дискуссии т р а в м а т о л о г и я и о р т о п е д и я р о с с и и 2013-2 (68) Сведения об авторах: барабаш анатолий Петрович-д.м.н., профессор, руководитель отдела инновационных проектов
Surgical outcomes were analyzed for 108 patients with infectious complications developed at different terms after large joints arthroplasty. When complications develop in the early postoperative period than independently of the process depth and in stable implant components radical surgical debridement of the inflammation focus is indicated. In the rest of cases the removal of all implant components with subsequent either joint arthrodesis or revision arthroplasty using spacers of different modifications should be performed. We consider spacer application to be a method of choice as it enables to preserve extremity function and to perform revision arthroplasty in future.
Purpose of study: to analyze the modern approaches to classification of large joints periprosthetic infection (PPI) and evaluate the results of revision surgical interventions in patients with deep PPI of the knee. Patients and methods. One hundred fifty three patients, 51 men and 102 women (mean age 57.3±12.4 years), with deep PPI were operated on. Treatment tactics was determined by the term after primary operation. In early PPI (n=31) sanitation interventions with implant preservation and in late PPI (n=122) - two step interventions with long period between the operations (over 4 weeks) were performed. Results. Follow up made up from 2 to 5 years. Sanitation interventions with implant preservation were successful in71% of patients. In group of patients with late PPI satisfactory results were achieved in 89.6% of cases. On the basis of the obtained data the variants of diagnosis and treatment tactics optimization as well as its adaptation to domestic public health system were proposed.
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