PDF(Pubmed)
Abstract：
The aim of this systematic review was to investigate the outcomes of knee arthrodesis (KA) after periprosthetic joint infection (PJI) of the knee. Differences in clinical outcomes and complication rates among the intramedullary nailing (IMN), external fixation (EF), and compression plating (CP) procedures were compared. A total of 23 studies were included. Demographics, microbiological data, types of implants, surgical techniques with complications, reoperations, fusion, and amputation rates were reported. A total of 787 patients were evaluated, of whom 601 (76.4%), 166 (21%), and 19 (2.4%) underwent IMN, EF, and CP, respectively. The most common causative pathogen was coagulase-negative Staphylococcus (CNS). Fusion occurred in 71.9%, 78.8%, and 92.3% of the patients after IMN, EF, and CP, respectively, and no statistically significant difference was found. Reinfection rates were 14.6%, 15.1%, and 10.5% after IMN, EF, and CP, respectively, and no statistically significant difference was found. Conversion to amputation occurred in 4.3%, 5%, and 15.8% of patients after IMN, EF, and CP, respectively; there was a higher rate after CP than after EF. The IMN technique is the most common option used for managing PJI with KA. No differences in terms of fusion, reinfection, or conversion-to-amputation rates were reported between IMN and EF. CP is rarely used, and the high amputation rate represents an important limitation of this technique.
摘要：
这项系统评价的目的是研究膝关节假体周围感染（PJI）后膝关节固定术（KA）的结果。髓内钉（IMN）的临床结果和并发症发生率的差异，外固定架(EF),和压缩电镀（CP）程序进行了比较。共纳入23项研究。人口统计,微生物数据,植入物的类型，有并发症的手术技术，重新操作,聚变,报告截肢率。对787例患者进行了评估，其中601人（76.4%），166（21%），19人(2.4%)接受了IMN，EF,CP,分别。最常见的病原体是凝固酶阴性葡萄球菌（CNS）。融合发生在71.9%，78.8%,IMN后92.3%的患者，EF,CP,分别,差异无统计学意义。再感染率为14.6%,15.1%,IMN后10.5%，EF,CP,分别,差异无统计学意义。转换为截肢的发生率为4.3％，5%,15.8%的患者在IMN后，EF,CP,CP后的发生率高于EF后。IMN技术是用于使用KA管理PJI的最常用选项。在融合方面没有差异，再感染,或在IMN和EF之间报告了截肢转化率。CP很少使用，高截肢率代表了该技术的重要限制。
