The Clinical Outcome of Management of Periprosthetic Infection in Total Knee Replacement: 治療全膝關節置換術假體周圍感染的臨床結果

Background/PurposeInfection is a severe complication after total knee replacement (TKR) and creates great disability. We reviewed our 11-year experience in the management of TKR infection and its outcome.MethodsPatients who had TKR infection from 2001 to 2011 in our hospital were reviewed retrospectively.ResultsA total of 727 TKRs were performed from 2001 to 2011 and 12 cases of post-TKR infection were identified (1.65%). In the acute group, two patients had debridement with exchange of liner and four patients had a two-stage operation. No re-infection was noted. For the chronic presentation group, four out of six patients had a two-stage operation and none of them suffered from re-infection. The remaining two patients had debridement and exchange of liner and both had re-infection with a two-stage operation performed afterwards. One patient had no re-infection thereafter. Another patient was on long-term suppressive antibiotics because of the failure to eradicate the infection.ConclusionThe incidence of TKR infection in our hospital is comparable to the reported incidence in the literature. This study also showed that a two-stage operation has a higher success rate in the management of chronic TKR infection.

中文摘要引言全膝關節置換術後感染是一種嚴重的併發症，並能引致巨大的殘障。我們回顧過去11年治療此併發症的經驗及其臨床結果。材料與方法我們回顧分析了由2001年至2011年，在本院患有全膝關節置換術後感染的病人。結果本院在2001年至2011年期間施行了727宗全膝關節置換術, 當中12病例有術後感染 (1.65%)。在急性術後感染組別的病人中, 2名病人接受了清創及塑膠假體更換手術, 4名病人接受了兩階段全膝關節重換手術, 他們在術後均沒有再受感染。在6名慢性術後感染组別的病人中, 4名病人接受了兩階段全膝關節重換手術而在術後並沒有再受感染，其餘2名病人接受了清創及塑膠假體更換手術，但因感染情況未能控制而需要接受兩階段全膝關節重換手術。其後1人的感染痊癒但另1人因感染未能根除而需長期服用抑制抗生素。結論本院全膝關節置換術後感染的發病率與其他同類研究相近。本研究亦顯示在慢性全膝關節置換術後感染患者施行兩階段全膝關節重換手術會有較高的成功率。