Zusammenfassung
Infektionen des Schultergelenks sind seltene, komplikationsreiche Ereignisse. Die erfolgreiche – in der Regel operative – Behandlung orientiert sich an den Ursachen, dem Infektionsstadium, der Ausdehnung des Infekts und dem Keimspektrum. Darüber hinaus müssen bei der Therapie der Allgemeinzustand des Patienten und seine Vorerkrankungen berücksichtigt werden. Patienten mit rheumatoider Arthritis und Immunsuppression zeigen besonders komplikationsreiche Verläufe und erfordern deshalb eine gesteigerte Aufmerksamkeit. Schulterinfektionen und periprothetische Schultergelenkinfekte können mittels arthroskopischer Spülung, durch offenes Débridement oder im Falle von Protheseninfekten durch einen ein- oder zweizeitigen Wechsel behandelt werden. Bei nicht beherrschbaren Infekten bietet sich als Rückzugsmöglichkeit die Resektionsarthroplastik oder als Alternative die Arthrodese an. Die Ergebnisse und Komplikationsmöglichkeiten werden auch anhand eigener Daten dargestellt.
Abstract
Infections of the shoulder joint are rare but nevertheless carry a high risk of complications. Successful therapy is mostly operative and should be planned according to the causes, stage, and expansion of the infection and the expected spectrum of bacteria. Moreover, the patient’s general condition and previous illnesses must be considered. Patients with rheumatoid arthritis and immunotherapy are especially at risk for complications and require special attention. Shoulder infections and periprosthetic infections can be treated with arthroscopy, with open debridement, or, in the case of periprosthetic infections, with one- or two-stage exchange procedures. In cases of noncontrollable infections, resection arthroplasty or arthrodesis can be performed as a last resort. Results and possible complications are described herein, including those based on our own results.
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Rolf, O., Stehle, J. & Gohlke, F. Behandlung von Schultergelenkinfektionen und periprothetischen Schulterinfekten. Orthopäde 36, 700–707 (2007). https://doi.org/10.1007/s00132-007-1116-1
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DOI: https://doi.org/10.1007/s00132-007-1116-1