Periprosthetic Joint Infection Treatment in Total Hip and Knee Arthroplasty

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• 作者：Roland Becker ; MD^* ; ^{roland_becker@yahoo.de" class="auth_mail" title="E-mail the corresponding author} ; Martin Clauss ; MD^&dagger ; ; Niccolo Rotigliano ; MD^&dagger ; ; Michael Tobias Hirschmann ; MD^&dagger ;
• 关键词：PJI ; one-stage ; two-stage ; biofilm ; rifampin ; DAIR ; implant related infection
• 刊名：Operative Techniques in Orthopaedics
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：26
• 期：1
• 页码：20-33
• 全文大小：367 K

文摘

The cumulative incidence of periarticular joint infection is about 1.2%, and there are multiple ways to surgically manage these patients. Arthroscopy is not recommended because of poor outcomes of high infection recurrence. Open debridement and irrigation shows a success rate up to 80%, and this technique should only be considered during the very early stages of infection. For definitive treatment, one-stage or two-stage exchange arthroplasty is recommended, and the success rate after single-stage revision and two-stage revision is about 93% and 86%, respectively. However, comparative studies have not shown significant difference in the success rate of infection control comparing one-stage and two-stage surgery. Static or articulating spacers are implanted in two-stage exchange arthroplasty, and articulating spacers seem to show some advantage with regard to range of motion. Cement abrasion is considered a problem with articulating spacer placement, and there has been no significant difference in clinical outcomes between spacers reported yet.