摘要
背景:髋、膝关节置换显著提高了患者的生活质量,但假体周围感染一直是该手术最严重的并发症,也是关节外科领域极具挑战性的问题之一。目的:从髋、膝关节假体周围感染的病因、流行病学、风险因素、诊断和治疗方法方面进行概述,重点介绍诊断和治疗方法,旨在为临床治疗髋、膝关节假体周围关节感染提供参考。方法:检索Pub Med数据库、Web of Science数据库、中国知网(CNKI)、万方数据库中从建库至2021年出版的文献,按与髋、膝关节假体周围感染诊断和治疗相关的入选标准,进行人工筛选和分析,排除与主题相关性差、重复及陈旧的文献,纳入研究的文献包括研究原著、综述、临床试验、荟萃分析、病例报告等。共检索到890篇参考文献,排除与主题相关性差、重复及陈旧的文献后,最终纳入97篇文献。结果与结论:对这些文献进行归纳和分析后发现:(1)髋、膝关节假体周围感染目前没有明确的诊断和治疗标准;(2)当前的诊断标准对髋、膝关节假体周围感染诊断的敏感性和特异性仍然较低,需要开发更准确、更简单、更快速的诊断方法;(3)Ⅱ期翻修仍然是髋、膝关节假体周围感染治疗的金标准,具有适应证广、感染根除率高的优势;(4)近年来,针对抑制和破坏细菌生物膜的生物治疗正逐渐成为一种新兴的治疗方法,但多处于基础研究,临床应用还不普遍,其远期疗效和安全性仍有待进一步验证。
BACKGROUND:Joint arthroplasty of hip and knee significantly improves the quality of life of patients,but periprosthetic joint infection has always been the most serious complication of the operation,and it is also one of the most challenging problems in the field of joint surgery.OBJECTIVE:To summarize the etiology,epidemiology,risk factors,diagnosis and treatment of periprosthetic joint infection on hip and knee,focusing on thediagnosis and treatment,in order to provide reference for clinical treatment of periprosthetic joint infection on hip and knee.METHODS:The articles from the establishment of the database to 2021 were searched in Pub Med,Web of Science,CNKI and Wanfang databases.According to the selecting criteria related to the diagnosis and treatment of periprosthetic joint infection of hip and knee joint,screening and analysis were carried out to exclude the articles with poor correlation with the topic and repetitive and obsolete articles.The articles included in the study contained original research,reviews,clinical trials,meta-analysis,and case reports.A total of 890 articles were retrieved.Totally 97 articles were finally included after excluding the poorly related,repetitive and obsolete articles.RESULTS AND CONCLUSION:After summarizing and analyzing these articles,it is found that:(1)At present,there are no clear criteria for diagnosis and treatment of periprosthetic joint infection of hip and knee joint.(2)The sensitivity and specificity of current diagnostic criteria for hip and knee joint periprosthetic joint infection are still low,so it is necessary to develop more accurate,simpler and faster diagnostic methods.(3)Two-stage revision is still the gold standard for the treatment of periprosthetic infection of hip and knee joint,which has the advantages of wide indication and high eradication rate of infection.(4)In recent years,biotherapy for inhibition and destruction of bacterial biofilm is gradually becoming a new treatment,but most of them are in basic research and clinical applications are not universal.Its long-term efficacy and safety remain to be determined.
作者
李树源
陈雷雷
黄林峰
赵赫然
吴素雯
蒋元康
Li Shuyuan;Chen Leilei;Huang Linfeng;Zhao Heran;Wu Suwen;Jiang Yuankang(Third School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第36期5859-5866,共8页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金资助项目(81673999),项目负责人:陈雷雷。
关键词
关节
假体感染
翻修
生物治疗
生物膜
综述
joint
periprosthetic joint infection
revision
biotherapy
biofilm
review
