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首页> 外文期刊>Kaohsiung Journal of Medical Sciences >Intravenous drug abuse is a risk factor in the failure of two-stage treatment for infected total hip arthroplasty
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Intravenous drug abuse is a risk factor in the failure of two-stage treatment for infected total hip arthroplasty

机译：静脉药物滥用是感染全髋关节置换术两阶段治疗失败的危险因素

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Reinfection after two-stage revision hip arthroplasty (RHA) is still a complex issue. Only few studies revealed the factors affecting the success rate in the treatment of periprosthetic hip infection (PHI), especially risk factors. A retrospective study was conducted using records of 30 patients underwent two-stage RHA for infected total hip arthroplasty (THA). Treatment was defined as successful if a patient did not need any reoperation or invasive procedure such as image-guided drainage during the two years after reimplantation. Treatment was defined as failure if any surgery or invasive procedure or long-term antibiotic suppression was considered necessary to control infection. Four patients had infection recurrence defined as failed and three of them had intravenous drug abuse. Twenty-six patients had no infection recurrence at the end of follow-up and one of them had intravenous drug abuse but quitting after surgery. We suggest that once adequate cleaning up achieved, risk of reinfection may be little even in immunocompromised patients with RHA because of relative less old age than those with revisional total knee arthroplasty. Patients of the reinfection group were younger and non-obese with adequate nutritional status. We may consider intravenous drug abuse could take a great toll on health and lead to reinfection. Finally, we suggest performing the gold-standard two-stage reimplantation technique to manage cases with infection, educating drug abusers regarding the risk of surgical failure, and implementing a quitting program at least 1 year before the index surgery.
机译：两阶段翻修髋关节置换术（RHA）后的再感染仍然是一个复杂的问题。只有很少的研究揭示了影响假体周围髋部感染（PHI）治疗成功率的因素，尤其是危险因素。一项回顾性研究使用了30例接受两期RHA感染的全髋关节置换术（THA）的患者的记录进行。如果患者在再植入后的两年内不需要任何重新手术或侵入性手术（如图像引导引流），则治疗定义为成功。如果认为必须进行任何外科手术或侵入性治疗或长期抑制抗生素以控制感染，则治疗定义为失败。 4例感染复发定义为失败，其中3例进行静脉药物滥用。 26例患者在随访结束时未发生感染复发，其中1例患者进行了静脉药物滥用，但手术后退出了治疗。我们建议，一旦达到足够的清理效果，即使是免疫功能低下的RHA患者，由于其年龄要比全膝关节置换术的患者相对少，因此再感染的风险也很小。再感染组的患者较年轻且不肥胖，营养状况良好。我们可能认为静脉内吸毒可能会严重损害健康并导致再次感染。最后，我们建议执行金标准的两阶段再植入技术，以管理感染病例，对吸毒者进行手术失败的风险教育，并在索引手术前至少一年实施戒烟计划。

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