Artroskopik rotator manşet onarımı sonrası proksimal humerusun psödomonas osteomiyeliti

Yıl 2014, , 685 - 689, 16.01.2015

Nuri Aydin Evrim Sirin Ahmet Nadir Aydemir Gokhan Zengin

https://doi.org/10.3944/AOTT.2014.13.0015

Öz

Artroskopik rotator manşet onarımı yapılan 59 yaşında erkek hastaya cerrahi sonrası erken dönemde gelişen Psödomonas aeruginosa enfeksiyonu nedeniyle artroskopik debridman ve antibiyoterapi yapıldı. Takip kontrollerine devam etmeyen hasta 2 yıl sonra proksimal humerusta P. aeruginosa osteomiyeliti tablosuyla tekrar başvurdu. Hastaya açık debridman yapıldı ve ölü boşluk antibiyotik emdirilmiş çimento boncuklarıyla dolduruldu. Altı hafta sonra boncuklar çıkartıldı. Hastanın cerrahi sonrası 2. yıl takibinde enfeksiyon bulgusuna rastlanmadı. Olgumuz, literatürde artroskopik rotator manşet onarımı sonrası P. aeruginosa osteomiyeliti olarak bildirilen ilk olgudur.

Anahtar Kelimeler

Enfeksiyon; omuz artroskopisi; osteomiyelit.

Pseudomonas osteomyelitis of the proximal humerus after arthroscopic rotator cuff repair

Öz

A 59-year-old male patient was operated arthroscopically due to a rotator cuff tear. An early postoperative Pseudomonas aeruginosa infection was treated with early arthroscopic debridement and antibiotic therapy. The patient was lost to follow-up and presented to our clinic with Pseudomonas aeruginosa osteomyelitis after two years. Debridement was again performed and antibiotic-impregnated cement beads were filled into the cavity and taken out 6 weeks postoperatively. No findings of infection were observed at the patient’s 2nd year follow-up. To our knowledge, this is the first case of Pseudomonas aeruginosa osteomyelitis of the shoulder after arthroscopic rotator cuff repair.

Anahtar Kelimeler

Infection, osteomyelitis, shoulder arthroscopy

Kaynakça

• Mansat P, Cofield RH, Kersten TE, Rowland CM. Com- plications of rotator cuff repair. Orthop Clin North Am 1997;28:205-13. CrossRef
• Settecerri JJ, Pitner MA, Rock MG, Hanssen AD, Cofield RH. Infection following open repair of the rotator cuff. Orthop Trans 1997;20:949.
• Martin CT, Gao Y, Pugely AJ, Wolf BR. 30-day morbidity and mortality after elective shoulder arthroscopy: a review of 9410 cases. J Shoulder Elbow Surg 2013;22:1667-75.
• Mirzayan R, Itamura JM, Vangsness CT Jr, Holtom PD, Sherman R, Patzakis MJ. Management of chronic deep in- fection following rotator cuff repair. J Bone Joint Surg Am 2000;82-A:1115-21.
• Dan M, Siegman-Igra Y, Pitlik S, Raz R. Oral ciprofloxa- cin treatment of Pseudomonas aeruginosa osteomyelitis. Antimicrob Agents Chemother 1990;34:849-52. CrossRef
• Mayberry-Carson KJ, Tober-Meyer B, Smith JK, Lambe DW Jr, Costerton JW. Bacterial adherence and glycocalyx formation in osteomyelitis experimentally induced with Staphylococcus aureus. Infect Immun 1984;43:825-33.
• Letts RM, Doermer E. Conversation in the operating the- ater as a cause of airborne bacterial contamination. J Bone Joint Surg Am 1983;65:357-62.
• Aydin N, Esemenli T. Sweating: a formidable challenge in orthopaedic surgery. J Hosp Infect 2010;75:236-7. CrossRef
• Armstrong RW, Bolding F. Septic arthritis after arthros- copy: the contributing roles of intraarticular steroids and environmental factors. Am J Infect Control 1994;22:16-8.
• Herrera MF, Bauer G, Reynolds F, Wilk RM, Bigliani LU, Levine WN. Infection after mini-open rotator cuff repair. J Shoulder Elbow Surg 2002;11:605-8. CrossRef
• Masini BD, Stinner DJ, Waterman SM, Wenke JC. Bacte- rial adherence to high--tensile strength sutures. Arthros- copy 2011;27:834-8. CrossRef
• Busfield BT. Glenohumeral joint sepsis after magnetic resonance imaging arthrogram. Am J Orthop (Belle Mead NJ) 2012;41:277-8.
• Klinger HM, Baums MH, Freche S, Nusselt T, Spahn G, Steckel H. Septic arthritis of the shoulder joint: an analysis of management and outcome. Acta Orthop Belg 2010;76:598-603.
• Duncan SF, Sperling JW. Treatment of primary isolated shoulder sepsis in the adult patient. Clin Orthop Relat Res 2008;466:1392-6. CrossRef
• Harding JW, Braddock GT, Croydon EA. Successful treatment of osteomyelitis caused by Pseudomonas aeru- ginosa. J Clin Pathol 1970;23:653-6. CrossRef
• Kanellakopoulou K, Giamarellos-Bourboulis EJ. Carrier systems for the local delivery of antibiotics in bone infec- tions. Drugs 2000;59:1223-32. CrossRef
• Bowyer GW, Cumberland N. Antibiotic release from im- pregnated pellets and beads. J Trauma 1994;36:331-5.
• Parnes N, DeFranco M, Wells JH, Higgins LD, Warner JJ. Complications after arthroscopic revision rotator cuff repair. Arthroscopy 2013;29:1479-86. CrossRef
• Pandey V, Varghese E, Rao M, Srinivasan NM, Mathew N, Acharya KK, et al. Nonfatal air embolism during shoulder arthroscopy. Am J Orthop (Belle Mead NJ) 2013;42:272-4.
• Austin L, Zmistowski B, Tucker B, Hetrick R, Curry P, Williams G Jr. Commercial liquid bags as a potential source of venous air embolism in shoulder arthroscopy. J Bone Joint Surg Am 2010;92:2110-4. CrossRef
• Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. 12th ed. Philadelphia: Elsevier Mosby; 2013. p. 2374-5.
• Meislin RJ, Halbrecht J. Complications in Knee and Shoul- der Surgery. London: Springer-Verlag; 2009. p. 238-9. CrossRef