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Re: Меронем и костный цемент
Maxim Agalakov 26 Август 2010, 22:24
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"In the early eighties Buchholz and coworkers published their experience in one
stage total hip revisions. Surgery included excision of soft tissue, removal of the
implant and cement, replacement with an appropriate prosthesis using antibiotic-
loaded cement and systemic antibiotics. Overall success rate after ten years was 77%
in 583 patients [5]. Hanssen and Rand could show that the use of antibiotic-loaded
cement in one stage revisions is significantlymore successful than usual cement (suc-
cess rate 83% vs. 60%) [25]. More recent studies showed a higher success rate in
small series of 90.9% [6], 91.7 [7] and 100% [47]. In a literature review including 12
reportsoverallsuccesswas83%[34]."
E.Meani · C. Roman` o · L. Crosby · G.Hofmann (Eds.)
Editorial Coordinator: G. Calonego
Infection and Local Treatment
in Orthopedic Surgery
Интересно, что 60% излечились как-то без антибиотика
От туда же
One-stage Non-cemented Revision of Septic Hip
Prosthesis Using Antibiotic-loaded Bone Graft
All patients could be followed with a minimum of 2 years and a maximum of 8
years (mean 4,1 years). 35 (из 37) patients showed no sign of infection until the last follow up.
Теперь уже антибиотики, но без цемента.
Dead space management therefore represents one critical point of septic surgery.
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Re: Меронем и костный цемент
Отправитель: Maxim Agalakov 27 Август 2010, 21:13
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Despite remarkably high
levels of antibiotics in adjacent cortical bone, the effi-
cacy of antibiotic-impregnated cement in the treatment
of infection at the site of a total hip arthroplasty has not
been established with use of comparative clinical stud-
ies, to our knowledge; however, the clinical experience
with antibiotic-impregnated cement has been wide-
spread3,11,29,36,51,55,56,66,76,78,81,91,93,94,96,100,114,115,121,122,136-138,141,142
. Several
different factors, such as variability in the type and
amount of antibiotic added to bone cement, proba-
bly account for the inability to demonstrate the efficacy
of local delivery.
Evaluation and Treatment of Infection
at the Site of a Total Hip or Knee Arthroplasty*†
BY ARLEN D. HANSSEN, M.D.‡, ROCHESTER, MINNESOTA, AND JAMES A. RAND, M.D.§, SCOTTSDALE, ARIZONA
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
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