二期翻修术治疗髋关节置换术后假体周围晚期感染

目的:探讨二期翻修术治疗髋关节置换术后假体周围晚期感染的疗效。方法:回顾性分析自2005年6月至2009年8月在河南省人民医院采用二期翻修术治疗人工髋关节术后感染25例。一期手术彻底清创后行旷置术加10%万古霉素骨水泥间隔体植入。感染控制后行二期翻修术根据患者情况使用了生物型或骨水泥型假体。结果:术后均超过24个月随访发现,24例未发现感染复发,1例患者二期翻修术后切口感染,遂行清创,切口愈合。本组病例在一期旷置术及二期翻修术中及术后无骨折、脱位、血管神经损伤等并发症出现。结论:二期翻修术治疗髋关节置换术后假体周围晚期感染,能有效控制感染,临床效果满意。

Two-stage revision for surgery of periprosthetic infection following hip arthroplasty

Objective: To evaluate the effectiveness of two-stage hip prosthesis revision in the treatment of infection after hip arthroplasty.Methods: We reviewed 25 patients with prosthetic hip infection who were managed with two-stage revision from June 2005 to August 2009.Thorough debridement and insertion of Vancomycin-loaded cement spacer was performed in the first stage,followed by conversion to THA after eradication of infection in the second stage.The mean duration of follow-up was 24 months.Results: There were no complications related to the use of the antibiotic-loaded cement spacer.There were no cases of recurrent prosthetic infection and no patient had required revision for aseptic loosening or mechanical instability.One patient occurred incision infection after THA revision which treated successfully with debridement.Conclusion: The two-stage hip prosthesis revision is considered to be effective for treatment of hip prosthesis infection.