Frank A. Petrigliano, Department of Orthopedic Surgery, David Geffen School of Medicine at UCLA, CHS, Box 956902, Los Angeles, CA 90095.
Am J Sports Med. 2014 Feb;42(2):437-41. doi: 10.1177/0363546513510686. Epub 2013 Dec 2.
An acute infection after arthroscopic shoulder surgery is a rare but serious complication. Previous studies estimating the incidence of infections after arthroscopic surgery have been conducted, but the majority of these had either relatively small study groups or were not specific to shoulder arthroscopic surgery.
To investigate the incidence of acute infections after arthroscopic shoulder surgery and compare infection rates by age group, sex, geographic region, and specific procedures.
Case series; Level of evidence, 4.
A retrospective review of a large insurance company database was performed for all shoulder arthroscopic surgeries performed in the United States between 2004 and 2009 that required additional surgery for infections within 30 days. The data were stratified by sex, age group, and region. Data were also stratified for specific procedures (capsulorrhaphy, treatment for superior labrum anterior-posterior tears, claviculectomy, decompression, and rotator cuff repair) and used to assess the variation in the incidence of infections across different arthroscopic shoulder procedures. Linear regression was used to determine the significance of differences in the data from year to year. χ(2) analysis was used to assess the statistical significance of variations among all groups. Poisson regression analysis with exposure was used to determine significant differences in a pairwise comparison between 2 groups.
The total number of arthroscopic shoulder surgeries performed was 165,820, and the number of infections requiring additional surgery was 450, resulting in an overall infection rate of 0.27%. The incidence of infections varied significantly across age groups (P < .001); the infection rate was highest in the ≥60-year age group (0.36%) and lowest in the 10- to 39-year age group (0.18%). The incidence of infections also varied by region (P < .001); the incidence was highest in the South (0.37%) and lowest in the Midwest (0.11%). The incidence of infection treatments was also significantly different between different arthroscopic procedures (P < .01) and was highest for rotator cuff repair (0.29%) and lowest for capsulorrhaphy (0.16%). The incidence did not significantly vary by year or sex.
The overall infection rate for all arthroscopic shoulder procedures was 0.27%. The incidence was highest in elderly patients, in the South, and for rotator cuff repair. The incidence was lowest in young patients, in the Midwest, and for capsulorrhaphy. In general, shoulder arthroscopic surgery in this study population had a low rate of reoperation in the acute period.
关节镜肩关节手术后的急性感染是一种罕见但严重的并发症。先前有研究估计了关节镜手术后感染的发生率，但大多数研究的样本量较小或并非专门针对肩关节关节镜手术。
调查肩关节镜手术后急性感染的发生率，并按年龄组、性别、地理位置和特定手术程序比较感染率。
病例系列；证据水平，4 级。
对美国 2004 年至 2009 年间进行的所有因肩关节镜手术而需要在 30 天内再次手术治疗感染的肩关节镜手术进行了大型保险公司数据库的回顾性分析。按性别、年龄组和地区对数据进行分层。还按特定手术程序（囊紧缩术、治疗上盂唇前-后撕裂、锁骨切除术、减压术和肩袖修复术）对数据进行分层，并用于评估不同肩关节镜手术程序之间感染发生率的差异。线性回归用于确定数据逐年差异的显著性。χ²分析用于评估所有组之间的显著性差异。泊松回归分析（具有暴露因素）用于确定 2 组之间的差异。
共进行了 165820 例肩关节镜手术，需要再次手术治疗感染的有 450 例，总感染率为 0.27%。感染发生率在不同年龄组之间差异显著（P<.001）；≥60 岁年龄组感染率最高（0.36%），10 至 39 岁年龄组感染率最低（0.18%）。感染发生率也因地区而异（P<.001）；南部地区发生率最高（0.37%），中西部地区发生率最低（0.11%）。不同关节镜手术程序之间的感染治疗发生率也有显著差异（P<.01），肩袖修复术的感染率最高（0.29%），囊紧缩术的感染率最低（0.16%）。感染发生率与年份或性别无关。
所有肩关节镜手术的总体感染率为 0.27%。老年患者、南部地区和肩袖修复术的感染率最高。年轻患者、中西部地区和囊紧缩术的感染率最低。总体而言，该研究人群的肩关节关节镜手术在急性期再次手术的发生率较低。
