慢性膝关节周围假肢关节感染的重复两阶段修订后高失败率:一个多中心研究
Ian W Kennedy1, Lisa C Howard2, Lyndsay Somerville3
1Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada; College of Medicine, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom.
The Journal of arthroplasty
|January 25, 2026
概括
复发性膝关节周围假肢关节感染 (PJI) 的重复两阶段检查的成功率很低,病率很高,包括23%的截肢风险. 年轻患者面临更大的治疗失败风险.
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
- 关节塑造研究 关节塑造研究
背景情况:
- 经过全膝关节整形修复后的复发性周围假肢关节感染 (PJI) 带来了重大的临床挑战.
- 重复的双阶段修订是一种救援程序,但其对慢性PJI的结果尚未确立.
研究的目的:
- 评估慢性膝关节周围假肢关节感染 (PJI) 的重复两阶段修复手术的疗效和结果.
- 为了确定治疗失败的预测因子,在接受PJI重复两阶段膝盖修复的患者中.
主要方法:
- 在1995年至2022年期间,在两个高等医疗中心对61名接受PJI重复两阶段膝关节修复的患者进行了回顾性评估.
- 使用2019年MSIS Tier 1标准评估治疗成功,使用Kaplan-Meier分析对植入物存活率和Cox回归对失败预测因子.
- 48名接受再植入的患者的平均随访时间为12.1年.
主要成果:
- 只有39.6% (21/48) 的病例获得治疗成功,截肢率为22.9%.
- 五年和10年植入物存活率分别为63.2%和42.3%的所有原因修订.
- 年龄较小是失败的唯一独立预测因素 (每年OR 0.898;P = 0.003),在31%的病例中发现了新的感染生物.
结论:
- 重复复发性膝盖PJI的两阶段审查表明感染控制率低,患者患病率显著.
- 高度的并发症率,包括截肢,需要仔细选择患者,并考虑替代治疗策略.
- 较年轻的患者年龄与在这个具有挑战性的场景中治疗失败的可能性更高有关.
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