Panella Antonio, Baglioni Marco, Rifino Francesco, De Crescenzo Angelo, Notarnicola Angela, Moretti Biagio
Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
SAGE Open Med Case Rep. 2020 May 6;8:2050313X20921326. doi: 10.1177/2050313X20921326. eCollection 2020.
Infection rates of arthroscopic procedures have been consistently reported at approximately 1% and are even less common in shoulder arthroscopy (0.3%). We are unaware of any prior reports of infection associated with an arthroscopic-assisted latissimus dorsi transfer and report on a 60-year-old male who experienced this event. At the 2-month follow-up, he reported an infection of the shoulder joint, characterized by a fistula on the portal scar. Laboratory tests revealed a infection which was treated with arthroscopic irrigation and debridement of the shoulder joint followed by oral antibiotics for 6 weeks. At 1-year follow-up no findings of infection were presented. To our knowledge, this is the first case of infection of the shoulder after an arthroscopic-assisted latissimus dorsi tendon transfer. Because the empirical pharmacological therapy initially adopted did not produce a clinically important improvement, a more organism-specific antibiotic was used. In conclusion, the key points of positive results were surgical approach with careful washout, debridement of surgical accesses, and targeted antibiotic therapy.
关节镜手术的感染率一直报告约为1%,在肩关节镜检查中甚至更少见(0.3%)。我们未发现任何先前关于关节镜辅助背阔肌转移相关感染的报告,现报告一名60岁男性发生了此事件。在2个月的随访中,他报告肩关节感染,其特征为切口瘢痕处有瘘管。实验室检查发现感染,对肩关节进行关节镜冲洗和清创,随后口服抗生素6周进行治疗。在1年的随访中未发现感染迹象。据我们所知,这是首例关节镜辅助背阔肌肌腱转移后肩关节感染的病例。由于最初采用的经验性药物治疗未产生临床上重要的改善,因此使用了更具针对性的抗生素。总之,取得积极结果的关键点是采用仔细冲洗的手术方法、清理手术切口以及进行针对性的抗生素治疗。