| Background and objectivePeriprosthetic infection is a serious complication of joint replacement,with studies showing that periprosthetic infections occur in 1%-3%of patients after initial total hip and total knee replacementc[1-2]and occur in up to 8%-12%of patients after joint revision[3].This has devastating effects on the local anatomy of the joint and the overall health of the patient,posing a significant challenge to patients,surgeons,and health care systems alike.The current treatment of periprosthetic infections is mainly based on the adoption of surgical treatment combined with local and systemic application of sensitive antibiotics,where the use of effective carriers for local application of antibiotics plays an important role in the treatment of periprosthetic infections and has been the most talked about treatment in recent years[4].The excellent characteristics of calcium sulfate extended release systems make them ideal carriers for local release of antibiotics.With the increased use of calcium sulfate extended-release systems,there is an increasing awareness of the advantages and disadvantages,and complications of calcium sulfate extended-release systems include problems such as transient blood calcium abnormalities,ectopic ossification,and aseptic wound exudate[5].Lin Zhijiong et al[6]showed that retained prosthetic debridement combined with the application of a calcium sulfate retardation system had good results in early periprosthetic infections.In this trial,we evaluated the effect of treatment with placement of calcium sulfate slow-release system by observing 24 patients with periprosthetic infections at all stages.MethodsRetrospective analysis of 24 patients,10 males and 14 females,with an average age of 62.30± 10.15 years,14 patients with periprosthetic infection in the knee joint and 10 patients with periprosthetic infection in the hip joint,admitted to the Department of Orthopaedic Sixth Affiliated Hospital of Zhengzhou University from January 2019 to April 2020 after joint replacement;early periprosthetic infection or acute periprosthetic The patients were treated by surgical methods of prosthetic debridement,one-stage revision or two-stage revision according to the presence or absence of pathogenic basis,and all of them had intraoperative placement of calcium sulfate slow-release system.The patients’ basic conditions and postoperative infection indicators and joint function scores were recorded,including(1)the patients’ general conditions:age,sex,preoperative diagnosis(early periprosthetic infection/acute periprosthetic infection/late chronic periprosthetic infection),preoperative comorbidities(rheumatoid arthritis,diabetes mellitus,immunodeficiency disease),and bacterial culture results;(2)pre-and postoperative blood calcium concentration,sedimentation,C-reactive protein),hip Harris score,American Hospital for Special Surgery knee score).Postoperative follow-up was 3 months.The data were analyzed statistically by paired-sample t-test using IBM SPSS22.0 software,and the differences between preoperative and final erythrocyte sedimentation rate,C-reactive protein,hip Harris score,and American Hospital for Special Surgery knee score were considered significant at P<0.01.ResultsThe erythrocyte sedimentation rate and C-reactive protein were significantly lower in all patients than before surgery(P<0.01);and the hip and knee Harris scores were higher than before surgery(P<0.01).Conclusion23 patients had good wound healing and good prosthesis position without recurrence,and one patient had recurrence of infection and recurrence after reoperation;all patients had better infection indexes and better joint function than before surgery,suggesting that the calcium sulfate slow-release system combined with a reasonable surgical approach can effectively treat periprosthetic infection and improve joint function after joint replacement. |
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