Infection after total knee arthroplasty
Infection after total knee arthroplasty
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DOI：
10.1302/0301-620x.86b5.14887
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发表时间：
2004-07-01
影响因子：
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通讯作者：
Bannister, GC
中科院分区：
文献类型：
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作者：
Blom, AW;Brown, J;Bannister, GC
我们研究的目的是确定我们单位目前感染全膝关节置换术（TKA）的发生率和结果，并将其与1986年的早期审计进行比较，该审计显示，平均随访2.8年，471例原发性TKA后感染率为4.4%，23例改型TKA后感染率为15%。在此期间，我们引入了严格的抗生素预防，并在垂直层流手术室常规使用闭塞的衣服，并在关节置换术中使用0.05%的氯己定灌洗。我们随访了931例原发性tka和69例改良tka，平均随访6.5年（5 ~ 8年）。通过邮寄问卷、电话访谈或查阅死者病例记录等方式对患者进行追踪。9例（1%）接受原发性TKA的患者和4例（5.8%）接受改良TKA的患者发生深度感染。9例患者中有2例（22.2%）在原发性TKA后发生感染，无需进一步手术即可成功治疗。所有4例改良TKA后感染的患者预后不佳，1例截肢，1例慢性排出窦和2例关节病。接受关节融合术的患者的牛津膝关节评分与接受两阶段翻修的患者相当。虽然感染率随着预防措施的引入而下降，并且更多的患者正在接受TKA，但感染TKA的结果改善甚微。
The aim of our study was to determine the current incidence and outcome of infected total knee arthroplasty (TKA) in our unit comparing them with our earlier audit in 1986, which had revealed infection rates of 4.4% after 471 primary TKAs and 15% after 23 revision TKAs at a mean follow-up of 2.8 years. In the interim we introduced stringent antibiotic prophylaxis, and the routine use of occlusive clothing within vertical laminar flow theatres and 0.05% chlorhexidine lavage during arthroplasty surgery.We followed up 931 primary TKAs and 69 revision TKAs for a mean of 6.5 years (5 to 8). Patients were traced by postal questionnaire, telephone interview or examination of case notes of the deceased.Nine (1%) of the patients who underwent primary TKA, and four (5.8%) of those who underwent revision TKA developed deep infection. Two of nine patients (22.2%) who developed infection after primary TKA were successfully treated without further surgery. All four of the patients who had infection after revision TKA had a poor outcome with one amputation, one chronic discharging sinus and two arthrodeses.Patients who underwent an arthrodesis had comparable Oxford knee scores to those who underwent a two-stage revision. Although infection rates have declined with the introduction of prophylactic measures, and more patients are undergoing TKA, the outcome of infected TKA has improved very little.