Diagnostik der periprothetischen Gelenkinfektion bei Schulterendoprothesen

Zusammenfassung

Periprothetische Gelenkinfektionen sind eine der häufigsten Ursachen für Schmerzen und Revisionsoperationen bei Schulterendprothesen. Propionibacterium acnes ist einer der am häufigsten nachgewiesenen Keime und ist aufgrund des sehr langsamen Wachstums schwer zu identifizieren. Die verschiedenen Verfahren zur Verifizierung einer periprothetischen Schulterinfektion werden in dieser Arbeit dargestellt. Hierbei ist eine Kombination von unspezifischen und spezifischen (Keimisolation mit Antibiogramm) Testverfahren hilfreich, um eine periprothetische Infektion bestmöglich zu diagnostizieren. Ein Punktat des Gelenks erlaubt, verschiedene unspezifische und spezifische Testverfahren zu kombinieren. Bei einer Punctio sicca und Infektverdacht empfehlen wir die Biopsie des Gelenks.

Abstract

Periprosthetic joint infection of shoulder arthroplasties is one of the most frequent reasons for pain and revision surgery of shoulder arthroplasties. Propionibacterium acnes is one of the commonest microorganisms causing periprosthetic joint infection in shoulder arthroplasties. It is difficult to detect this slow growing microorganism. This paper gives an overview of the different diagnostic methods. A combination of unspecific and specific tests (detection of microorganism and sensitivity to antibiotics) is helpful in identifying a periprosthetic shoulder infection. Aspiration of the joint can combine different unspecific and specific tests. In patients with punctio sicca and suspected periprosthetic joint infection, we recommend biopsy of periprosthetic tissue.

Schlüsselwörter

periprothetische Infektion - Schulterendoprothese - Diagnostik

Key words

diagnostic - periprosthetic joint infection - shoulder arthroplasty

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