反式全肩关节置换术中感染的预防与治疗

Preventing and Treating Infection in Reverse Total Shoulder Arthroplasty.

作者信息

Markes Alexander R, Bigham Joseph, Ma C Benjamin, Iyengar Jaicharan J, Feeley Brian T

机构信息

Department of Orthopaedic Surgery, University of California-San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA.

Department of Orthopaedic Surgery, University of Washington, Seattle, WA, USA.

出版信息

Curr Rev Musculoskelet Med. 2023 Aug;16(8):371-380. doi: 10.1007/s12178-023-09843-1. Epub 2023 May 25.

Abstract

PURPOSE OF REVIEW

Periprosthetic infection after shoulder arthroplasty is relatively uncommon though associated with severe long-term morbidity when encountered. The purpose of the review is to summarize the recent literature regarding the definition, clinical evaluation, prevention, and management of prosthetic joint infection after reverse shoulder arthroplasty.

RECENT FINDINGS

The landmark report generated at the 2018 International Consensus Meeting on Musculoskeletal Infection has provided a framework for diagnosis, prevention, and management of periprosthetic infections after shoulder arthroplasty. Shoulder specific literature with validated interventions to reduce prosthetic joint infection is limited; however existing literature from retrospective studies and from total hip and knee arthroplasty allows us to make relative guidelines. One and two-stage revisions seem to demonstrate similar outcomes; however, no controlled comparative studies exist limiting the ability to make definitive recommendations between the two options. We report on recent literature regarding the current diagnostic, preventative, and treatment options for periprosthetic infection after shoulder arthroplasty. Much of the literature does not distinguish between anatomic and reverse shoulder arthroplasty, and further high-level shoulder specific studies are needed to answer questions generated from this review.

摘要

综述目的

肩关节置换术后假体周围感染相对少见,但一旦发生会导致严重的长期并发症。本综述旨在总结近期有关反肩关节置换术后假体关节感染的定义、临床评估、预防及处理的文献。

最新发现

2018年国际肌肉骨骼感染共识会议发布的标志性报告为肩关节置换术后假体周围感染的诊断、预防及处理提供了框架。有有效干预措施以减少假体关节感染的肩关节相关文献有限;然而,来自回顾性研究以及全髋关节和膝关节置换术的现有文献使我们能够制定相关指南。一期和二期翻修术似乎显示出相似的结果;然而,尚无对照比较研究,这限制了我们在这两种选择之间做出明确推荐的能力。我们报告了近期有关肩关节置换术后假体周围感染的当前诊断、预防及治疗选择的文献。许多文献并未区分解剖型和反肩关节置换术,需要进一步开展高水平的肩关节专项研究来回答本综述中提出的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec56/10382412/91a6398cdf7c/12178_2023_9843_Fig1_HTML.jpg

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