人工膝關節手術後膝關節疼痛──少見感染病例報告

Knee Pain After Primary Total knee Arthroplasty A Rare Infection Case Report

在老年人患有嚴重退化性關節炎的標準治療是全人工膝關節置換術，預估到了2030年，每年接受全人工膝關節的病人數目會增加為現在的7倍，這種手術會改善病人的膝關節疼痛及膝功能。我們報告一個女性病人，她在接受膝關節置換術之後的五個月仍有嚴重的膝疼痛，這個75歲女性病人被診斷為近平滑念珠菌關節感染，我們利用清創，移除人工關節，骨水泥墊片植入抗真菌藥物治療這個病人，我們成功地幫病人重新植入人工膝關節，且病人沒有再度感染及膝關節疼痛，整個療程一共40週，在18個月的定期追蹤，病人一切良好，沒有膝痛及感染復發。

The gold standard of treatment of severe knee osteoarthritis in old patients is total O knee arthroplasty. It has been estimated that by the year 2030 the annual number of total knee arthroplasties that is performed will increase by 700 %. Total knee arthroplasty would improve knee pain of patient and knee function. We reported a female patient who complained of severe knee pain after total knee arthroplasty for 5 months. This 75 years old female patient presented severe knee pain and swelling and was diagnosed as Candida parapsilosis fungal infection after TKA. Debridement, removal of implant and cement spacer insertion, antifungal therapy with Amphotericin B were given followed by delayed revision TKA. Reimplantation of total knee arthroplasty was performed successfully without recurrent of infection and recurrent knee pain. Total duration of treatment was 40 weeks. At 18 months follow up, this patient had no knee pain and no evidence of recurrent of infection.