鏡視下デブリドマンによる化膿性肩関節炎の治療経験

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Background: Septic arthritis of the shoulder is uncommon and rarely responds well to treatment. After open management, the functional result was usually poor. But, in a more recent study, patients who were diagnosed early and treated by arthroscopic debridement had a good result. Methods: We treated three patients (2 males and 1 female, aged 31 to 82 years old) with septic arthritis of the shoulder with arthroscopic debridement and inserted a suction drain postoperatively. Results: The cause of infection was injection in all cases. Cultured organisms were Staphylococcus aureus, Streptococcus gordonii, Staphylococcus aureus and Staphylococcus epidermidis. Synovial proliferation was shown at the glenohumeral joint and subacromial bursa. The patients inflammatory synovium and necrotic tissue were excised. The number of operations in all cases was one. Their procedures had improved the inflammatory reaction and obtained good function without contracture. Recurrence of the infection did not occur in any case. Conclusion: Arthroscopic debridement with suction drain is more effective and less invasive to patients with septic arthritis of the shoulder than open treatment because rotator cuff was preserved by this strategy.
日本肩関節学会の論文