脛骨内側顆に関節破壊を伴う化膿性膝関節炎に対し，部分セメントスペーサーで感染を鎮静化させた後，人工膝関節に置換した1例

Two-Stage Total Arthroplasty with a Cement Spacer after Controlling Infection in a Septic Knee with Joint Destruction. Case Report

　関節注射後に発生した関節破壊を伴う化膿性膝関節炎に対して，抗生剤入り部分的セメントスペーサーを充塡し，二期的に人工膝関節置換術を行った症例を経験したので報告する．症例は69歳の女性で，他院でヒアルロン酸の関節内注入を受けた後，化膿性膝関節炎を発症した．単純X線写真で脛骨内側顆の透遼像を認め，肉眼的にも同部の破壊がみられた．洗浄・病巣掻爬を行い，欠損部には抗生剤入りのセメントを注入した．感染の鎮静化が得られた後，二期的に人工膝関節置換術を行い，感染の鎮静化後1年6カ月の現在，経過良好である．

　We report a case in which two-stage total knee arthroplasty was performed on a septic knee.　A 69-year-old woman who had received intra-articular injections of hyaluronic acid in her right osteoarthritis knee was diagnosed with arthritis of her right knee.　Radiographs revealed radiolucency of the medial condyle of the right tibia, and destruction of the medial condyle was seen intraoperatively.　Irrigation and debridement was performed, and antibiotic-containing cement was injected into the defect.　After the infection had been controlled, we performed two-stage total knee arthroplasty.　As of 18 months postoperatively there is no evidence of recurrence, and the patient is able to walk pain-free.