J Am Acad Orthop Surg. 2014 Jul;22(7):410-9. doi: 10.5435/JAAOS-22-07-410.
Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy. Deep infection following arthroscopic shoulder surgery is rare; however, the shoulder is particularly susceptible to Propionibacterium acnes infection, which is mildly virulent and has a benign presentation. The surgeon must maintain a high index of suspicion for this infection. Thromboemoblic complications associated with arthroscopic shoulder techniques are also rare, and studies have shown that pharmacologic prophylaxis has minimal efficacy in preventing these complications. Because high-quality studies on the subject are lacking, minimal evidence is available to suggest strategies for prevention.
在过去的 20 到 30 年中，关节镜下肩部技术越来越受欢迎。尽管这些技术比开放性手术具有许多优势，但手术并发症并不比开放性技术少或不严重。与关节镜下肩部手术相关的一些并发症包括复发性不稳定、软组织损伤和神经麻痹。通过仔细考虑手术适应证、仔细选择患者和定位以及对肩部解剖结构的透彻了解，可以最大限度地减少这些并发症。关节镜下肩部手术后深部感染很少见；然而，肩部特别容易感染痤疮丙酸杆菌，这种细菌毒性轻微，表现为良性。外科医生必须对这种感染保持高度怀疑。与关节镜下肩部技术相关的血栓栓塞并发症也很少见，研究表明，药物预防在预防这些并发症方面效果甚微。由于缺乏关于该主题的高质量研究，因此几乎没有证据表明可以采取哪些预防策略。
