化膿性肩関節炎に対する鏡視下手術の小経験

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Background: The septic arthritis of the shoulder joint is an uncommon and difficult diagnosis requiring a high index of suspicion. We describe the therapeutic results of 6 patients on whom we have performed arthroscopic debridement with consistent drainage for a week using a silicone drain. Methods: The subjects were 6 patients (2 males and 4 females). The mean age at the time of surgery was 68.8 years old (38 to 83 years old). The mean duration of symptoms prior to surgery was 18.5 days (10 to 42 days). Of the 6 patients, three patients had had local injections into the subacromial space or glenohumeral joint. Positive cultures in the glenohumeral joint were obtained in 4 of the 6 patients. The causative organism was staphylococcus aureus in every patient. All patients were treated by arthroscopic debridement with consistent drainage for a week. The mean follow-up period was 23 months (15-40 months). The functional outcome was evaluated with use of JOA scoring system. Results: The inflammatory findings in the laboratory research became negative in 4 patients within two weeks. The infectious organism was negative in 4 patients at a week. Conclusion: Arthroscopic procedure for the treatment of septic arthritis of the shoulder joint was safe and efficient. Underlying medical diseases such as prior injections or a preexisting cuff tear were confirmed at a high frequency in these patients.