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用于假体周围反肩关节置换感染的两阶段翻修关节成形术与初次反肩关节置换术具有相当的功能结果。

Two-Stage Exchange Arthroplasty for Periprosthetic Reverse Shoulder Arthroplasty Infection Provides Comparable Functional Outcomes to Primary Reverse Shoulder Arthroplasty.

作者信息

Saccomanno Maristella Francesca, Lädermann Alexandre, Collin Philippe

机构信息

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.

Department of Bone and Joint Surgery, Spedali Civili, 25123 Brescia, Italy.

出版信息

J Clin Med. 2024 Feb 4;13(3):904. doi: 10.3390/jcm13030904.

DOI:10.3390/jcm13030904
PMID:38337598
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10856729/
Abstract

This study aimed to compare functional outcomes after two-stage revision reverse shoulder arthroplasty (RSA) for periprosthetic joint infection (PJI) with the results of primary RSA. Patients affected by PJI and treated by means of two-stage revision RSA were 1:1 matched with a group of patients who were treated electively with RSA without developing any complications. Out of 1477 RSAs performed between 2009 and 2021, 16 patients developed a PJI. Each matched cohort comprised 16 patients (3 females, 13 males). The mean age was 69.13 ± 5.43 years old in the PJI group and 70.28 ± 5.04 ( = 0.543) in the matched cohort. The mean follow-up was 41.23 ± 26.9 months in the PJI group and 28.5 ± 20.2 ( = 0.142) in the matched group. Only one patient showed recurrent PJI five years after revision RSA. Comparison between the PJI patients and matched patients did not show any significant differences at the latest follow-up, nor for subjective shoulder value (SSV) ( = 0.101) or Constant score ( = 0.134). Two-stage exchange RSA for PJI allows for appropriate control of the disease and good functional outcomes. Comparison with an age- and sex-matched cohort of uninfected patients showed no significant differences, thus confirming the idea that revision surgeries may lead to satisfactory functional outcomes, as expected after primary surgery.

摘要

本研究旨在比较两阶段翻修反肩关节置换术(RSA)治疗假体周围关节感染(PJI)后的功能结果与初次RSA的结果。受PJI影响并接受两阶段翻修RSA治疗的患者与一组选择性接受RSA治疗且未发生任何并发症的患者进行1:1匹配。在2009年至2021年期间进行的1477例RSA手术中,有16例患者发生了PJI。每个匹配队列包括16例患者(3名女性,13名男性)。PJI组的平均年龄为69.13±5.43岁,匹配队列的平均年龄为70.28±5.04岁(P =

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本文引用的文献

1
Quantifying success after first revision reverse total shoulder arthroplasty: the minimal clinically important difference, substantial clinical benefit, and patient acceptable symptomatic state.量化首次翻修反式全肩关节置换术后的成功:最小临床重要差异、实质性临床获益和患者可接受的症状状态。
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Periprosthetic Joint Infection.人工关节周围感染
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Changes in microbiological spectrum and antibiotic susceptibility in two-stage exchange for periprosthetic shoulder infections.二期清创旷置治疗人工肩假体周围感染的微生物谱和抗生素敏感性变化。
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5
One Versus 2-Stage Revision for Shoulder Arthroplasty Infections: A Systematic Review and Analysis of Treatment Selection Bias.一期与二期翻修治疗肩关节置换术后感染:系统评价与治疗选择偏倚分析。
JBJS Rev. 2021 Sep 9;9(9):01874474-202109000-00004. doi: e20.00219.
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Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic mini-open approach.生物力学评估在肩袖撕裂修复中的作用:关节镜下小切口入路。
World J Orthop. 2021 Dec 18;12(12):991-1000. doi: 10.5312/wjo.v12.i12.991.
7
Two-stage shoulder arthroplasty after deep infection of the shoulder caused by arthroplasty, osteosynthesis or other surgical procedures: microbial spectrum, complications and functional outcome after at least 1 year follow-up.两阶段肩关节置换术治疗因关节置换术、骨接合术或其他外科手术引起的深部肩部感染:至少 1 年随访后的微生物谱、并发症和功能结局。
Arch Orthop Trauma Surg. 2023 Feb;143(2):707-715. doi: 10.1007/s00402-021-04129-y. Epub 2021 Aug 25.
8
Clinical Outcome of Two-Stage Revision after Periprosthetic Shoulder Infection.人工肩关节周围感染后两阶段翻修的临床结果
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9
Infection control and outcome of staged reverse shoulder arthroplasty for the management of shoulder infections.分期反肩关节置换术治疗肩部感染的感染控制与疗效
JSES Int. 2020 Oct 8;4(4):959-963. doi: 10.1016/j.jseint.2020.08.012. eCollection 2020 Dec.
10
Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review.反式肩关节置换术后假体周围感染:综述
Curr Rev Musculoskelet Med. 2020 Dec;13(6):757-768. doi: 10.1007/s12178-020-09670-8.