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Septic arthritis and arthropathy of the rotator cuff: remember this association()

OBJECTIVE: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures. METHODOLOGY: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. A...

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Autores principales: Sobreira, Danilo, Souza, Neydson de, Almeida, José Inácio de, Pochini, Alberto de Castro, Andreoli, Carlos Vicente, Ejnisman, Benno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974163/
https://www.ncbi.nlm.nih.gov/pubmed/27517024
http://dx.doi.org/10.1016/j.rboe.2015.09.016
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author Sobreira, Danilo
Souza, Neydson de
Almeida, José Inácio de
Pochini, Alberto de Castro
Andreoli, Carlos Vicente
Ejnisman, Benno
author_facet Sobreira, Danilo
Souza, Neydson de
Almeida, José Inácio de
Pochini, Alberto de Castro
Andreoli, Carlos Vicente
Ejnisman, Benno
author_sort Sobreira, Danilo
collection PubMed
description OBJECTIVE: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures. METHODOLOGY: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. All the patients presented arthropathy of the rotator cuff (four males and three females). Six patients presented pyoarthritis in the dominant shoulder. The age range was from 53 to 93 years (mean: 74 years). The mean duration of the symptoms before the surgical lavage was six weeks. Six patients underwent treatment consisting of a combination of arthroscopic irrigation and debridement, and one patient was treated by means of open arthrotomy. All the patients received systemic antibiotic therapy in accordance with their bacterial sensitivity. RESULTS: All seven patients achieved satisfactory results, taking into consideration especially the improvement of pain and the patients’ satisfaction. The functional assessment was performed using the University of California Los Angeles (UCLA) scale. Only one patient needed to go through another arthroscopic procedure. Staphylococcus aureus was isolated from four cultures and Escherichia coli from one culture. There were two situations in which the patients used empirical antibiotic therapy and the cultures showed negative results. Among the associated procedures, tenotomy of the biceps was performed in four cases, resection of the lateral third of the clavicle due to osteomyelitis in one case and arthrotomy of the knee in one case. CONCLUSION: Surgical treatment was effective in the cases of arthritis associated with arthropathy of the rotator cuff. In patients with arthropathy of the rotator cuff and subclinically altered laboratory signs, the possibility of pyoarthritis should always be suspected.
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spelling pubmed-49741632016-08-11 Septic arthritis and arthropathy of the rotator cuff: remember this association() Sobreira, Danilo Souza, Neydson de Almeida, José Inácio de Pochini, Alberto de Castro Andreoli, Carlos Vicente Ejnisman, Benno Rev Bras Ortop Original Article OBJECTIVE: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures. METHODOLOGY: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. All the patients presented arthropathy of the rotator cuff (four males and three females). Six patients presented pyoarthritis in the dominant shoulder. The age range was from 53 to 93 years (mean: 74 years). The mean duration of the symptoms before the surgical lavage was six weeks. Six patients underwent treatment consisting of a combination of arthroscopic irrigation and debridement, and one patient was treated by means of open arthrotomy. All the patients received systemic antibiotic therapy in accordance with their bacterial sensitivity. RESULTS: All seven patients achieved satisfactory results, taking into consideration especially the improvement of pain and the patients’ satisfaction. The functional assessment was performed using the University of California Los Angeles (UCLA) scale. Only one patient needed to go through another arthroscopic procedure. Staphylococcus aureus was isolated from four cultures and Escherichia coli from one culture. There were two situations in which the patients used empirical antibiotic therapy and the cultures showed negative results. Among the associated procedures, tenotomy of the biceps was performed in four cases, resection of the lateral third of the clavicle due to osteomyelitis in one case and arthrotomy of the knee in one case. CONCLUSION: Surgical treatment was effective in the cases of arthritis associated with arthropathy of the rotator cuff. In patients with arthropathy of the rotator cuff and subclinically altered laboratory signs, the possibility of pyoarthritis should always be suspected. Elsevier 2016-06-29 /pmc/articles/PMC4974163/ /pubmed/27517024 http://dx.doi.org/10.1016/j.rboe.2015.09.016 Text en © 2016 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Ortopediae Traumatologia. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sobreira, Danilo
Souza, Neydson de
Almeida, José Inácio de
Pochini, Alberto de Castro
Andreoli, Carlos Vicente
Ejnisman, Benno
Septic arthritis and arthropathy of the rotator cuff: remember this association()
title Septic arthritis and arthropathy of the rotator cuff: remember this association()
title_full Septic arthritis and arthropathy of the rotator cuff: remember this association()
title_fullStr Septic arthritis and arthropathy of the rotator cuff: remember this association()
title_full_unstemmed Septic arthritis and arthropathy of the rotator cuff: remember this association()
title_short Septic arthritis and arthropathy of the rotator cuff: remember this association()
title_sort septic arthritis and arthropathy of the rotator cuff: remember this association()
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974163/
https://www.ncbi.nlm.nih.gov/pubmed/27517024
http://dx.doi.org/10.1016/j.rboe.2015.09.016
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