Diagnostik und Management des Endoprotheseninfekts am Schultergelenk View Full Text


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Article Info

DATE

2016-06

AUTHORS

Philipp Moroder, Christian Gerhardt, Nora Renz, Andrej Trampuz, Markus Scheibel

ABSTRACT

Periprothetische Infekte stellen eine seltene jedoch schwerwiegende Komplikation nach Schulterendoprothesenimplantation dar. Je nach zeitlichem Auftreten und klinischer Manifestation können sie in Früh-, verzögerte oder Spätinfekte sowie Low-grade- und High-grade-Infekte eingeteilt werden. Das Erregerspektrum umfasst neben Staphylococcus aureus, Streptokokken, Enterokokken und gramnegativen Stäbchen auch niedrig-virulente Keime der Hautflora wie z. B. koagulasenegative Staphylokokken (z. B. Staphylococcus epidermidis) und Anaerobier (z. B. Propionibacterium acnes). Die Diagnostik des Schulterendoprotheseninfekts beruht neben der klinischen Untersuchung und allgemeinen Bildgebung v. a. auf labortechnischen Untersuchungen. Ein wichtiger Faktor ist hierbei die Gewinnung von Gewebeproben zur mikrobiologischen Untersuchung. Unterstützende diagnostische Mittel sind die Bestimmung der systemischen Entzündungsparameter, die histologische Untersuchung von Gewebeproben sowie die Bestimmung der Leukozytenzahl im Gelenkpunktat. Bei Frühinfekten oder akut aufgetretenen Infekten kann ein endoprothesenerhaltendes Vorgehen mit radikalem Débridement und Inlaywechsel gewählt werden. Sind die Voraussetzungen für ein endoprothesenerhaltendes Vorgehen nicht erfüllt, so empfiehlt sich der zweizeitige Endoprothesenwechsel mit temporärer Spacerimplantation und begleitender antibiotischer Therapie. Bei Vorliegen eines Low-grade-Infekts durch einen niedrig-virulenten Erreger mit Suszeptibilität auf biofilmaktive Antibiotika kann unter der Voraussetzung einer guten Weichteilsituation ein einzeitiger Wechsel durchgeführt werden. More... »

PAGES

78-87

Journal

TITLE

Obere Extremität

ISSUE

2

VOLUME

11

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11678-016-0361-5

DOI

http://dx.doi.org/10.1007/s11678-016-0361-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1047906301


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Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s11678-016-0361-5'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s11678-016-0361-5'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s11678-016-0361-5'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s11678-016-0361-5'


 

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