万古霉素骨水泥假体在羊人工髋关节翻修术中的抗感染作用

目的：建立羊股骨假体置换术后感染模型，探讨万古霉素骨水泥假体在髋关节翻修术中抗感染作用。方法：内蒙古绵羊30只, 行右侧股骨假体置换术。术毕将含有1×10⁶CFU耐甲氧西林金黄色葡萄球菌的明胶海绵置入至右侧髋关节内, 术后3周时，羊髋关节置换后感染模型建立。模型建立后清创, 实验组15只羊植入万古霉素骨水泥假体，对照组15只羊植入单纯骨水泥假体。间隔5周后，观察两组感染控制率、关节周围软组织病理变化及假体位置。结果：耐甲氧西林金黄色葡萄球菌接种3周后感染率为100%。间隔5周后，实验组感染控制率为93.33%，对照组感染控制率为33.33%，两组间比较差异有显著性(χ² =12.36, P<0.05)。X线片证实两组假体位置良好。病理切片镜下实验组中性粒细胞<5个（除外被证实感染的1只），对照组可见满视野的中性粒细胞。结论：万古霉素骨水泥假体在羊人工髋关节翻修术中能有效地控制感染。

Anti-infection effects of VCM-PMMA prosthesis on revision after sheep hip arthroplasty

Objective To study the anti-infection effects of VCM-PMMA femoral prosthesis on revision after sheep hip arthroplasty.Methods Right lateral femoral replacement on thirty Inner Mongolia sheep was taken.Gelatin sponge,having methicillin resistant staphylococcus aureus(MRSA),was implanted in the right hip.Three weeks later,the model of infected hip after arthroplasty was established in sheep.VCM-PMMA prosthesis(experimental group)and PMMA prosthesis(control group)were implanted in the right hip after the debridement.The infection control rate,the pathological changes of soft tissue and the prosthesis position were observed in the two groups after the internal of five weeks.Results The rate of infection in the right hip joints was 100% on the third week.After five weeks,the rate of infection control was 93.33% in experimental group;the rate of infection control was 33.33% in control group,the difference was significant between two groups(χ2 =12.36,P<0.05).The prosthesis was on the good place by the X-ray.Pathological section was observed under microscope.Neutrophilic granulocytes were hardly found in the experimental group.Neutrophilic granulocytes were much in control group.Conclusion The anti-infection effects of VCM-PMMA prosthesis on revision after sheep hip arthroplasty are very significant.