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首页> 外文期刊>Orthopedics >Inadequacy of Joint Aspiration for Detection of Persistent Periprosthetic Infection During Two-Stage Septic Revision Knee Surgery
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Inadequacy of Joint Aspiration for Detection of Persistent Periprosthetic Infection During Two-Stage Septic Revision Knee Surgery

机译：双阶段化粪池修正膝关节手术中持久性危险性感染检测的关节抱负不足

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摘要

Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol. After explantation surgery, including temporary arthrodesis with an intramedullary stabilized PMMA spacer, all patients had synovial aspiration 2 weeks before reimplantation to exclude persistent periprosthetic joint infection. Patients had a 2-week antibiotic holiday before aspiration. Sensitivity and specificity of the synovial PMMA spacer joint aspiration for the detection of periprosthetic joint infection were determined and referenced against intraoperative microbiologic and histologic samples obtained at second-stage surgery. Sensitivity of the synovial PMMA spacer aspiration was 21%. Because of poor diagnostic validity, synovial PMMA spacer aspiration cannot be recommended for routine exclusion of persistent periprosthetic joint infection before TKA reimplantation. Therefore, exclusion of persistent periprosthetic joint infection should be supplemented by other diagnostic methods, and it is not necessary to delay TKA reimplantation for PMMA spacer aspiration.
机译：尽管缺乏验证，但在2阶段化粪池修订版总膝关节置换术（TKA）期间，滑膜愿望仍然是一种常见的做法。本研究的目的是探讨滑膜聚甲基丙烯酸甲酯（PMMA）间隔物的诊断有效性临时膝关节节节术前检测TKA再普遍之前的持续存在的髋臼关节感染。此回顾性队列研究包括根据标准方案进行2阶段化粪池修订TKA的73名连续患者。在脱盐手术后，包括用髓内稳定的PMMA间隔物的临时关节，所有患者在再占用前2周具有滑膜，以排除持续存在的腰髓性关节感染。患者在愿望之前有2周的抗生素假期。测定了在第二阶段手术中获得的术中微生物学和组织学样品的检测的滑膜PMMA间隔性接头吸入的敏感性和特异性。滑膜PMMA间隔痉挛的敏感性为21％。由于诊断有效性差，因此在TKA再持有之前，不能建议滑膜PMMA间隔患者常规排除持续的持续的持久性持续的持久性关节感染。因此，应通过其他诊断方法补充持续存在的持续危险性关节感染，并且没有必要延迟PMMA间隔吸入的TKA再植入。

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  • 来源
    《Orthopedics》 |2017年第4期|共4页
  • 作者

    Preininger Bernd; Janz Viktor; von Roth Philipp; Trampuz Andrej; Perka Carsten F.; Pfitzner Tilman;

  • 作者单位

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

    Charite Dept Orthopaed Ctr Musculoskeletal Surg Charitepl 1 D-10117 Berlin Germany;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 骨科学（运动系疾病、矫形外科学）;
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