The Application Of Antibiotic Bone Cement Type Prosthesis In The Treatment Of Infection After Artificial Hip Replacement

ObjectiveInfection after total hip arthroplasty(THA)is a catastrophic complication and difficult to treat.This article aims to investigate the clinical value of cement-based prosthesis in the treatment of peri-implantation infection(PJI)after THA.MethodsRetrospectively included 47 patients with peri-implantation infection after 47 hip total hip arthroplasty admitted to the Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University from February 2012 to February 2018.They were divided into two groups for treatment,25 patients.The cemented prosthesis(observation group)was used for the sputum,and the self-made antibiotic bone cement occupant(control group)was used in 22 patients.All patients stopped antibiotics 2 weeks before surgery,and the artificial hip joint prosthesis was removed in the first operation to remove the residual bone cement.At the same time,the joints were thoroughly debrided,and the joint fluid or infected tissue obtained during the operation was fragmented and sent for pathology.Bacterial culture;after debridement,the observation group was filled with antibiotic bone cement in the proximal end of the acetabulum and femoral medullary cavity,and a setofcement-type prosthesis was placed in the antibiotic bone cement dough.In the control group,a self-made half-hip antibiotic bone cement placeholder was placed in the operation.The average duration of the first phase was 4.8 months(from March to June),followed by the second revision surgery.The average follow-up period was 13.4 months(7-21 months).The hip joint Harri score(HSS)was used to evaluate the first phase.Hip function before and after surgery,before and after revision surgery.The hospital stay(LOS)was compared between the two groups.The CRP and ESR values were compared before and after operation.The visual analog scale(VAS)was used to evaluate postoperative pain.ResultsForty-seven patients recovered well after surgery.The average follow-up time was 7-21 months,with an average of 13.4 months.There was no infection recurrence after 47 hips,and the infection control rate was 100%.On the hospital days,the observation group averaged 7.1 days,and the control group averaged 13.1 days.The hospitalization time of the two groups was statistically significant(p<0.05).The hip joint Harris score was observed 4 weeks after the operation.The average group was 82.9,and the control group averaged 65.9.The Harris scores of the two groups after surgery were statistically significant(p<0.05).During the postoperative follow-up period,2 patients in the observation group had complications.In the control group,7 patients had complications.The incidence of postoperative complications in the observation group and the control group was statistically significant(P<0.05).The VAS score was 2 weeks after the operation.The average observation group was 2.5.The control group had an average of 2.7.There was no significant difference in the VAS score between the two groups(p>0.05).The infection around the 47 hip prosthesis was well controlled.The second stage surgery was performed after the revision prosthesis.Week,the observation group Harris score was 92.4 on average,and the control group was 85.5 on average.The Harris scores at 4 weeks after revision were statistically significant(p<0.05).ConclusionAntibiotic cemented prosthesis and self-made half-hip antibiotic bone cement placeholder have ideal infection control rate.Antibiotic cemented prosthesis has lower incidence of complications than self-made half-hip antibiotic cemented prosthesis.A higher score of hip function significantly improves the quality of life after the patient is placed,which is more conducive to the second phase of revision.