Shoulder arthroscopy is generally a safe and effective method for treating a wide variety of shoulder pathology. Fortunately, complications following shoulder arthroscopy are rare, with reported rates between 4.6% and 10.6%.¹⁻⁷ These rates may be underestimated, as underreporting of complications and varying definitions of the term complication are likely. During shoulder arthroscopy, complications may occur at numerous points. The surgeon must be aware of potential problems and take necessary measures to prevent them. This article describes common complications after arthroscopic shoulder surgery. Although failure of treatment and postoperative stiffness are undesirable outcomes, they are not described.
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"One of the most feared complications of shoulder arthroscopy, although rare, remains deep articular infection, with potentially destructive joint sequelae [2–4]. When occurring, it poses the double challenge of eradicating the infectious agent while preserving the articulation and its function [2, 3, 5]. Experience with this rare occurrence remains extremely scarce and is mostly based on case reports and small series, reflecting experience with the more common post-arthroplasty infections . "
[Show abstract][Hide abstract] ABSTRACT: Arthroscopic revision of rotator cuff lesions is an increasingly popular procedure with a relatively safe profile. However, associated deep articular infection has been described, with potentially destructive joint sequelae. When occurring, it poses the double challenge of eradicating the infectious agent while preserving the articulation and its function. Experience remains scarce and is mostly based on case reports and small series. These also rely on the evidence from the better-described lower extremity joint infections. Through a complex case, the following report addresses this exceptional situation and offers an unusual solution, taking into consideration the peculiarities of the shoulder joint. With the consent of the patient, a single-stage resection arthroplasty with the implantation of an antibiotic-impregnated cement spacer was performed as a long-lasting-if not definite-treatment. After 4 years, the patient maintains excellent function with no radiological signs of wear or loosening.
Strategies in Trauma and Limb Reconstruction 09/2013; 8(3). DOI:10.1007/s11751-013-0176-5
"In the beach chair position, anesthesia-related complications, including spinal and cerebral ischemia and death are more common than in any other positions [3,15,16]. In the previous case that the left shoulder replacement surgery was performed in the beach chair position and a noninvasive blood pressure cuff was placed on the calf, brain death was reported. "
[Show abstract][Hide abstract] ABSTRACT: During shoulder surgery, blood pressure is frequently measured at the ankle. Anesthetic complications may result when ankle blood pressure is higher than brachial blood pressure and anesthesiologists misinterpret ankle blood pressure as brachial blood pressure. Therefore, we investigated whether ankle blood pressure is significantly higher than brachial blood pressure before anesthesia induction, during induction, after tracheal intubation, before beach chair position, and in the beach chair position.
Thirty patients requiring general anesthesia for shoulder surgery were included in this study. Ankle and brachial blood pressure were simultaneously measured before induction, during induction, after intubation, before beach chair position, and in the beach chair position.
Ankle blood pressure was higher than brachial blood pressure before induction, during induction, after intubation, before beach chair position, and in the beach chair position. Ankle-brachial blood pressure differences in the beach chair condition were much higher than in four other conditions. The correlation coefficient between mean ankle-brachial blood pressure differences before the beach chair position and mean ankle-brachial blood pressure differences in the beach chair position was 0.616. Brachial systolic blood pressure could be predicted by regression equations (R(2) = 0.306-0.771).
These results suggest that anesthesiologists should consider these ankle-brachial blood pressure differences when monitoring anesthesia in the beach chair position.
Korean journal of anesthesiology 12/2012; 63(6):515-20. DOI:10.4097/kjae.2012.63.6.515
[Show abstract][Hide abstract] ABSTRACT: In den vergangenen 5 Jahren hat die diagnostische und operative Schulterarthroskopie in der Traumatologie und Orthopdie zunehmend an Bedeutung gewonnen. Die Indikation mu streng und exakt gestellt und die Technik nach einem einheitlichen und reproduzierbaren Prinzip durchgefhrt werden. Verletzungen des Limbus glenoidalis (v. a. nach erstmaliger traumatischer Schulterluxation bei zungen Patienten), Rotatorenmanschettenlsionen, Behandlung bei bakteriellen Infektionen und unklare posttraumatische Schmerzen sind heute klare Indikationen fur die diagnostische und operative Schulterarthroskopie. In der Behandlung von krankheitsbedingten Vernderungen am Schultergelenk ist die Arthroskopie ebenfalls nicht mehr wegzudenken. Keine andere Untersuchung liefert so viele und so genaue Informationen. Neben der exakten Diagnosestellung bieten die arthroskopischen Operationen am Schultergelenk die Mglichkeit einer gleichzeitigen und definitiven Therapie. Die Indikation sollte daher grozgig gestellt werden, trotz einer Komplikationsrate von rund 5%.Diagnostic and operative arthroscopy of the shoulder joint has gained considerable importance in traumatology and orthopedic surgery over the last years. Injuries of the limbus glenoidalis, in particular traumatic shoulder luxation, injuries of the rotator cuff, infection of the glenohumeral joint and unclear posttraumatic pain are indications for diagnostic and operative arthroscopy. Arthroscopy of the shoulder is a procedure, which offers exact diagnosis and the possibility of immediate surgery at the same time. The technique of the shoulder joint arthroscopy has to be carried out carefully and according to a standard protocol. The complication rate of around 5% of shoulder arthroscopy has not to be neglected.
Langenbeck s Archives of Surgery 01/1993; 378(4):200-205. DOI:10.1007/BF00184361 · 2.19 Impact Factor