初次掌指关节和近端指间关节置换术后假体周围关节感染的发生率和表现。

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-04-01 DOI:10.1016/j.jhsa.2024.12.008

Adam T. Schluttenhofer BS , Matthew M. Rode MS , Marco Rizzo MD , Peter M. Murray MD

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引用次数: 0

摘要

目的：假体周围关节感染（PJI）是大关节置换术中一种毁灭性的并发症，已被广泛研究。然而，这在掌指关节（MCP）和近端指间关节（PIP）置换术后的报道并不一致。本研究的目的是报道MCP或PIP关节置换术后PJI患者的表现和治疗。方法：我们对1418例原发性MCP或PIP关节置换术的642例患者进行了回顾性研究，从1991年到2020年，在一家机构进行了至少180天（平均9.0年）的随访。我们还分析了患者（体重指数、吸烟、糖尿病和免疫功能低下状态）和手术（手指、植入物、手术时间和再手术）因素与感染的关系。结果：6个关节发生PJI(0.4%)，均为独立患者。到PJI的中位时间为91.5天。在6例PJI患者中，5例无全身症状，白细胞计数正常。最常见的培养菌为金黄色葡萄球菌。PJI最常用的治疗方法是去除硬体和抗生素。结论：MCP或PIP关节置换术后不常见PJI。它通常没有全身性症状或白细胞计数，最常由金黄色葡萄球菌引起。需要更多的研究来确定MCP和PIP关节PJI的最佳诊断标准、治疗和预防策略。研究类型/证据水平：治疗性IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Incidence and Presentation of Periprosthetic Joint Infection After Primary Metacarpophalangeal and Proximal Interphalangeal Arthroplasty

Purpose

Periprosthetic joint infection (PJI) is a devastating complication that has been extensively investigated in large joint arthroplasty. However, this has been inconsistently reported after metacarpophalangeal (MCP) and proximal interphalangeal (PIP) arthroplasty. The objective of the study was to report the presentation and treatment of patients with PJI after MCP or PIP joint arthroplasty.

Methods

We performed a retrospective review of 1418 primary MCP or PIP arthroplasties in 642 patients with a minimum of 180 days of follow-up (mean 9.0 years) at a single institution from 1991 to 2020. We also analyzed the association of patient (body mass index, smoking, diabetes, and immunocompromised status) and surgical (digit, implant, operative time, and reoperation) factors with infection.

Results

There were six joints, all in separate patients, that developed PJI (0.4%). The median time to PJI was 91.5 days. Of the six patients with PJI, five had no systemic symptoms and a normal leukocyte count. The most common cultured organism was Staphylococcus aureus. PJI was most commonly treated with hardware removal and antibiotics.

Conclusions

PJI is uncommon after MCP or PIP arthroplasties. It commonly presents without systemic symptoms or leukocyte count and is most frequently caused by Staphylococcus aureus. More studies are needed to identify the optimal diagnostic criteria, treatment, and preventive strategies of PJI of the MCP and PIP joints.

Type of study/level of evidence

Therapeutic IV.

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.