感染人工股関節の処置

• Published in: Japanese Journal of Rheumatism and Joint Surgery Vol. 11; no. 3; pp. 257 - 262
• Main Authors: KIM Yoon Taek, 種子田 斎, 進藤 裕幸, 東 博彦
• Format: Journal Article
• Language: Japanese
• Published: 日本関節病学会 1992; Japanese Society for Joint Diseases
• Subjects: closed irrigation; hip replacement; infection; MRSA; revision
• ISSN: 0287-3214; 1884-9059
• DOI: 10.11551/jsjd1982.11.257

Twelve hips of 11 patients with deep infection following total hip replacement and endoprosthetic replacement were treated from 1980 to 1989. These included 6 early and 6 late infections. The infection rate in the total number of hip replacements was 1.6% during the above period. The pathogenetic organisms involved were Staphylococcus aureus in 7 hips, Staphylococcus epidermidis in 4, and one unknown.The methods used to reduce the infection were removal of prothesis with continuous closed irrigation or antibiotic impregnated cement beads in 9 hips, and continuous closed irrigation without prosthesis removal in 3. We performed two THRs and one BPR (bipolar prosthetic replacement) reimplantation a mean of 16 (12 to 18) months after the objective signs of infection had disappeared. But in one of these, severe MRSA (methicillin resistant S. aureus) infection occurred and the patient finally had to undergo hip disarticulation as a life-saving measure.