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ISSN 1810-8997 (печатная версия)
DOI: http://dx.doi.org/10.14531/ss1810-8997
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Российский индекс научного цитирования (РИНЦ)
Архив научных журналов Central and Eastern European Online Library Архив научных журналов
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Российская Ассоциация Хирургов-вертебрологов

Петрова Н.В.
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Представлен обзор лабораторных исследований, позволяющих поставить диагноз имплант-ассоциированной инфекции у пациентов, перенесших ортопедические операции. Проанализированы диагностическая ценность различных тестов и особенности динамики показателей в зависимости от вида оперативного вмешательства.

DOI: http://dx.doi.org/10.14531/ss2012.1.74-83

  1. Божкова С.А. Современные принципы диагностики и антибактериальной терапии инфекции протезированных суставов // Травматол. и ортопед. России. 2011. № 3. С. 126–136.
  2. Лабораторная диагностика / Под ред. В.В. Долгова, О.П. Шевченко. М., 2005.
  3. Льюис С.М., Бэйн Б., Бэйтс И. Практическая и лабораторная гематология. М., 2009.
  4. Методики клинических лабораторных исследований: Т. 2 / Под ред. В.В. Меньшикова. М., 2009.
  5. Тихилов Р.М., Шаповалов В.М. Осложнения после эндопротезирования тазобедренного сустава: Парапротезная инфекция [Электронный ресурс] // http://bone-surgery.ru/view/oslozhneniya_posle_ endoprotezirovaniya_tazobedrennogo_sustava_ paraproteznay/
  6. Banit DM, Kaufer H, Hartgord JM. Intraoperative frozen section analysis in revision total joint arthroplasties. Clin Orthop Relat Res. 2002;(401):230–238.
  7. Bauer TW, Brooks PJ, Sakai H, et al. A diagnostic algorithm for detecting an infected hip arthroplasty. Orthopedics. 2003;26:929–930.
  8. Bauer TW, Parvizi J, Kobayashi N, et al. Diagnosis of periprosthetic infection. J Bone Joint Surg Am. 2006;88:869–882.
  9. Baumann H, Gauldie J. The acute phase response. Immunol Today. 1994;15:74–80.
  10. Bilgen O, Atici T, Durak K, et al. C-reactive protein values and erythrocyte sedimentation rates after total hip and total knee arthroplasty. J Int Med Res. 2001;29:7–12.
  11. Birmingham P, Helm JM, Manner PA, et al. Simulated joint infection assessment by rapid detection of live bacteria with real-time reverse transcription polymerase chain reaction. J Bone Joint Surg Am. 2008;90:602–608.
  12. Bottner F, Wegner A, Winkelmann W, et al. Interleukin- 6, procalcitonin and TNF-alpha: markers of peri-prosthetic infection following total joint replacement. J Bone Joint Surg Br. 2007;89:94–99.
  13. Carlsson AS. Erythrocyte sedimentation rate in infected and non-infected total-hip arthroplasties. Acta Orthop Scand. 1978;49:287–290.
  14. Clohisy JC, Kamath GV, Byrd GD, et al. Patient compliance with clinical follow-up after total joint arthroplasty. J Bone Joint Surg Am. 2008;90: 1848–1854.
  15. Collins I, Wilson-MacDonald J, Chami G, et al. The diagnosis and management of infection following instrumented spinal fusion. Eur Spine J. 2008;17: 445–450.
  16. Corless CE, Guiver M, Borrow R, et al. Contamination and sensitivity issues with a real-time universal 16S rRNA PCR. J Clin Microbiol. 2000;38:1747–1752.
  17. Costerton JW. Biofilm theory can guide the treatment of device-related orthopaedic infections. Clin Orthop Relat Res. 2005;(437):7–11.
  18. Della Valle GJ, Bogner E, Desai P, et al. Analysis of frozen sections of intraoperative specimens obtained at the time of reoperation after hip or knee resection arthroplasty for the treatment of infection. J Bone Joint Surg Am. 1999;81:684–689.
  19. Della Valle C, Parvizi J, Bauer TW, et al. Diagnosis of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg. 2010;18:760–770.
  20. Di Cesare PE, Chang E, Preston CF, et al. Serum Interleukin-6 as a marker of periprosthetic infection following total hip and knee arthroplasty. J Bone Joint Surg Am. 2005;87:1921–1927.
  21. Feldman DS, Lonner JH, Desai P, et al. The role of intraoperative frozen sections in revision total joint arthroplasty. J Bone Joint Surg Am. 1995;77: 1807–1813.
  22. Gelalis ID, Arnaoutoglou CM, Politis AN, et al. Bacterial wound contamination during simple and complex spinal procedures. A prospective clinical study. Spine J. 2011;11:1042–1048.
  23. Ghanem E, Parvizi J, Burnett RS, et al. Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am. 2008;90:1637–1643.
  24. Hahn F, Zbinden R, Min K. Late implant infection caused by Propionibacterium acnes in scoliosis surgery. Eur Spine J. 2005;14:783–788.
  25. Harle A. Infection management in total hip replacement. Arch Orthop Trauma Surg. 1989;108:63–71.
  26. Husain TM, Kim DH. C-reactive protein and erythrocyte sedimentation rate in orthopaedics. U Penn Orthop J. 2002;15:13–16.
  27. Kienapfel H, Kühn KD (eds.). The Infected Implant. Heidelberg: Springer-Verlag, 2009.
  28. Kobayashi N, Inaba H, Chloe H, et al. Simultaneous intraoperative detection of methicillin-resistant Staphylococcus and pan-bacterial infection during revision surgery: use of simple DNA release by ultrasonication and real-time polymerase chain reaction. J Bone Joint Surg Am. 2009;91:2896–2902.
  29. Koj A. Metabolic studies of acute-phase proteins. In: Mariani E (ed.). Pathophysiology of Plasma Protein Metabolism. N. Y., MacMillan, 1984:221–248.
  30. Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus Aureus infections in adults and children. Clin Infect Dis. 2011;52:e18–e55.
  31. Lonner JH, Desai P, Dicesare PE, et al. The reliability of analysis of intraoperative frozen sections for identifying active infection during revision hip or knee arthroplasty. J Bone Joint Surg Am. 1996;78: 1553–1558.
  32. O’Neill KR, Smith JG, Abtahi AM, et al. Reduced surgical site infections in patients undergoing posterior spinal stabilization of traumatic injuries using vancomycin powder. Spine J. 2011;11:641–646.
  33. Pichelmann MA, Lenke LG, Bridwell KH, et al. Revision rates following primary adult spinal deformity surgery: six hundred forty-three consecutive patients followed-up to twenty-two years postoperative. Spine. 2010;35:219–226.
  34. Pullter Gunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine. 2009;34:1422–1428.
  35. Sampedro MF, Huddleston PM, Piper KE, et al. A biofilm approach to detect bacteria on removed spinal implants. Spine. 2010;35:1218–1224.
  36. Schinsky MF, Della Valle CJ, Sporer SM, et al. Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am. 2008;90:1869–1875.
  37. Sell S, Schleh T. C-reactive protein as an early indicator of the formation of heterotopic ossification after total hip replacement. Arch Orthop Trauma Surg. 1999;119:205–207.
  38. Spangehl MJ, Masri BA, O’Connell JX, et al. Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999;81:672–683.
  39. The Diagnosis of Periprosthetic Joint Infections of the Hip and Knee. Guideline and Evidence Report. Adopted by the American Academy of Orthopaedic Surgeons Board of Directors. June 18, 2010. URL: http://www. aaos.org/reseach/guidelines/PJIguideline.pdf
  40. Tillett WS, Francis T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med. 1930;52:561–571.
  41. Trampuz A, Hanssen AD, Osmon DR, et al. Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med. 2004;117:556–562.
  42. Tunney MM, Patrick S, Gorman SP, et al. Improved detection of infection in hip replacement. J Bone Joint Surg Br. 1998;80:568–572.
  43. White J, Kelly M, Dunsmuir R. C-reactive protein level after total hip and total knee replacement. J Bone Joint Surg Br. 1998;80:909–911.
  44. Wirtz DC, Heller KD, Miltner O, et al. Interleukin- 6: a potential inflammatory marker after total joint replacement. Int Orthop. 2000;24:194–196.
  45. Wong YC, Lee QJ, Wai YL, et al. Intraoperative frozen section for detecting active infection in failed hip and knee arthroplasties. J Arthroplasty. 2005;20: 1015–1020.
Ключевые слова: имплант-ассоциированная инфекция, парапротезная инфекция, инфекции области хирургического вмешательства, маркеры острофазовой реакции, операции на позвоночнике, микродискэктомия

Петрова Н.В.
канд. мед. наук
630091, Новосибирск, ул. Фрунзе, 17,
Новосибирский НИИ травматологии и ортопедии