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中华损伤与修复杂志(电子版) ›› 2025, Vol. 20 ›› Issue (06) : 476 -489. doi: 10.3877/cma.j.issn.1673-9450.2025.06.004

指南与共识

单髁置换术后假体周围感染的抗生素使用专家共识(2025版)
国家骨科医学中心保膝联盟, 中国老年保健协会骨关节保护与健康分会, 单髁置换术后感染抗生素使用专家共识工作组   
  • 收稿日期:2025-06-12 出版日期:2025-12-01
  • 基金资助:
    国家自然科学基金面上项目(82272512,82472463); 安徽省卫生健康科研项目-重点项目(AHWJ2024Aa10144)

Expert consensus on the use of antibiotics for periprosthetic joint infection after unicompartmental knee arthroplasty

National Orthopedic Medical Center Knee Preservation Alliance, Chinese Aging Well Association Bone and Joint Protection and Health Branch, Expert Consensus Working Group on Antibiotic Therapy for Posteroperative Infection after Unicompartmental Knee Arthroplasty   

  • Received:2025-06-12 Published:2025-12-01
引用本文:

国家骨科医学中心保膝联盟, 中国老年保健协会骨关节保护与健康分会, 单髁置换术后感染抗生素使用专家共识工作组. 单髁置换术后假体周围感染的抗生素使用专家共识(2025版)[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(06): 476-489.

National Orthopedic Medical Center Knee Preservation Alliance, Chinese Aging Well Association Bone and Joint Protection and Health Branch, Expert Consensus Working Group on Antibiotic Therapy for Posteroperative Infection after Unicompartmental Knee Arthroplasty. Expert consensus on the use of antibiotics for periprosthetic joint infection after unicompartmental knee arthroplasty[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(06): 476-489.

单髁关节置换术后假体周围感染(UKA-PJI)的抗生素管理面临多重挑战,其缺乏统一标准、治疗方案受手术方式及宿主因素影响显著,且在培养阴性PJI(CN-PJI)、静脉-口服转换时机、局部用药策略及利福平应用等方面存在争议。为解决上述问题,权威学术组织基于循证医学原则共同制订本共识,旨在规范和指导个体化用药实践。共识工作组整合现有循证依据与临床经验,经多轮专家论证,采用推荐意见分级的评估、制定与评价(GRADE)体系及国际卫生指南报告标准(RIGHT),系统构建UKA-PJI抗生素使用方案。本共识旨在为临床医生提供UKA-PJI抗生素决策的循证参考,以期提升感染控制率、降低耐药风险,最终保障患者安全并促进抗菌药物合理应用。

Antibiotic management for periprosthetic joint infection following unicompartmental knee arthroplasty (UKA-PJI) faces multiple challenges, which lack of standardized protocols, significant influence of surgical approach and host factors on treatment strategies, and ongoing controversies regarding management of culture-negative PJI (CN-PJI), timing of intravenous-to-oral antibiotic conversion, local antibiotic delivery strategies, and Rifampicin use. To address these issues, leading academic organizations have collaboratively developed this consensus document based on evidence-based medicine principles, aiming to standardize and guide individualized therapeutic practices. The consensus working group synthesized available evidence-based evidence alongside clinical experience. Through multiple rounds of expert deliberation and employing the grading of recommendations assessment, development, and evaluation (GRADE) system and the reporting items for practice guidelines in healthcare (RIGHT) statement, this consensus systematically formulates an antibiotic management strategy for UKA-PJI. This document seeks to provide clinicians with an evidence-based reference for antibiotic decision-making in UKA-PJI, with the ultimate goals of enhancing infection control rates, reducing antimicrobial resistance risks, ensuring patient safety, and promoting rational antimicrobial use.

表1 推荐强度分级
表2 GRADE证据质量分级及定义
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