Infected Total Knee Arthroplasty

台北榮民總醫院從1984到1990年期間共有22位病人得到全膝人工關節感染，而且超過二年以上的追蹤檢查。其中有19位骨性關節炎及3位類風濕關節炎；平均追蹤有58個月。有7位病人是術後三個月內的早期感染，其中有5位病人使用靜脈抗生素注射及擴創術的治療即成功的控制感染。另外的15位病人遲性感染，只有3位病人使用靜脈抗生素注射及擴創術治療成功的控制感染；其餘的除做擴創術外需將人工關節拿掉才能控制感染(7位做膝關節固定術，1位拿掉人工關節沒再做其他手術，有6位分階段將人工關節再裝上)。大部分是葡萄球菌的感染。台北榮民總醫院全膝人工關節感染的機率是2.1%(其中加骨泥的人工關節是4.5%，不加骨泥的是1.1%)，骨性關節炎的機率是2%，而類風濕性關節炎是10%；分階段將人工關節再裝上的6位病例只有4位成功的控制感染。有7位使用外固定將膝關節做固定術，6位得到很好的骨頭癒合；其他15例膝關節沒固定的病人中，80%得到好的功能狀況；使用這些方法全部22位並人中有20位成功的控制感染。

關鍵字

無資料

並列摘要

Twenty-two deep-infected total knee arthroplasty patients were treated from May 1984 to December 1990. Among these, there were 19 patients with osteoarthritsis and 3 with rheumatoid arthritis. The average follow-up period was 58 months (range, 30=97 months). Seven patients developed early infection within three months after surgery. Of these, five had successful management with intravenous antibiotics and debridement. Fifteen patients were treated for late infection postsurgery. Of these, three patients were tratedsuccessfully with debridement and intravenous antibiotics. Others required removal of the implant (7 arthrodesis, 1 resection arthoplasty and 6 two-stage reimplantation). The most common isolated organism was coagulase-positive staphylococcus. The incidence in the series was 2.1% (cemented TKA, 4.5%; cementless TKA, 1.1%). The incidence of rheumatoid arthritis in total knee arthroplasty was 10% (2/22); osteoarthritis 2% (14/730). Treatment was successful in 67% (4/6) cases in two-stage reimplantation. In 15 salvaged knees, excellent or good functional result was 80% (12/15). The result of arthrodesis (N=7) for failed knee arthroplasty 86% was solid union by external fixation. The overall success rate in the control infectin of total knee arthroplasty was 91% (20/22).

並列關鍵字

Resection arthroplasty ； Arthrodesis ； Revision arthroplasty

國際替代計量

Infected Total Knee Arthroplasty

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