Infections following arthroscopic rotator cuff repair: incidence, risk factors, and prophylaxis

Pauzenberger, Leo; Grieb, Annemarie; Hexel, M; Laky, Brenda; Anderl, Werner; Heuberer, Philipp R.

doi:10.1007/s00167-016-4202-2

Cited by 67 publications

(74 citation statements)

References 29 publications

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“…Deep infections of the shoulder after arthroscopic RCR are uncommon. The results of the present study indicate an overall deep infection rate of 0.44% that appears to be lower than the rate of 0.85% reported by Pauzenberger et al 5 . This difference in rate of infection can possibly be attributed to the difference be- tween the number of patients included in the present study and the study from Pauzenberger et al 5 1,6,7,12,13 .…”

Section: Discussioncontrasting

confidence: 81%

“…Microbiological evaluation revealed positive culture results in all except for one patient, who was started on oral antibiotics by his family physician before he was seen by the operating surgeon. Seven patients had growth of single microorganisms including Staphylococcus aureus (5), Propionibacterium acnes (1), and Phaeoacremonium parasiticum (1). Culture results from each of the remaining two patients showed growth of two microorganisms: Propionibacterium acnes with Staphylococcus saccharolyticus, and Staphylococcus epidermidis with Staphylococcus saccharolyticus.…”

Section: Resultsmentioning

confidence: 99%

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The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Ateşok

MacDonald

Leiter

et al. 2019

Muscle Ligaments and Tendons J

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Introduction:The purpose of this study was to evaluate the effects of deep shoulder infections after RCR on patient outcomes. Methods: A retrospective chart review was conducted involving all patients with deep shoulder infections after arthroscopic RCR (study group). Another group of patients who were matched with the study group by age, gender and rotator cuff tear size, and did not develop deep shoulder infections after arthroscopic RCR were randomly identified (control group). The two groups were compared in terms of time to start physiotherapy, shoulder function, and delay in return to work. Results: There were 10 patients in each group. The mean time to start physiotherapy after surgery was 145.3 (SD=158.8) days for the study group and 40.0 (SD=13.7) days for the control group (p=.051). The average forward elevation of the operated shoulder was 133 (SD=33.4) degrees for the study group, and 172 (SD=12.0) degrees for the control group (p=0.003). The average time to return to work at preoperative level was 5.6 months for the study group and 3 months for the control group. Conclusion: Deep shoulder infections after RCR significantly impedes time to start physiotherapy, shoulder function, and patients' ability to return to work. Level of evidence: III b [retrospective comparative (case-control) study]. KEY WORDS: rotator cuff tear, arthroscopic cuff repair, post-operative complications, deep shoulder infections, patient outcomes. K. Asetok et al.

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Section: Discussioncontrasting

confidence: 81%

Section: Resultsmentioning

confidence: 99%

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Ateşok

MacDonald

Leiter

et al. 2019

Muscle Ligaments and Tendons J

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show abstract

“…They reported, similar to other studies, that constitutional symptoms such as fever or chills were less commonly seen 6 8 9 13. Pauzenberger et al 14 noted the only symptom consistently present in all patients with an infection was diffuse shoulder pain; however, this complaint is commonly found in the early weeks following any shoulder surgery. They concluded that in patients with shoulder pain after an uneventful initial rehabilitation phase, infectious complications should be considered, even in the absence of clinical signs of infection.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of RCRs are performed using braided, non-absorbable suture, which creates a favourable environment for bacteria given the increased surface area compared with monofilament suture. Pauzenberger et al 14 performed a retrospective study of 3294 arthroscopic RCRs, including 28 infections during a 10-year period. Surgical treatment in their group included open I & D for 26 patients, with only two patients undergoing arthroscopic I & D, and removal of anchors and suture material in all cases.…”

Section: Discussionmentioning

confidence: 99%

Suture and anchors may be retained during treatment of deep infection after rotator cuff repair: a systematic review

et al. 2019

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“…The treatment of rotator cuff tears has become one of the most common orthopaedic sports procedures [1,2]. While this operation has a low morbidity, it is not without risk for complications such as chondrolysis, athrofibrosis, nerve damage, and infection [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The Use of Regional Flaps for the Repair of Synovio-Cutaneous Fistulas of the Shoulder after Attempted Rotator Cuff Repair: A Report of Two Cases

Rl¹,

Kj²,

Nl³

et al. 2016

Bone Rep Recommendations

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Context: The treatment of rotator cuff tears has become one of the most common orthopaedic sports procedures. The development of a synovio-cutaneous fistula is a rare, but serious, complication that has been described after rotator cuff repair. The purpose of this report is to present the local rotational flap as a treatment option for synovio-cutaneous fistulas of the shoulder and to emphasize the importance of recognizing when primary closure may not be sufficient for adequate repair.Case Reports: A 67-year-old male who previously underwent a right rotator cuff and a biceps tendon repair presented with a persistently draining shoulder fistula. The decision was made to proceed with extensive debridement and closure using vascularized tissue. A 63-year-old male presented for a postoperative wound complication following attempted open debridement of a left torn rotator cuff. The wound was initially managed conservatively, but a persistently draining fistula necessitated the use of vascularized tissue for closure of the wound. The recovery of both patients was uneventful with no recurrent fistula formation. Both patients had improved shoulder range of motion following surgery and resolution of their pain. Conclusions:The excessive tension placed on the rotator cuff tendons and deltoid during repair and the resultant inflammation may contribute to tissue necrosis and facial dehiscence over the glen humeral joint, allowing for fistula formation. Surgeons should be aware that when adequate soft tissue coverage cannot be accomplished over the glen humeral joint via primary closure, there are local flaps available to provide complete coverage over the joint.

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Infections following arthroscopic rotator cuff repair: incidence, risk factors, and prophylaxis

Abstract: Retrospective comparative study, Level III.

Cited by 67 publications

References 29 publications

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study

Suture and anchors may be retained during treatment of deep infection after rotator cuff repair: a systematic review

The Use of Regional Flaps for the Repair of Synovio-Cutaneous Fistulas of the Shoulder after Attempted Rotator Cuff Repair: A Report of Two Cases

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