Jacquot Adrien, Samargandi Ramy, Peduzzi Lisa, Mole Daniel, Berhouet Julien
Centre for Chirurgie des Articulations et du Sport (ARTICS), 24 rue du XXIème Régiment d'Aviation, 54000 Nancy, France.
Service de Chirurgie Orthopédique et Traumatologique, CHRU Trousseau, Faculté de Médecine de Tours, Université de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France.
Microorganisms. 2023 Nov 14;11(11):2770. doi: 10.3390/microorganisms11112770.
Periprosthetic joint infection (PJI) after shoulder arthroplasty remains a significant complication. This study aimed to explore the epidemiology and risk factors of shoulder PJI in patients aged 60 and younger, analyze treatment options, and evaluate outcomes after 1-year follow-up. In this retrospective multicentric observational study, data from 1404 shoulders in patients under 60 who underwent primary shoulder arthroplasty were analyzed. Patients with PJI and at least 1-year follow-up after infection treatment were included. The study identified 55 shoulders with PJI, resulting in a 2.35% infection rate after primary shoulder arthroplasty in the young population. Male gender and reverse shoulder arthroplasty were risk factors for infection, while previous surgeries did not significantly contribute. The most common causative agents were and . Open washout had a 52.9% success rate for acute infections, while one-stage and two-stage revisions achieved infection control rates of 91.3% and 85.7%, respectively. Resection arthroplasty had an 81.8% success rate but poorer functional outcomes. PJI following shoulder arthroplasty in young patients is a significant concern. Preoperative planning should be carefully considered to minimize infection risk. Treatment options such as open washout and one-stage and two-stage revisions offer effective infection control and improved functional outcomes. Resection arthroplasty should be reserved for complex cases where reimplantation is not a viable option.
肩关节置换术后的人工关节周围感染(PJI)仍然是一个严重的并发症。本研究旨在探讨60岁及以下患者肩关节PJI的流行病学和危险因素,分析治疗方案,并评估1年随访后的结果。在这项回顾性多中心观察性研究中,分析了1404例60岁以下接受初次肩关节置换术患者的肩部数据。纳入了发生PJI且感染治疗后至少随访1年的患者。该研究确定了55例发生PJI的肩部,在年轻人群中初次肩关节置换术后的感染率为2.35%。男性性别和反向肩关节置换术是感染的危险因素,而既往手术并非主要危险因素。最常见的病原体是……和……。开放清创术治疗急性感染的成功率为52.9%,而一期和二期翻修术的感染控制率分别为91.3%和85.7%。关节切除成形术的成功率为81.8%,但功能结果较差。年轻患者肩关节置换术后的PJI是一个重大问题。术前规划应仔细考虑以尽量降低感染风险。开放清创术以及一期和二期翻修术等治疗方案可有效控制感染并改善功能结果。关节切除成形术应保留用于无法进行再植入的复杂病例。