Related Experiment Videos
Infection after rotator cuff repair
J J Settecerri1, M A Pitner, M G Rock
1Department of Orthopedic Surgery, Mayo Medical School, Mayo Clinic/Mayo Foundation, Rochester, MN, USA.
Abstract:
Sixteen patients (15 men and 1 woman) were treated for infection complicating rotator cuff repair during the period 1975 through 1994. Eight of the 16 patients had their initial procedure performed elsewhere. The remaining 8 procedures were performed at our institution with the known incidence of this complication being 0.27%. In addition to intravenous antibiotic therapy, an average of 3.5 (range 2 to 8) operative procedures were required to eradicate the infections. Micro-organisms cultured were Propionibacter in 6, coagulase negative Staphylococcus in 4, Staphylococcus aureus in 4, Peptostreptococcus magnus in 1, and both Propionibacter and coagulase-negative Staphylococcus in 1. The deltoid was restored in all patients; the rotator cuff was reparable in 11. In the 12 shoulders with greater than 1 year of follow-up (average 51 months, range 14 to 165 months), active elevation averaged 110 degrees and external rotation 50 degrees. Four patients had no pain, 4 had minimal pain, and the remaining 4 had moderate pain. Satisfactory final results, which were determined by the patients' opinion or with the use of either the University of California, Los Angeles score or the modified Neer system, were obtained in 5 (42%) of the shoulders.
Insights
Treating rotator cuff repair infections requires multiple surgeries and antibiotics. While deltoid function was restored, only 42% of patients achieved satisfactory outcomes, highlighting challenges in managing these complex cases.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
- Musculoskeletal Health
Background:
- Rotator cuff repair is a common orthopedic procedure.
- Infections following rotator cuff repair are a significant complication.
- Managing these infections often involves complex treatment protocols.
Purpose of the Study:
- To evaluate the outcomes of treating infections after rotator cuff repair.
- To identify common microorganisms involved in post-operative infections.
- To assess the functional recovery and patient satisfaction following treatment.
Main Methods:
- Retrospective review of 16 patients treated for rotator cuff repair infection between 1975-1994.
- Analysis of causative microorganisms, surgical interventions, and functional outcomes.
- Assessment of patient-reported outcomes and clinical scoring systems.
Main Results:
- Propionibacter and Staphylococcus species were the most common pathogens.
- An average of 3.5 additional operative procedures were needed per patient.
- Functional outcomes showed average active elevation of 110 degrees and external rotation of 50 degrees.
- 42% of patients achieved satisfactory results based on patient opinion or validated scoring systems.
Conclusions:
- Infections complicating rotator cuff repair present a significant challenge requiring aggressive management.
- While functional recovery is possible, a substantial proportion of patients experience suboptimal outcomes.
- Further research into preventative strategies and optimized treatment protocols is warranted.