保留假体清创联合局部万古霉素治疗全膝关节置换术后早期感染

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Abstract Objective To investigate the clinical effect and feasibility of debridement，antibiotics irrigation and implant retention combined with local injection of vancomycin in the treatment of early infection after total knee arthroplasty.Methods From January 2015 to February 2018，the clinical data of 24 patients with early infection after total knee arthroplasty treated by debridement antibiotics irrigation and implant retention combined with local vancomycin in our hospital were retrospectively analyzed.Among them，there were 10 males and 14 females，including 22 cases of infection in other hospitals and 2 cases in our hospital.The patients aged from 56 years to 79 years (Mean，64.1±7.2 years).The course of disease ranged from 12 days to 28 days(Mean，20.3±2.4 days).The KSS sore，HSS score，VAS score at preoperative time and last follow-up，postoperative recurrence and complications were recorded and compared The simplified Likert scale method was applied to evaluate the patient satisfaction.Results The patients were followed up for 8 to 41 months (mean，27.8±5.8 months)，the cure rate was 87.5%(21/24)，and the complication rate was16.7% (4/24).The KSS score (83.4±18.0) and HSS score (90.6±14.5) were significantly higher than those before the operation (52.3±9.8) and (54.7±10.3)，the difference was statistically significant (P＜0.05).Preoperative VAS score was (6.3±1.8)，and the last follow-up decreased to (1.1±0.9).The difference was significant (P＜0.05).Using the simple Likert scale method to analyze patient satisfaction，the satisfaction was 83.3%(20/24).Conclusion Debridement antibiotics irrigation and implant retention combined with local vancomycin is safe and effective in the treatment of early infection after total knee arthroplasty.It can significantly relieve the pain，accelerate the recovery of knee joint function，and has a high cure rate and patient satisfaction.But the long-term effect still needs further observation.

Key words： debridement with implant retention total knee arthroplasty postoperative infection vancomycin

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