Infecção periprotética do joelho – Parte 2: Tratamento

Resumo

Diversas modalidades de tratamento são propostas para as infecções periprotéticas, com índices de sucesso variáveis. No entanto, a eficácia está relacionada à seleção adequada dos casos para cada tipo de tratamento.

O desbridamento com retenção do implante é indicado em infecções agudas com implante fixo, e seu sucesso depende do tipo de infecção, das comorbidades do hospedeiro e da virulência do agente etiológico.

A revisão em um ou dois estágios se impõem nos casos em que haja formação de biofilme, ou nos quais se tenha afrouxamento do implante. A escolha entre realizar a revisão em um ou dois estágios depende de fatores como identificação do agente etiológico, virulência do patógeno, fatores locais e sistêmicos do hospedeiro.

Os procedimentos de salvamento como artrodese, amputação, artroplastia de ressecção ou, ainda, supressão antibiótica são reservados para os casos em que não se conseguiu erradicação da infecção.

Palavras-chave

artroplastia do joelho - infecção de sítio cirúrgico - tratamento - revisão cirúrgica - antibiótico

Publication History

Received: 06 November 2020

Accepted: 17 December 2020

Article published online:
27 May 2022

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