二期全膝关节置换术治疗重度感染性膝关节炎△

Two-stage total knee arthroplasty for treatment of advanced septic arthritis of the knee

摘要:

[目的] 探讨二期全膝关节置换术治疗重度感染性膝关节炎的临床效果。[方法] 回顾性分析 2012 年 1 月—2020 年 12 月本科收治的重度感染性膝关节炎 11 例患者的临床资料，一期手术清创，放置抗生素骨水泥占位器，二期手术行 TKA。记录围手术期资料，采用膝伸屈活动度 (ROM) 和 HSS 评分评价临床效果。[结果]11 例患者经一期手术后，感染均有效控制。CRP 在(3.36±1.43)周后恢复正常，ESR 在(16.27±2.97)周后恢复正常。两次手术平均间隔时间 12~14 周，平均 (12.51±0.82)周。随时间推移，ROM 和 HSS 均显著增加(P＜0.05)。至末次随访时，感染均无复发。[结论] 二期 TKA 是治疗重度感染性关节炎的可靠选择，可取得良好治疗效果。

Abstract:

[Objective] To explore the clinical outcomes of two-stage total knee arthroplasty (TKA) for advanced septic arthritis of the knee. [Methods] A retrospective study was conducted on 11 patients who received surgical treatment for advanced septic arthritis of the knee in our hospital from January 2012 to December 2020. In the first stage of operation, complete debridement was conducted and antibiot- ic cement space was placed. In the second stage, TKA was performed as the infection proved totally subsidized. The perioperative data were recorded and the clinical outcome was evaluated by ROM and HSS score. [Results] The infection was effectively controlled in all the 11 pa- tients after the first stage operation, with CRP returned to normal in (3.36±1.43) weeks, whereas ESR returned to normal in (16.27±2.97) weeks. The intervals between the two stages of surgeries ranged from 12 to 14 weeks, with a mean of (12.51±0.82) weeks. Both ROM and HSS increased significantly over time (P＜0.05) . There was no recurrence of infection until the last follow-up. [Conclusion] The two-stage TKA is a reliable choice for the treatment of advanced septic arthritis of the knee and has achieved good therapeutic effet.