摘要
Abstract
Objective To explore the role of antibiotic-eluting absorbable calcium sulfate in treating periprosthetic infec-tion after one-stage revision of knee arthroplasty.Methods A retrospective analysis was performed on 36 patients(36 knees)who underwent phase Ⅰ revision for periprosthesis infection after total knee arthroplasty from January 2018 to March 2022.All patients were underwent knee cavity puncture before operation and had positive results of aseptic body fluid culture,21 pa-tients received revision combined with antibiotic loaded calcium sulfate at stage Ⅰ(calcium sulfate group)during operation,and 15 patients underwent renovation at stage Ⅰ(revision group).There were 9 males and 12 females in calcium sulfate group,aged from 54 to 76 years old with an average of(67.6±6.2)years old.There were 15 patients in revision group,including 4 males and 11 females,aged from 60 to 75 years old with average of(69.6±4.1)years old.The levels of serum C-reactive pro-tein(CRP),interleukin-6(IL-6)at 7,14,30 and 90 days after operation were compared between two groups,and the rate of end-infection control at follow-up were compared.The systemic antibiotic application time,hospital stay and postoperative com-plications were observed between two groups.Results Calcium sulfate group were followed up for 12 to 29 months with an aver-age of(18.9±4.2)months,and the infection control rate was 90.5％;while revision group were followed up 18 to 29 months with average of(21.6±3.7)months,and the infection control rate was 86.7％(13/15).There were no significant differences in fol-low-up time and infection control rate between two groups(P＞0.05).Postoperative levels of CRP and IL-6 at 7,14 and 30 days in calcium sulfate group were(32.79±11.48),(15.50±6.52),(9.36±3.32)mg·L-1 and(17.31±6.15)pg·ml-1,respectively;which were lower than those in revision group(40.65±1 1.32),(30.15±10.57),(18.97±5.86)mg·L-1 and(25.54±6.73)pg·ml-1,had statistical differences(P＜0.05).There were no significant differences in IL-6 levels at 7 and 14 days after operation and CRP levels at 90 days after operation between two groups(P＞0.05).The hospitalization time and systemic antibiotic applica-tion time in calcium sulfate group were(18.4±2.2)and(63.5±21.4)d,respectively;which were better than those in revision group(20.5±2.4)and(82.7±16.9)d,and had statistical differences(P＜0.05).No significant wound complications and hyper-calcemia were observed in calcium sulfate group.Conclusion Antibiotic eluted absorbable calcium sulfate could be used to treat periprosthetic knee infection,significantly reducing CRP levels in the early postoperative period,shortening hospital stay and systemic antibiotic application time,but it does not significantly improve the control rate of revision infection at stage Ⅰ.关键词
假体周围感染/膝关节/硫酸钙/翻修术/病例对照研究Key words
Periprosthetic infection/Knee joint/Calcium sulfate/Revision/Case-control study分类
医药卫生
