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Beitragstitel The role of anchor and suture removal in rotator cuffs infections
Beitragscode P002
Autoren
  1. Elias Ammann Vortragender
  2. Ilker Uçkay Infektiologie, Universitätsklinik Balgrist
  3. Samy Bouaicha Universitätsklinik Balgrist
  4. Karl Wieser Universitätsklinik Balgrist
  5. Dominik C. Meyer Universitätsklinik Balgrist
Präsentationsform Poster
Themengebiete
  • A01 - Schulter/Ellbogen
Abstract Abstract
Introduction To investigate the benefit of surgical implant (anchor and/or suture) removal and prolonged antibiotic therapy in acute and chronic infections of rotator cuff repair.
Methods Single-centre cohort and case-control study (Cox regression) with emphasis on the role of surgical anchor and suture removal in infected rotator cuff repairs (RCI). Outcome variables are remission of infection and post-infectious re-operations due to failed tendon healing (mechanical sequels). Minimal active follow-up was six months.
Results We identified 53 RCIs (18 early infections; 35 chronic; 43 males; median age 54 years; 5 diabetic patients) which were surgically treated. Twenty-six repairs (49%) were intact upon revision surgery (debridement); 9 partially and 18 totally re-ruptured. Total anchor removal was performed in 11 cases, and total suture removal in 25 cases. The median number of surgical revisions was 1 (range, 1-3 procedures) and the median duration of post-surgical antibiotic therapy 75 days. During a median active follow-up of two years, eight infections (8/53; 15%) clinically recurred. Among 38 patients with persistent pain, 26 (26/38; 68%) needed a revision surgery not related to persistent infection. By multivariate analysis, anchor removal neither influenced remission (hazard ratio [HR] 0.9, 95%CI 0.4-2.1), nor the need for revision surgery due to mechanical sequels (HR 0.6, 0.2-1.8). The corresponding results for suture removal were HR 1.3, 0.7-2.5 and HR 0.7, 0.3-1.7, respectively. Likewise, the numbers of revision surgery (HR 1.3, 0.7-2.5) and antibiotics beyond six weeks failed to influence remission (HR 0.8, 0.3-2.4).
Conclusion In our RCI cohort, the removal of anchors or sutures, repeated revision surgery or an antibiotic therapy beyond six weeks, failed to improve remission or to reduce sequels.