聚维酮碘在人工关节置换术中治疗骨关节炎的临床研究进展

Clinical Research Progress of Povidone-Iodine in the Therapy for Osteoarthritis during Artificial Joint Replacement

摘要: 人工关节置换术后假体周围感染(prosthetic joint infection, PJI)是手术失败的主要并发症。术中抗生素冲洗预防感染效果有限，且可能引发耐药菌问题。聚维酮碘(Povidone-Iodine, PVP-I)具有广谱抗菌特性，能有效对抗生物膜，且无耐药性，已成为关节置换术中的重要环节。但其在临床应用中的浓度、作用时间和冲洗频次等参数尚无共识。本文梳理了PVP-I在骨关节炎人工关节置换术中的现状，并探讨了不同使用方案的效果和风险。当前，国际指南缺乏对骨科手术消毒剂使用规范，导致临床决策依赖个体经验。在精准医疗时代，制定规范操作流程显得尤为迫切。本文通过解析PVP-I的抗菌机制和临床应用争议，旨在为科学化、标准化的关节置换感染防控体系提供理论支持。

Abstract: Prosthetic joint infection (PJI) after artificial joint replacement is the main complication of operation failure. Intraoperative antibiotic irrigation has limited effect on preventing infection and may cause the problem of drug-resistant bacteria. Povidone-Iodine (PVP-I) has broad-spectrum antibacterial properties, can effectively fight against biofilm, and has no drug resistance, which has become an important link in joint replacement. However, there is no consensus on its concentration, action time and washing frequency in clinical application. This paper reviews the current situation of PVP-I in artificial joint replacement for osteoarthritis, and discusses the effects and risks of different use schemes. At present, there is a lack of international guidelines for the use of disinfectants in orthopedic surgery, which leads to the dependence of clinical decision-making on individual experience. In the era of precision medicine, it is particularly urgent to formulate standardized operating procedures. This paper aims to provide theoretical support for scientific and standardized prevention and control system of joint replacement infection by analyzing the antibacterial mechanism and clinical application controversy of PVP-I.