Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis
Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis
复制标题
DOI：
10.1086/368182
复制
发表时间：
2003-04-01
影响因子：
11.8
通讯作者：
Keating, MR
中科院分区：
文献类型：
--
作者：
Meehan, AM;Osmon, DR;Keating, MR
1969-1998年期间，马约诊所（罗切斯特，明尼苏达州）18名患者中发生了19例青霉素敏感性链球菌人工关节感染，清创术和假体保留是其初始治疗方式。所有假体关节感染病例均发生在假体植入后130天，清创时假体固定良好。清创前症状的中位持续时间为4天（范围，1-10天）。在中位随访期3.9年（范围0.3-21.7年）期间，2例（10.5%）病例发生治疗失败（定义为原始微生物感染复发）。1年累积复发风险为11%（95%置信区间，0%-26%）。在清创和保留假体后，由于青霉素敏感链球菌引起的假体关节感染复发是罕见的。对于假体固定良好且症状持续时间较短的患者，清创术和保留术似乎是一种有效的治疗方式。
Debridement with retention of the prosthesis was the initial treatment modality for 19 cases of penicillin-susceptible streptococcal prosthetic joint infection that occurred in 18 patients who presented to the Mayo Clinic (Rochester, Minnesota) during 1969-1998. All of the cases of prosthetic joint infection occurred 130 days after implantation of the prosthesis, which was well fixed at the time of debridement. The median duration of symptoms before debridement was 4 days (range, 1-10 days). Treatment failure (defined as relapse of infection with the original microorganism) occurred in 2 cases (10.5%) during a median follow-up period of 3.9 years (range, 0.3-21.7 years). The 1-year cumulative risk of relapse was 11% (95% confidence interval, 0%-26%). Relapse of prosthetic joint infection due to penicillin-susceptible streptococci after debridement and retention of the prosthesis is uncommon. For patients who present with a well-fixed prosthesis and a short duration of symptoms, debridement with retention appears to be an effective treatment modality.