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Outcome of Irrigation and Debridement after Failed Two-Stage Reimplantation for Periprosthetic Joint Infection
被引:9
作者:
Faschingbauer, M.
[1
,2
]
Boettner, R.
[2
]
Bieger, R.
[1
]
Weiner, C.
[1
]
Reichel, H.
[1
]
Kappe, T.
[1
]
机构:
[1] Univ Ulm, RKU, Dept Orthopaed Surg, Oberer Eselsberg 45, D-89081 Ulm, Germany
[2] Hosp Special Surg, 535 East 70th St, New York, NY 10021 USA
关键词:
TOTAL HIP-ARTHROPLASTY;
TOTAL KNEE ARTHROPLASTY;
CEMENT SPACERS;
STATIC SPACERS;
SINGLE-STAGE;
REVISION;
RETENTION;
COMPLICATIONS;
PROTOCOL;
D O I:
10.1155/2018/2875018
中图分类号:
Q81 [生物工程学(生物技术)];
Q93 [微生物学];
学科分类号:
071005 ;
0836 ;
090102 ;
100705 ;
摘要:
Introduction. Two-stage revision is the gold standard for the treatment of deep implant infection after knee or hip arthroplasty. Irrigation and debridement may be a treatment option for failed 2-stage revisions in cases where a reinfection occurs within 30 days or the symptoms exist not longer than 3 weeks and is appealing because of its low morbidity. We determined the incidence of recurrent infections following irrigation and debridement for failed two-stage revision hip and knee arthroplasty. Methods. We performed a single center retrospective review of periprosthetic hip and knee infections treated with a two-stage procedure from 2002 to 2010. All patients that subsequently underwent irrigation and debridement for a subsequent infection were selected for the current study. Results. 440 two-stage revisions were performed between 2002 and 2010. Fifty-one two-stage revisions failed (11.6%). Nineteen failed two-stage revisions were treated with irrigation and debridement; 12 (63.2%) patients remained free of infection at follow-up (mean follow-up: 39 months; range, 24-90 months), infection persisted in 6 patients (31.6%), and 1 patient died (5.3%). Conclusions. Success rates of irrigation and debridement for failed two-stage procedures are similar to the success rates of irrigation and debridement in primary implant infections. According to the current paper, irrigation and debridement are an acceptable treatment for acute reinfections after failed two-stage revision if performed within the first 30 postoperative days after failed two-stage procedure or if symptoms are present for less than 3 weeks in the presence of a susceptible organism.
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