Short-term Therapeutic Effect of Antibiotic Bone Cement Implantation Technology for Gouty Stones and Bone Defects in the First Metatarsophalangeal Joint
Objective To compare the short-term efficacy of tophi debridement combined with antibiotic bone cement implantation and conventional surgical debridement in patients with tophi.Methods The clinical data of 40 patients with tophi in the first metatarsophalangeal joint with bone defect admitted to the Department of Hand,Foot and Ankle Surgery,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from May 2020 to May 2023 were retrospectively analyzed.According to different surgical methods,the patients were divided into observation group and control group,with 20 cases in each group,all males,aged 22-82 years old.The observation group was treated with tophus lesion debridement combined with antibiotic bone cement implantation,and the control group was treated with conventional surgery.The white blood cell(WBC)count,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),hospitalization time,dressing change times,and complete wound healing time were compared between the two groups.American Orthopaedic Foot and Ankle Society(AOFAS)score and visual analogue scale(VAS)score,serum uric acid(sUA)were recorded at admission and at 3rd month during the follow-up period.Results The patients were followed up for 3 months after operation.The wounds of all the patients in the observation group were completely healed,while 7 of the 20 patients in the control group had delayed wound healing.The hospitalization time,dressing change times,wound healing time,WBC count,CRP,ESR,and VAS score after operation in the observation group were significantly lower than those in the control group(P＜0.05).The AOFAS score in the control group was significantly lower than that in the observation group at 3rd month after operation(P＜0.05).There was no significant difference in sUA level between the two groups at 3rd month after operation(P＞0.05).Conclusion For patients with tophi and bone defect in the first metatarsophalangeal joint,the application of surgical removal of tophi lesions combined with antibiotic bone cement implantation has the advantages of shortening the length of hospital stay,reducing the infection rate,relieving the pain of patients,and fastening postoperative functional recovery.It can be used as a surgical treatment for severe tophi with bone defect,and is worthy of promotion and application.
Antibiotic cementFirst metatarsal toe jointGouty stoneBone defect
万方数据
维普
