中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (4): 673-678.doi: 10.3969/j.issn.1673-8225.2012.06.024

• 人工假体 artificial prosthesis • 上一篇    下一篇

含抗生素骨水泥占位器在髋关节置换后感染二期翻修中的应用*★

闫韵飞1，郭  亭2，周利武2，王  瑞2，包倪荣2，程秀红2，赵建宁1，2   

  1. 1南京大学医学院临床学院，江苏省南京市 210002；2解放军南京军区南京总医院骨科，江苏省南京市 210002
  • 收稿日期:2011-08-15 修回日期:2011-11-25 出版日期:2012-01-22 发布日期:2014-04-04
  • 通讯作者: 赵建宁，教授，主任医师，博士生导师，解放军南京军区南京总医院骨科，江苏省南京市 210002 zhaojianning.0207@163.com
  • 作者简介:闫韵飞★，男，1986年生，山东省高密市人，南京大学医学院，解放军南京军区南京总医院在读硕士，主要从事关节外科方面的研究。 yanyunfei04@126.com
  • 基金资助:

    国家自然科学基金(81000792)。

Application of antibiotic-loaded bone cement spacer in second-stage revision for infected total hip arthroplasty  

Yan Yun-fei1, Guo Ting2, Zhou Li-wu2, Wang Rui2, Bao Ni-rong2, Cheng Xiu-hong2, Zhao Jian-ning1, 2   

  1. 1Clinical Institute of Nanjing University Medical School, Nanjing  210002, Jiangsu Province, China; 2Department of Orthopedics, Nanjing General Hospital of PLA Nanjing Military Region, Nanjing  210002, Jiangsu Province, China
     
  • Received:2011-08-15 Revised:2011-11-25 Online:2012-01-22 Published:2014-04-04
  • Contact: Zhao Jian-ning, Professor, Chief physician, Doctoral supervisor, Clinical Institute of Nanjing University Medical School, Nanjing 210002, Jiangsu Province, China; Department of Orthopedics, Nanjing General Hospital of PLA Nanjing Military Region, Nanjing 210002, Jiangsu Province, China zhaojianning.0207@163.com
  • About author:Yan Yun-fei★, Studying for master’s degree, Clinical Institute of Nanjing University Medical School, Nanjing 210002, Jiangsu Province, China yanyunfei04@126.com
  • Supported by:

    the National Natural Science Foundation of China, No. 81000792*

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摘要：

背景：感染是髋关节置换后灾难性的并发症，其治疗方法很多，但是二次翻修是公认的疗效比较肯定的方法。
目的：回顾分析含抗生素骨水泥占位器在髋关节置换后感染二期翻修过程中的应用效果。
方法：在26例(27髋)髋关节置换后感染患者的二期翻修过程中使用含抗生素骨水泥占位器，置入原假体的位置，制作时，在占位器中央放入一根斯氏针作为支架。治疗后随访并行Harris评分。
结果与结论：1例患者因治疗后不恰当负重活动导致占位器断裂，取出骨水泥占位器，行清创后关节旷置。其余25例患者均获得随访，随访时间1~7年。患者治疗后Harris评分平均为90.2分，较治疗前平均改善61.9分，感染控制率为96.3%。提示在使用含抗生素骨水泥占位器的基础上使用二期翻修治疗髋关节置换后感染，具有感染控制率高，置换后关节功能良好等优点。

关键词: 人工髋关节置换, 感染, 二期翻修, 含抗生素骨水泥占位器

Abstract:

BACKGROUND: Infection is one of the most serious complications of total hip arthroplasty (THA) surgery, although there are many ways can treat the infection, secondary revision procedures is recognized as an effect treatment method.
OBJECTIVE: To retrospectively study the effect of antibiotic-loaded bone cement spacer in second-stage revision for infected THA.
METHODS: Totally 27 hips from 26 cases who infected after THA were treated with two-stage revision using antibiotic-loaded bone cement spacer to instead the position of original prosthesis. During this procedure, a steinmann pin was load in the center of the spacer as scaffold. All the cases were followed up after the surgery and Harris score was evaluated.
RESULTS AND CONCLUSION: Due to improper weight-bearing activities after surgery, the spacer of one case was ruptured, after removal of the bone cement spacer and debridement, the joint was spacious placed. The other 25 cases were all followed up for 1 to 7 years. After surgery, the mean Harris hip score reached 90.2 which improved 61.9 as compared with before operation, and the cure rate was 96.3%. It is indicated that infected THA can be successfully treated by two-stage revision surgery with antibiotic-loaded bone cement spacers, and has the advantage of higher infection control rate and joint function recovery.

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