Skip to main content
Log in

Low-grade-Infektionen

Differenzialdiagnose der postoperativen Schultersteife?

Low grade infections

Differential diagnosis for postoperative shoulder stiffness?

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Verfügbare Daten über die Inzidenz von Komplikationen nach schulterarthroskopischen Eingriffen sind unvollständig, zumal Entitäten wie Low-grade-Infektionen bisher unzureichend definiert und untersucht sind. Diese können sich klinisch z. B. als protrahierte Schmerzsymptomatik oder Schultersteife ohne eindeutige paraklinische Infektparameter präsentieren. Neben einer Übersicht der verfügbaren Literatur beschreibt der vorliegende Artikel einen diagnostischen und therapeutischen Algorithmus zur Therapie von Low-grade-Infektionen der Schulter nach schulterarthroskopischen Eingriffen.

Abstract

Available reports on the incidence of complications following arthroscopic shoulder surgery are possibly incomplete as entities, such as low grade infections are still poorly defined and explored. From the clinical perspective they can present as prolonged pain or shoulder stiffness without the presence of obvious inflammation parameters. This article therefore provides an overview of the available literature as well as an algorithm for diagnosis and treatment of low grade infections following shoulder arthroscopy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2

Literatur

  1. Achermann Y, Goldstein EJ, Coenye T et al (2014) Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev 27:419–440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Brislin KJ, Field LD, Savoie FH 3rd (2007) Complications after arthroscopic rotator cuff repair. Arthroscopy 23:124–128

    Article  PubMed  Google Scholar 

  3. Chuang MJ, Jancosko JJ, Mendoza V et al (2015) The incidence of Propionibacterium acnes in shoulder arthroscopy. Arthroscopy 31:1702–1707

    Article  PubMed  Google Scholar 

  4. Furustrand Tafin U, Corvec S, Betrisey B et al (2012) Role of rifampin against Propionibacterium acnes biofilm in vitro and in an experimental foreign-body infection model. Antimicrob Agents Chemother 56:1885–1891

    Article  PubMed  PubMed Central  Google Scholar 

  5. Horneff JG 3rd, Hsu JE, Voleti PB et al (2015) Propionibacterium acnes infection in shoulder arthroscopy patients with postoperative pain. J Shoulder Elbow Surg 24:838–843

    Article  PubMed  Google Scholar 

  6. Hudek R, Sommer F, Kerwat M et al (2014) Propionibacterium acnes in shoulder surgery: true infection, contamination, or commensal of the deep tissue? J Shoulder Elbow Surg 23:1763–1771

    Article  PubMed  Google Scholar 

  7. Kanafani ZA, Sexton DJ, Pien BC et al (2009) Postoperative joint infections due to propionibacterium species: a case-control study. Clin Infect Dis 49:1083–1085

    Article  PubMed  Google Scholar 

  8. Levy O, Iyer S, Atoun E et al (2013) Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis? J Shoulder Elbow Surg 22:505–511

    Article  PubMed  Google Scholar 

  9. Masini BD, Stinner DJ, Waterman SM et al (2011) Bacterial adherence to high – tensile strength sutures. Arthroscopy 27:834–838

    Article  PubMed  Google Scholar 

  10. Millett PJ, Yen YM, Price CS et al (2011) Propionibacterium acnes infection as an occult cause of postoperative shoulder pain: a case series. Clin Orthop Relat Res 469:2824–2830

    Article  PubMed  PubMed Central  Google Scholar 

  11. Patel A, Calfee RP, Plante M et al (2009) Propionibacterium acnes colonization of the human shoulder. J Shoulder Elbow Surg 18:897–902

    Article  PubMed  Google Scholar 

  12. Portillo ME, Corvec S, Borens O et al (2013) Propionibacterium acnes: an underestimated pathogen in implant-associated infections. Biomed Res Int 2013:804391

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rienmuller A, Borens O (2016) Propionibacterium prosthetic joint infection: experience from a retrospective database analysis. Eur J Orthop Surg Traumatol 26:429–434

    Article  PubMed  PubMed Central  Google Scholar 

  14. Schafer P, Fink B, Sandow D et al (2008) Prolonged bacterial culture to identify late periprosthetic joint infection: a promising strategy. Clin Infect Dis 47:1403–1409

    Article  PubMed  Google Scholar 

  15. Schneeberger AG, Gilbart MK, Sheikh R et al (2009) Non-purulent low-grade infection as cause of pain following shoulder surgery: preliminary results. Chir Organi Mov 93(Suppl 1):71–77

    Google Scholar 

  16. Sethi PM, Sabetta JR, Stuek SJ et al (2015) Presence of Propionibacterium acnes in primary shoulder arthroscopy: results of aspiration and tissue cultures. J Shoulder Elbow Surg 24:796–803

    Article  PubMed  Google Scholar 

  17. Weber SC, Abrams JS, Nottage WM (2002) Complications associated with arthroscopic shoulder surgery. Arthroscopy 18:88–95

    Article  PubMed  Google Scholar 

  18. Zappe B, Graf S, Ochsner PE et al (2008) Propionibacterium spp. in prosthetic joint infections: a diagnostic challenge. Arch Orthop Trauma Surg 128:1039–1046

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Pauly.

Ethics declarations

Interessenkonflikt

S. Pauly, M. Scheibel und A. Trampuz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pauly, S., Scheibel, M. & Trampuz, A. Low-grade-Infektionen. Arthroskopie 29, 159–163 (2016). https://doi.org/10.1007/s00142-016-0088-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00142-016-0088-8

Schlüsselwörter

Keywords

Navigation