Acta Biomedica Scientifica (Jan 2021)
Using an Algorithm to Choose the Surgical Tactics for the Treatment of Periprosthetic Infection of Large Joints
Abstract
Background. The known methods of choosing the surgical treatment of infectious complications of arthroplasty of large joints have their drawbacks.Aim of the study. To assess the effectiveness of the proposed algorithm for choosing surgical tactics in patients with periprosthetic infection of the hip and knee joints.Materials and methods. The analysis of the results of surgical treatment of 67 patients with deep periprosthetic infection of the hip and knee joints, who were in the clinic of the Irkutsk Scientific Centre of Surgery and Traumatology from 2014 to 2019. The average age of the patients was 67.8 ± 6.3 years (from 36 to 81 years). 50.7 % were men. In 42 patients, the infectious process developed in the area of the hip joint endoprosthesis, in 25 – in the knee joint. The patients were divided into two groups depending on the method of choosing surgical tactics. The first group consisted of 47 patients in whom the choice of surgical tactics was performed as standard. In 20 patients of the second group, the treatment tactics were determined using the proposed algorithm. The proposed algorithm for choosing surgical tactics for periprosthetic infection includes determining the degree of risk of maintaining the infectious process in the area of the prosthetic joint after the proposed surgical treatment and evaluating additional criteria.Results. Analysis of the results of the treatment of patients with deep periprosthetic infection of the hip and knee joint showed that in patients of the first group, it was possible to arrest the infectious process in 61.7 % of cases, in the second group of patients, relief of periprosthetic infection was achieved in 90 % of cases.Conclusion. The use of the proposed algorithm for choosing surgical tactics for periprosthetic infection, taking into account the risk factors for maintaining the infectious process and evaluating additional criteria, makes it possible to determine the type of surgical intervention that is optimal for each patient, and contributes to the relief of the infectious process in the area of the prosthetic joint.
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