METHOD FOR TREATMENT TACTICS SELECTION FOR PATIENTS WITH PERIPROSTHETIC INFECTION Russian patent published in 2017 - IPC A61B10/00 G01N33/48 

FIELD: medicine.

SUBSTANCE: through a trocar inserted into the joint cavity, biomaterials are sampled for research by alternate evacuation of the joint aspirate with a syringe through the central channel of the trocar. The biofilm is taken from the implanted endoprosthesis surface by directing a cylindrical brush attached to an elastic wire element through the central channel of the trocar, and moving along the endoprosthesis surface in the "back-forward" direction. During the bacteriological study, the quantitative values of optical densities of the cultured biofilm obtained from the endoprosthesis surface K_biop. and articular aspirate K_asp. are determined. During the cytological study, the neutrophilic leukocyte count in articular aspirate L. is determined. The coefficient K is calculated according to the proposed formula. At K≥2 and L≥3600/mcL the endoprosthesis is remove followed by a two-stage surgical treatment, including installation of an articulating antibacterial spacer and endoprosthesis replacement. At K≤1 and L≥3600/mcL the endoprosthesis components are replaced with sanation and drainage of the infection focus. At 1<K<2 and L<3600/mcl conservative treatment is performed, which consists in antibacterial therapy.

EFFECT: method allows to select the tactics of treatment of periprosthetic infection in the knee joint with high sensitivity and specificity, adequate to its course, severity and prevalence, by determining the predominant localization of the infectious process in the biotic environment or on the abiotic surface.

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