The two-stage standard in revision total hip replacement

被引：84

作者：

Cooper, H. J. ^{[1
]}

Della Valle, C. J. ^{[1
]}

机构：

[1] Rush Univ, Med Ctr, Chicago, IL 60612 USA

来源：

BONE & JOINT JOURNAL | 2013年 / 95B卷 / 11期

关键词：

EXTENDED TROCHANTERIC OSTEOTOMY; RESECTION ARTHROPLASTY; CEMENT SPACERS; BONE-CEMENT; INFECTION; MANAGEMENT; RETENTION; DEBRIDEMENT; THERAPY; ELUTION;

D O I：

10.1302/0301-620X.95B11.32906

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Two-stage exchange remains the gold standard for treatment of peri-prosthetic joint infection after total hip replacement (THR). In the first stage, all components and associated cement if present are removed, an aggressive debridement is undertaken including a complete synovectomy, and an antibiotic-loaded cement spacer is put in place. Patients are then treated with six weeks of parenteral antibiotics, followed by an 'antibiotic free period' to help ensure the infection has been eradicated. If the clinical evaluation and serum inflammatory markers suggest the infection has resolved, then the second stage can be completed, which involves removal of the cement spacer, repeat debridement, and placement of a new THR.

引用

收藏

页码：84 / 87

页数：4

相关论文

共 34 条

[1] Increasing the Elution of Vancomycin from High-Dose Antibiotic-Loaded Bone Cement: A Novel Preparation Technique [J].

Amin, Tanay J. ;

Lamping, Jeffrey W. ;

Hendricks, Kelly J. ;

Mclff, Terence E. .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2012, 94A (21) :1946-1951

[2] Irrigation and Debridement in the Management of Prosthetic Joint Infection: Traditional Indications Revisited [J].

Azzam, Khalid A. ;

Seeley, Mark ;

Ghanem, Elie ;

Austin, Matthew S. ;

Purtill, James J. ;

Parvizi, Javad .

JOURNAL OF ARTHROPLASTY, 2010, 25 (07) :1022-1027

[3] Resection arthroplasty: When enough is enough [J].

Barrack, Robert L. ;

Aggarwal, Ajay ;

Burnett, R. Stephen J. .

ORTHOPEDICS, 2006, 29 (09) :820-821

[4] Treatment of Early Postoperative Infections after THA: A Decision Analysis [J].

Bedair, Hany ;

Ting, Nicholas ;

Bozic, Kevin J. ;

Della Valle, Craig J. ;

Sporer, Scott M. .

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2011, 469 (12) :3477-3485

[5]

Bloomfield Michael R, 2010, Orthopedics, V33, P649, DOI 10.3928/01477447-20100722-21

[6] Retention treatment after periprosthetic total hip arthroplasty infection [J].

Choi, Ho-Rim ;

von Knoch, Fabian ;

Kandil, Abdurrahman O. ;

Zurakowski, David ;

Moore, Slade ;

Malchau, Henrik .

INTERNATIONAL ORTHOPAEDICS, 2012, 36 (04) :723-729

[7] The use of a preformed spacer in two-stage revision of infected hip arthroplasties [J].

D'Angelo F. ;

Negri L. ;

Binda T. ;

Zatti G. ;

Cherubino P. .

MUSCULOSKELETAL SURGERY, 2011, 95 (2) :115-120

[8] Role of early intravenous to oral antibiotic switch therapy in the management of prosthetic hip infection treated with one- or two-stage replacement [J].

Darley, E. S. R. ;

Bannister, G. C. ;

Blom, A. W. ;

MacGowan, A. P. ;

Jacobson, S. K. ;

Alfouzan, W. .

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2011, 66 (10) :2405-2408

[9] Infectiological, functional, and radiographic outcome after revision for prosthetic hip infection according to a strict algorithm [J].

De Man, F. Harald R. ;

Sendi, Parham ;

Zimmerli, Werner ;

Maurer, Thomas B. ;

Ochsner, Peter E. ;

Ilchmann, Thomas .

ACTA ORTHOPAEDICA, 2011, 82 (01) :27-34

[10] Surgical procedures in the treatment of 784 infected THAs reported to the Norwegian Arthroplasty Register Best survival with 2-stage exchange revision, but also good results with debridement and retention of the fixed implant [J].

Engesaeter, Lars B. ;

Dale, Havard ;

Schrama, Jan C. ;

Hallan, Geir ;

Lie, Stein Atle .

ACTA ORTHOPAEDICA, 2011, 82 (05) :530-537

← 1 2 3 4 →