Komplikationen bei rheumachirurgischen Eingriffen der Schulter

Zusammenfassung

Das Schultergelenk ist bei der rheumatoiden Arthritis häufig mitbefallen. Aufgrund seines komplexen Aufbaus führt der rheumatische Befall früh zu Funktionsstörungen, die aber subjektiv oft erst spät empfunden werden. Arthroskopische Eingriffe weisen eine geringe Komplikationsrate auf. Rotatorenmanschettenrekonstruktionen führen aufgrund der rheumatisch bedingten Veränderungen des Muskel- und Sehnengewebes häufig zu Rerupturen. Die endoprothetische Versorgung wird bei der rheumatisch stark veränderten Schulter durch die entzündlichen Gewebsveränderungen erschwert. Periprothetische Frakturen treten aufgrund der verminderten Knochenqualität auf und sind nur erschwert osteosynthetisch zu versorgen. Multipler Gelenkersatz erfordert hierbei mitunter individuelle Lösungsmöglichkeiten. Protheseninfekte an der Schulter sind schwerwiegende Komplikationen und bedürfen einer frühzeitigen Diagnosestellung und operativer Revision.

Abstract

The shoulder joint is frequently involved in rheumatoid arthritis. Due to the complex structure of the joint, rheumatoid affection of the shoulder causes early dysfunction, which is often subjectively underestimated at first. Arthroscopic surgery of the rheumatoid shoulder is associated with a low rate of complications. Due to the rheumatic changes in muscle and tendon tissues, reconstructive surgery of the rotator cuff leads to a high incidence of reruptures. Replacement of the shoulder is compromised by inflammatory tissue changes in severely affected shoulders. Reduced bone quality leads to periprosthetic fractures, which are hard to treat with osteosynthesis. Complications in cases with multiple joint replacements require individual solutions. Periprosthetic infections after total shoulder arthroplasty are serious complications requiring early diagnosis and operative revision.

Schlüsselwörter

rheumatoide Arthritis - Rheumachirurgie - Schulter - Komplikationen

Key words

rheumatoid arthritis - surgery - shoulder - complications

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