The two-stage standard in revision total hip replacement
The two-stage standard in revision total hip replacement
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DOI：
10.1302/0301-620x.95b11.32906
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发表时间：
2013-11-01
影响因子：
4.6
通讯作者：
Della Valle, C. J.
中科院分区：
文献类型：
--
作者：
Cooper, H. J.;Della Valle, C. J.
两阶段置换仍然是治疗全髋关节置换术（THR）后假体周围关节感染的金标准。在第一阶段，移除所有组件和相关的水泥（如果存在），进行积极的清创，包括完整的滑膜切除术，并放置抗生素水泥间隔器。然后，患者接受六周的肠外抗生素治疗，然后是一段“无抗生素期”，以帮助确保感染被根除。如果临床评估和血清炎症指标表明感染已经消退，则可以完成第二阶段，包括移除水泥间隔器，重复清创，并放置新的THR。
Two-stage exchange remains the gold standard for treatment of peri-prosthetic joint infection after total hip replacement (THR). In the first stage, all components and associated cement if present are removed, an aggressive debridement is undertaken including a complete synovectomy, and an antibiotic-loaded cement spacer is put in place. Patients are then treated with six weeks of parenteral antibiotics, followed by an 'antibiotic free period' to help ensure the infection has been eradicated. If the clinical evaluation and serum inflammatory markers suggest the infection has resolved, then the second stage can be completed, which involves removal of the cement spacer, repeat debridement, and placement of a new THR.