Reimplantation Following Resection Hip Arthroplasty For Infection With and without an Antibiotic-Loaded

人工髖關節感染以二階段再置換手術使用及不使用含接生素骨水泥植入物之比較

謝邦鑫(Pang-Hsin Hsieh) ； 施俊雄(Chun-Hsiung Shih) ； 張毓翰(Yu-Han Chang) ； 李炫昇(Mel S Lee) ； 施信農(Hsin-Hung Shih) ； 楊文一(Wen-E Yang)

《Journal of Orthopaedic Surgery Taiwan》 20卷4期 (2003/12) Pp. 163-171

摘要

無資料

關鍵字

total hip arthroplasty ； infection ； revision surgery

並列摘要

This retrospective study compares the outcome of 40 infected hips treated with a two-stage reimplantation surgery with an interim antibiotic-loaded cement spacer to that of 40 infected hips treated without a spacer. The control of infection, restoration of function, and surgical complications were assessed. Recurrence of infection was noted in 2 (5%) hips treated with an interim spacer and 3 (7.5%) hips treated without a spacer. Thirty-one (77.5%) patients who had a spacer could walk with various aids while only 7 (17.5%) patients treated without a spacer remained ambulatory in the interim period. On performing the second-stage surgery, the operative time was shorter and the estimated blood was less when a spacer was previously used. Complications associated with the use of a spacer included a fracture of the spacer in 3 hips, and dislocation of the spacer prosthesis in 3 hips. Eight (20%) hips treated without a spacer had dislocations following reimplantation while only one (2.5%) dislocation was encountered in hips that were treated with a spacer before revision. We concluded that two-stage reimplantation is an excellent method to eradicate hip infection. The use of a temporary cement spacer was associated with better ambulatory function between stages, an easier revision surgery, and a lower dislocation rate following reimplantation.