在发生格拉姆阴性周围假肢关节感染后,高而惊人的早期失败率 - - 一项对72例病例的回顾性队列研究
Benjamin Schlossmacher1, Bibiana Mathes2, Vincent Lallinger2
1Department of Orthopaedics and Sports Orthopaedics, Technical University of Munich, Munich, Germany. benjamin.schlossmacher@mri.tum.de.
Archives of orthopaedic and trauma surgery
|February 2, 2026
概括
格拉姆阴性周围假肢关节感染 (PJI) 的失败率很高,通常发生在早期. 与其他方法相比,双阶段修复手术显示出更好的结果.
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
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJI) 是全关节关节整形术的一个重要并发症.
- 格拉姆阴性细菌导致PJIs的显著比例,但结果数据有限.
- 这项研究解决了关于格拉姆阴性PJI治疗结果的文献稀缺问题.
研究的目的:
- 为了评估氏阴性PJI的整体治疗成功.
- 找出最有效的手术策略来根除格拉姆阴性PJI.
- 分析格拉姆阴性PJI中的病原体特异性结果.
主要方法:
- 对72例格兰阴性PJI病例 (2010-2022) 的回顾性队列研究.
- 使用2013年德尔菲共识标准进行评估的最低12个月的随访.
- 根据EBJIS标准定义的PJI.
主要成果:
- 总体无感染生存率为43.1%;无修订生存率为56.9%.
- Pseudomonas aeruginosa PJI的结果很差 (18.2%的存活率),而Enterobacter cloacae的成功率更高 (58.3%).
- 两个阶段的修改 (65.0%) 比DAIR (36.0%),多阶段 (38.1%) 和单阶段 (16.7%) 的修改更成功.
结论:
- 格拉姆阴性PJI可以具有早期,高失败率的攻击性.
- 两阶段的修订趋向于更好的无感染生存率.
- 病原体特异性数据支持格拉姆阴性PJI的个性化治疗策略.
相关概念视频
Gram-negative Bacterial Protein Secretion Systems
918
Gram-negative bacteria utilize sophisticated protein secretion systems to transport proteins across their double-membrane envelope into the extracellular environment or host cells. Based on their mechanism of action, these systems are classified into one-step and two-step pathways.One-Step Secretion Systems (Types I, III, IV, and VI)One-step secretion systems bypass the periplasm entirely, forming a continuous channel that spans both the inner and outer membranes:Type I Secretion System (T1SS):...
918
Reaction Rate
63.3K
The rate of reaction is the change in the amount of a reactant or product per unit time. Reaction rates are therefore determined by measuring the time dependence of some property that can be related to reactant or product amounts. Rates of reactions that consume or produce gaseous substances, for example, are conveniently determined by measuring changes in volume or pressure.
The mathematical representation of the change in the concentration of reactants and products, over time, is the rate...
The mathematical representation of the change in the concentration of reactants and products, over time, is the rate...
63.3K
Structural Joints: Synovial Joints
6.9K
Synovial joints are the most common type of joint in the body. A key structural characteristic for a synovial joint is the presence of a joint cavity. This fluid-filled space is where the articulating surfaces of the bones contact each other. Also, unlike fibrous or cartilaginous joints, the articulating bone surfaces at a synovial joint are not directly connected to each other with fibrous connective tissue or cartilage. This gives the bones of a synovial joint the ability to move smoothly...
6.9K
Structural Joints: Fibrous Joints
3.8K
Fibrous joints are a type of joint where the bones are connected by fibrous connective tissue. These joints provide stability and minimal to no movement between the articulating bones. There are three types of fibrous joints.
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
3.8K
Structural Joints: Cartilaginous Joints
4.0K
As the name indicates, at a cartilaginous joint, the adjacent bones are united by cartilage, a tough but flexible type of connective tissue. Unlike synovial joints, these types of joints lack a joint cavity and involve bones joined together by either hyaline cartilage or fibrocartilage.
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
4.0K
Joints
35.7K
Joints, also called articulations or articular surfaces, are points at which ligaments or other tissues connect adjacent bones. Joints permit movement and stability, and can be classified based on their structure or function.
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...
35.7K


