硫酸钙骨替代物局部应用抗生素治疗前交叉韧带重建术后感染。结果3例,文献复习

I. Babiak, J. Banasiewicz
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引用次数: 0

摘要

介绍。我们报告了前交叉韧带重建(ACLR)后复发感染的翻修手术的结果,包括移植物管清创和在移植物管和感染灶局部应用硫酸钙骨替代物(CSBS),并添加庆大霉素和万古霉素。材料和方法。3例患者(3个膝关节)因ACLR术后慢性膝关节感染而手术治疗失败。两名患者接受了多次先前的修复(分别为4次和9次)。在所有病例中,对胫骨前交叉韧带移植物管和邻近的骨灶进行清理。在股骨和胫骨的清创后缺损以及胫骨的移植物隧道中加入庆大霉素和万古霉素填充CSBS。如果确定没有ACL移植物,则用胶原海绵和庆大霉素从关节侧封闭胫骨管。结果。随访20 ~ 26个月后,所有患者炎症完全消退,CRP恢复正常。未观察到与CSBS相关的副作用。与翻修前相比,膝关节功能和稳定性没有恶化。结论。在移植物管和周围松质骨炎症灶中加入庆大霉素和万古霉素的CSBS被证明是有效的,与ACLR后慢性感染的并发症无关。证据等级:IV(病例系列)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The local application of a calcium sulfate bone graft substitute with antibiotics for the treatment of infection after anterior cruciate ligament reconstruction. The results of 3 cases and a literature review
Introduction. We report the results of revision surgery in recurrent infection after anterior cruciate ligament reconstruction (ACLR) consisting of graft canal debridement and the local application of a calcium sulfate bone substitute (CSBS) with the addition of gentamicin and vancomycin in graft canal and infected foci. Materials and methods. Three patients (3 knees) were operated due to a chronic and unsuccessfully treated knee infection after ACLR. Two patients underwent multiple previous revisions (4 and 9, respectively). In all cases, the tibial ACL graft canal and adjacent bone foci were debrided. Post debridement defects in the femur and tibia and the graft tunnel in the tibia were filled with CSBS with an addition of gentamicin and vancomycin. If the absence of the ACL graft was stated, the tibial canal was closed from the joint side with a collagen sponge with gentamicin. Results. After a follow-up of 20 to 26 months, all patients obtained a complete resolution of inflammation and CRP normalization. No side effects related to CSBS were observed. There was no deterioration in the knee function and stability compared to the pre-revision status. Conclusions. CSBS with the addition of gentamicin and vancomycin applied in the graft canal and inflammatory foci in the surrounding cancellous bone proved to be effective and unrelated to complications in chronic infection after ACLR. Level of Evidence: IV (case series).
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