Prosthetic joint infection (PJI) yog ib qho teeb meem uas muaj ntaub ntawv pov thawj ntawm tag nrho cov kev sib koom tes arthroplasty uas ua rau muaj kev mob hnyav thiab kev tuag rau tus neeg, nrog rau tus nqi rau kev kho mob.
Nyob rau hauv cov ntsiab lus ntawm cov neeg laus, qhov kev thov rau tag nrho lub hauv caug arthroplasty (THA) thiab tag nrho lub hauv caug arthroplasty (TKA) yuav tsum nce 174% thiab 673%, feem, los ntawm 2030, lub nra ntawm PJI kwv yees nce.
Pulsed lavage nrog 0.9% saline (PSL) yog ib qho kev siv dav rau kev tiv thaiv PJI [12]. PSL tau pom tias muaj kev vam meej hauv kev txo qis ntawm qhov chaw phais mob kis thoob plaws cov kev phais mob sib txawv, piv rau yav dhau los kev siv cov tshuaj tua kab mob lossis lub ntiajteb txawj nqus lavage. Thaum lub ntim siv hauv PSL txawv raws li qhov kev xav ntawm lub cev thiab kev xaiv kws phais mob, ob peb txoj kev tshawb fawb qhia tias 4 litres yog qhov zoo tagnrho rau TKA [20,21], tab sis tsis muaj cov lus pom zoo tshwj xeeb rau PJI.
Ntawm tus nqi ntawm $38.28, tus nqi pib kis ntawm 1.10% rau TKA thiab 1.63% rau THA, thiab tus nqi kho dua $32,132 rau TKA thiab $39,713 rau THA, PSL yuav raug nqi ntawm ARR ntawm { {13}}.12% rau TKA thiab 0.10% rau THA (Table 1). Txhawm rau kom muaj txiaj ntsig zoo nyob rau hauv cov xwm txheej no, cov txheej txheem yuav tsum tiv thaiv 1 rooj plaub ntawm PJI xav tau kev kho dua tshiab ntawm 839 tus neeg mob uas tau txais TKA thiab 1037 cov neeg mob uas tau txais THA (Table 1). Ntawm tus nqi pheej yig tshaj plaws ntawm $20. Table 1). Ntawm qhov kev txwv siab tshaj ntawm $ 150.00 rau kev siv PSL, ARR yuav tsum tau ua kom muaj txiaj ntsig zoo yuav yog 0.47% thiab 0.38% nrog NNTs ntawm 214 thiab 265 rau TKA thiab THA, raws li, (Table 1).
Pulsed lavage nrog 0.9% saline tau pom tias muaj kev nyab xeeb thiab kev kho mob zoo, nrog qee cov kev tshawb fawb qhia tias nws ua haujlwm zoo tshaj qhov qub syringe lossis lub ntiajteb txawj nqus lavage ntawm cov ntaub so ntswg thiab cog kev nkag mus, nrog rau kev tiv thaiv kab mob [ 12, [33], [34], [35]. Ntau qhov kev tshawb fawb hauv orthopedics tau pom qhov ua tau zoo ntawm PSL. Nyob rau hauv ib tug prospective randomized sim ntawm lub duav hemiarthroplasty rau femoral caj dab pob txha, ib tug 2-liter PSL muaj tag nrho cov kab mob tus nqi ntawm 5.5%, piv rau 15.6% rau ib tug 2-litre ib txwm-saline gravity los yog noob syringe lavage (P =.002) [15]. Hauv ob qhov kev tshawb nrhiav ntawm cov txheej txheem fusion ntawm tus txha caj qaum, tus kab mob kis ntawm PSL piv rau lub qhov muag syringe lavage yog 1.6% vs 10.1% (P =.046) thiab 2.5% vs 20% (P<.001). [13,14].
Qhov kev soj ntsuam kev sib cais no qhia tau hais tias cov kua dej ua kua nrog 0.9% saline yog tus nqi zoo heev los tiv thaiv PJI tom qab TJAs.
