Zusammenfassung
Die Anzahl der Knietotalendoprothesenträger nimmt jedes Jahr kontinuierlich zu. Ursache dafür sind die gestiegene Lebenserwartung der Bevölkerung, die höheren Ansprüche an die Lebensqualität der Patienten und die Ausweitung der Indikation, bedingt durch verbesserte Prothesendesigns, Qualität und Implantationsmöglichkeiten, sowie die verbesserte Implantationsqualität. Die positiven Effekte der Versorgung eines Patienten mit einer totalen Knieendoprothese sind hinlänglich bekannt und wurden in den vorangegangenen Kapiteln ausführlich beschrieben. Neben den direkten Nachteilen einer Operation wie Schmerz, Krankenhausaufenthalt, verlängerte Nachbehandlung etc. muss der Patient jedoch das Risiko einer bakteriellen Kniegelenkinfektion in Kauf nehmen. In den letzten Jahrzehnten ist das Risiko einer periprothetischen Infektion durch Verbesserung der perioperativen Infektprophylaxe deutlich gesunken. Das tatsächliche Risiko eines Patienten, nach totalem Kniegelenkersatz an einer bakteriellen Besiedelung zu erkranken, ist in der Literatur nicht einheitlich angegeben. Man muss von einer Infektionsrate nach primärer Knietotaloperation von bis zu 2 % in den ersten zwei Jahren ausgehen. In der Literatur wird die Infektionsrate elektiver Gelenkersatzoperation je nach Kollektiv und Erfassungszeitraum in Größenordnungen von 0,5–1,5 % angegeben. Bei Vorerkrankungen und Revisionserkrankungen steigen die Angaben auf bis zu 5 %, bei Reimplantationen nach periprothetischer Infektion bis in die Größenordnung von 15–20 % an.
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Lohmann, C.H., Krüger, A.P. (2011). Diagnostik und therapeutisches Vorgehen beim Knieprotheseninfekt. In: Trieb, K., Heller, KD., Wirtz, D.C. (eds) Revisionsendoprothetik des Kniegelenks. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16123-0_15
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