶段的再植入显示了与安装完善的植入器的肘部相似的成功率 (70-80%).
- 复杂的重建与全移植和延伸机制缺陷是第二阶段再植入的常见挑战.
结论:
- 在全肘关节整形手术后,对周围假肢关节感染的有效管理需要采用多方面的方法.
- 虽然一些手术选择提供了适度的成功,但仍然存在重大挑战,特别是在复杂的情况下.
- 治疗方案和外科手术技术的进一步进展对于改善肘部PJI患者的治疗结果至关重要.
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