髋关节和膝关节置换术后发生的假体周围关节感染（PJI）对患者的治疗结果和医疗费用有重大影响。本研究评估了 PJI 肿瘤、淋巴结和转移 (PJI-TNM) 分类系统的有效性以及治疗 PJI 的局部抗生素递送方法的最新进展。该研究对 23 名接受脓毒症治疗的患者进行了回顾性分析2022 年 1 月 1 日至 2024 年 2 月 10 日期间，SUUB 骨科和创伤诊所提供髋关节或膝关节假体。出于伦理考虑，获得了批准。使用 PJI-TNM 系统对患者进行分类，并根据感染的严重程度定制治疗方案。外科手术涉及一阶段或两阶段修正，利用载有万古霉素和庆大霉素抗生素的硫酸钙珠局部施用抗生素。收集并检查了有关人口统计学、临床特征和微生物学的数据。该研究包括 14 名男性和 9 名女性患者，平均年龄 68 岁。大多数情况下可见慢性感染的存在，表明成熟生物膜的形成。常见的共存疾病包括糖尿病、肥胖和心力衰竭。感染控制措施的持续时间平均为六个月，65% 的患者报告活动能力增强。具有阳性抗生素反应的急性感染经历了一阶段的修改。对于大多数患者来说，涉及两阶段修改的治疗方法（包括使用载有抗生素的垫片，然后安装假体）被证明是有益的。PJI-TNM 分类系统通过提供以下功能改善了 PJI 的管理：定制治疗的系统方法。硫酸钙珠是抗生素的可生物降解载体，具有显着的优势，特别是对于患有严重合并症的个体。诊断技术和抗生素局部给药的持续进步对于增强 PJI 治疗和改善患者预后至关重要。版权所有 © 2024，Popa 等人。

Periprosthetic joint infections (PJIs) that occur after hip and knee arthroplasty have a major influence on patient outcomes and healthcare expenses. This study assesses the effectiveness of the PJI tumor, node, and metastasis (PJI-TNM) categorization system and the latest developments in local antibiotic delivery methods for the treatment of PJIs.The study involved a retrospective analysis of 23 patients who received treatment for septic hip or knee prostheses at the SUUB Orthopedics and Traumatology Clinic between January 1, 2022, and February 10, 2024. Approval was gained following ethical considerations. Patients were categorized using the PJI-TNM system, and their therapy was customized based on the severity of the infection. The surgical procedures involved either one-stage or two-stage revisions, utilizing vancomycin and gentamicin antibiotic-loaded calcium sulfate beads to administer antibiotics locally. Data pertaining to demographics, clinical characteristics, and microbiology were gathered and examined.The study comprised 14 male and 9 female patients, with an average age of 68 years. The presence of chronic infections was mostly seen, indicating the development of mature biofilm. Prevalent coexisting medical conditions included diabetes, obesity, and heart failure. The duration of infection control measures was, on average, six months, and 65% of patients reported experiencing enhanced mobility. Acute infections with positive antibiotic responses underwent one-stage modifications. For the majority of patients, a treatment approach involving two-stage modifications, which includes the use of antibiotic-loaded spacers followed by the installation of a prosthesis, proved to be beneficial.The PJI-TNM classification system improves the management of PJI by offering a systematic method for customized therapy. Calcium sulfate beads, which are biodegradable carriers for antibiotics, provide notable advantages, especially for individuals with severe comorbidities. Continuous progress in diagnostic techniques and localized administration of antibiotics is essential for enhancing the therapy of PJI and improving patient outcomes.Copyright © 2024, Popa et al.