Garmann S, Dilmac N, Marquardt B, Pötzl W, Steinbeck J
Klinik und Poliklinik für Allgemeine Orthopädie, Universitätsklinikum Muenster.
Z Orthop Ihre Grenzgeb. 2003 Nov-Dec;141(6):643-9. doi: 10.1055/s-2003-812398.
In a consecutive case series the results of operative treatment of patients with shoulder joint infections following rotator cuff surgery, endoscopic subacromial decompression or subacromial injection were studied.
Between 1990 and 2001 26 patients developed a postoperative infection. 24 patients were available for a mean follow-up of 4.3 (1-12) years. The mean age of the study group was 59.8 (28-84) years. Patients were divided into three groups. Group I consisted of 9 patients with infection after rotator cuff repair, group II consisted of 4 patients with infection after endoscopic subacromial decompression and there were 11 patients in group III with an infection that developed following subacromial injection. Patient evaluation was done according to the Constant and ASES Scores, the SF-36 and a visual analogue scale (VAS) for postoperative pain and satisfaction.
The mean postoperative Constant Score was 68.6 pts (SD 25.1) in group I, 84.6 pts (SD 10.4) in group II and 75.6 pts (SD 25.1) in group III. The mean ASES-Score was 65.6 pts (SD 30.0) in group I, 69.8 pts (23.6) in group II and 78.5 pts (SD 25.7) in group III. The SF-36 showed for the summarized physical scale 37.3 pts (SD 12.6) in the first, 39.8 pts (SD 5.8) in the second and 37.7 pts (SD 12.4) in the third group and for the summarized psychometric scale 40.4 pts (SD 2.7) in the first, 44.3 pts. (SD 10.8) in the second and 45.7 pts. (SD 10.1) in the third group. For the VAS for pain, group I had 4.3, group II 4.0 and group III 2.5 pts Patient satisfaction showed similar results with 6.4 pts in the first, 6.5 pts in the second and 6.8 pts in the third group.
Considering the functional results of operative revision, infection of the shoulder joint following rotator cuff surgery, endoscopic subacromial decompression or subacromial injection is a rare but severe complication.
在一个连续病例系列中,研究了肩袖手术、关节镜下肩峰下减压或肩峰下注射后肩关节感染患者的手术治疗结果。
1990年至2001年间,26例患者发生术后感染。24例患者可进行平均4.3(1 - 12)年的随访。研究组的平均年龄为59.8(28 - 84)岁。患者分为三组。第一组包括9例肩袖修复术后感染的患者,第二组包括4例关节镜下肩峰下减压术后感染的患者,第三组有11例肩峰下注射后发生感染的患者。根据Constant和ASES评分、SF - 36以及术后疼痛和满意度的视觉模拟量表(VAS)对患者进行评估。
第一组术后Constant评分平均为68.6分(标准差25.1),第二组为84.6分(标准差10.4),第三组为75.6分(标准差25.1)。第一组ASES评分平均为65.6分(标准差30.0),第二组为69.8分(23.6),第三组为78.5分(标准差25.7)。SF - 36显示,第一组综合身体量表评分为37.3分(标准差12.6),第二组为39.8分(标准差5.8),第三组为37.7分(标准差12.4);第一组综合心理量表评分为40.4分(标准差2.7),第二组为44.3分(标准差10.8),第三组为45.7分(标准差10.1)。疼痛VAS评分方面,第一组为4.3分,第二组为4.0分,第三组为2.5分。患者满意度结果相似,第一组为6.4分,第二组为6.5分,第三组为6.8分。
考虑到手术翻修的功能结果,肩袖手术、关节镜下肩峰下减压或肩峰下注射后肩关节感染是一种罕见但严重的并发症。