Т.А. KILMETOV¹, S.A. LAPSHINA^1,2, S.A. ARDASHEV¹

¹Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012

²Republican Clinical Hospital of the MH of RT, 138 Orenburgskiy trakt, Kazan, Russian Federation, 420064

Kilmetov T.A. — postgraduate student of Traumatology, Orthopedics and Emergency Surgery Department, tel. +7-917-286-78-27, e-mail: t.kilmetov@gmail.com

Lapshina S.A. — Cand. Med. Sc., Assistant of the Department of Hospital Therapy, tel. +7-987-290-15-65, e-mail: hospther@mail.ru

Ardashev S.A. — resident of the Traumatology, Orthopedics and Emergency Surgery Department, tel. +7-917-886-07-17, e-mail: ardashev-sergei@mail.ru

This article appears to be the result of treatment of 35 patients with infectious complications after arthroplasty of a large joints. In the treatment was used a two-stage variant revision surgery, where the intermediate stage was the setting of a spacer from the bone cement which was prepared intraoperative. All patients were divided into 2 groups. In the main group during the preparing of the spacer was added an antibiotic, and postoperative course includes immunostimulating therapy. In the control group was used the spacer from the bone cement with prophylactic doses of gentamicin, and in the postoperative period immunostimulatory therapy wasn’t given. In the main group achieved a more stable remission, in comparison with the control group. The authors analyzed the immune status of patients with periprosthetics infection.

Key words: arthroplasty, periprosthetic infection, immune status, immunostimulatory therapy.

REFERENCES

1. Akhtyamov I.F., Kuz’min I.I. Oshibki i oslozhneniya endoprotezirovaniya tazobedrennogo sustava [Errors and complications of hip replacement]. Kazan: Tsentr operativnoy pechati, 2006. 328 p.
2. Tentino J.R. Prosthetic joint infections: bane of orthopedists, challenge for infectious disease specialists. Clin Infect Dis., 2003, May 1, 36(9): 1157. P. 61.
3. Kornilov N.V., Voytovich A.V., Mashkov V.M. et al. Khirurgicheskoe lechenie degenerativno-distroficheskikh porazheniy tazobedrennogo sustava [Surgical treatment of degenerative lesions of the hip joint]. Saint Petersburg: LITO-Sintez, 1997. 292 p.
4. Bernakevich A.I., Es’kin N.A., Nuzhdin V.I. Features of anesthesia endoprosthesis large joints of the lower extremities. Vestnik travmatologii i ortopedii, 2005, no. 1, pp. 85-89 (in Russ.).
5. Kuz’min I.I. Pathogenic features of infection in traumatology and orthopedics. Vestnik travmatologii i ortopedii im. N.N. Priorova, 2000, no. 4, pp. 67-71 (in Russ.).
6. Klimov V.V. Klinicheskaya immunologiya i allergologiya [Clinical Immunology and Allergology]. Tomsk: Pechatnaya manufaktura, 2008. 212 p.
7. Khaitov R.M., Ignat’eva G.A., Sidorovich I.G. Immunologiya. Norma i patologiya [Immunology. Health and disease]. Moscow: Meditsina, 2010. 752 p.
8. Sergeev A.Yu., Sergeev Yu.V. Kandidoz. Priroda infektsii, mekhanizmy agressii i zashchity, laboratornaya diagnostika, klinika i lechenie [Candidiasis. The nature of the infection, the mechanisms of aggression and defense, laboratory diagnosis, clinical features and treatment]. Moscow: Triada-X, 2001. 472 p.
9. Khaitov R.M. Immunologiya i allergologiya: Uchebnik [Immunology and Allergology: Textbook]. Moscow: GEOTAR-Media, 2006. 622 p.
10. Tatochenko V.K., Ozertskovskiy N.A., Fedorov A.M. et al. Immunoprofilaktika 2009 [Immunization 2009]. Moscow: Yaroslavskiy poligrafkombinat, 2009. 176 p.
11. Medunitsyn N.V., Pokrovskiy V.P. Osnovy immunoprofilaktiki i immunoterapii infektsionnykh bolezney [Fundamentals of immunization and immunotherapy of infectious diseases]. Moscow: GEOTAR-Media, 2005. 525 p.