(精编)【医学精品课件之抗生素】与关节相连的带抗生素的结合剂假体教学课件.pptVIP

Construction of an articulating antibiotic-loaded cement spacer 与关节相连的带抗生素的结合剂假体 Options for management of infected total hip arthroplasties include suppressive antibiotic therapy, irrigation and debridement ,excision arthroplasty，single-stage exchange arthroplasty ,and 2-stage exchange arthroplasty . 选择处理感染髋关节的方法包括抑制抗生素疗法，冲洗，清创切除术，一种材料关节成形和二种材料关节成形。 Although selection of the most appropriate choice of management must be individualized to the patient ,2-stage exchange arthroplasty is a popular choice in north america because of the low recurrence of infection when this protocol is used . 尽管选择最恰当方法必须对病人个体化，两种材料的关节成形在北美普遍选择因为使用这个 草案有较低的感染再发率 The interval insert of an antibiotic-loaded cement spacer is commonly used as part of a 2-stage exchange protocol to deliver a high local concentration of antibiotics and to prevent soft tissue contractures that may complicate the second stage procedure . 两种材料的关节成形普遍使用带抗生素的骨水泥以达到集中的高浓度的抗生素来阻止软组织感染和第二阶段恶化 Fig. 1. antibiotic-loaded cement is poured into the removed bulb of a syringe (arrow),and when it has reached a doughy consistency ,the femoral head of the prosthesis is inserted into it to form the metal-on –cement articulation. ..\..\My Documents\未标题-1.jpg Fig. 2 . Appearance of the articulating spacer after removal of the bulb syringe to form a smooth surface that articulates with the acetabulum. The femoral component is coated with antibiotic-loaded cement before final insertion . Fig .3. postoperative radiograph of the articulating antibiotic-loaded spacer in place. Advantages of the articulating antibiotic-loaded cement spacer described include the use of materials already available in the operating room , the ease and speed in fashioning the spacer , a smooth cement-bone acetabular interface to minimize excessive bony wear ,and a constrained metal-on-cement articulation to minimize the risk of femoral head di