Abstract:
INTRODUCTION:Cutibacterium acnes is one of the major pathogens responsible for infection after shoulder surgery. Surgical dissection of the dermis may expose C. acnes from sebum-producing hair follicles. Due to contact with surgeon's gloves and instruments these are further spread throughout the surgical field. The purpose of this study was to determine if subcutaneous tissue disinfection could reduce the C. acnes culture rate in primary open shoulder surgery. METHODS:All patients eligible for primary open shoulder surgery using a deltopectoral approach were prospectively enrolled in our 2-arm randomized, single blinded clinical trial. In all patients a skin swab of the operative field was taken prior to standard surgical skin preparation. After exposure of the deltoid fascia, the disinfection group received an additional preparation of the subcutaneous layer with povidone-iodine solution. Once the proximal humerus was completely exposed, 5 swabs from different sites were taken for microbiological examination according to a strict specimen collection protocol. All cultures were incubated in aerobic and anaerobic conditions for 14 days. RESULTS:Between February 2019 and December 2019, 108 patients were enrolled in two groups (70 treatment vs 38 control). The two groups did not show any significant difference in terms of gender, age, BMI or occurrence of diabetes. The subcutaneous disinfection protocol reduced significantly the positive culture rate of the operating field for all germs combined (p = 0.036) and specifically for C. acnes (p = 0.013). The reduction of positive swabs for C. acnes was significant for the surgeon's gloves (p = 0.041) as well as for the retractors (p = 0.007). CONCLUSION:Disinfection of the subcutaneous tissue significantly reduced the C. acnes culture rate during primary open shoulder surgery. We highly recommend this simple step as adjunct to the current surgical practice in order to limit iatrogenic contamination of the surgical field. Future studies may observe a reduction in postoperative shoulder infection due to this practice.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Moor BK,Léger B,Steffen V,Troillet N,Emonet S,Gallusser Ndoi
10.1016/j.jse.2020.11.018subject
Has Abstractpub_date
2021-01-06 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(21)00001-Xpub_type
杂志文章abstract:BACKGROUND:The subscapularis is an important mover and stabilizer of the glenohumeral joint. Since the advent of shoulder arthroscopy, partial tears are found in 43% of rotator cuff patients. While partial tears to the upper band occur more commonly, little is known about the structure and mechanical behavior of the in...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.11.038
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Glenoid bone deficiencies may be addressed by specialized components. The purpose of this study is to evaluate the clinical and radiographic outcomes of 3 different types of nonstandard glenoid components. MATERIALS AND METHODS:Thirty-eight patients with a mean age of 65 years (range, 34-84 years) underwent...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.09.023
更新日期:2014-07-01 00:00:00
abstract::Six hundred one total shoulder arthroplasties and eighty-nine hemiarthroplasties were performed for primary osteoarthritis of the shoulder. Patients were evaluated with a physical examination, Constant score, and radiographic evaluation. The minimum follow-up was 2 years. At follow-up, the Constant score averaged 64 p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s1058-2746(02)86804-5
更新日期:2003-05-01 00:00:00
abstract::It is well known that cervical radiculopathy sometimes causes shoulder pain. Hypothesizing that the cause of painful shoulder is related to the cervical spine in the absence of obvious radiculopathy, we measured the anteroposterior diameter of the spinal canal and the range of motion of the cervical spine in patients ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(99)90150-7
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:The global spread of the 2019 novel coronavirus (COVID-19) has profoundly affected the way we conduct our health care practices. The goal of this paper is to report the outcomes of 11 patients who underwent humeral fracture surgery in the first few weeks of the COVID-19 outbreak in Spain. METHODS:This was a...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.06.001
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The purpose of this computed tomography-based study was to quantify erosions in B2 glenoids. We hypothesized that erosions do not occur symmetrically and that they have a predictable orientation. METHODS:This study evaluated 55 type B2 glenoid cases. Computed tomography data were used to create three-dimens...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.08.021
更新日期:2015-04-01 00:00:00
abstract::The impingement test, placement of local anesthetic in the subacromial space, is considered a useful tool in diagnosing impingement syndrome. The purpose of this study was to examine the predictive value of the impingement test with respect to outcome after arthroscopic subacromial decompression. Fifty-five patients w...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2003.12.006
更新日期:2004-03-01 00:00:00
abstract::The possibility that functional impingement results from muscular imbalance has been discussed. This study investigates whether disturbance of muscular coordination is reflected in a shift in the balance of fast-twitch and slow-twitch fibers, as fast-twitch fibers enable a rapid reaction or contraction and slow-twitch...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(03)00036-3
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible. MATERIA...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2012.03.004
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The advocacy for operative fixation of midshaft clavicle fractures has prompted a reemergence of interest in clavicle anatomy. Three-dimensional (3D) anatomical studies provide more information than 2-dimensional studies, but are currently rare. MATERIAL AND METHODS:Twenty-five skeletonized clavicles were d...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.01.019
更新日期:2013-01-01 00:00:00
abstract::Examination of a large number (1232) of elbows from skeletal specimens revealed that 16% displayed a characteristic pattern of bone formation exactly underlying the area of exquisite point tenderness at the lateral humeral epicondyle found in clinical cases of tennis elbow. These changes are usually not seen on standa...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.112020
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Significant controversy surrounds optimal treatment of displaced 4-part proximal humeral fractures. Reverse total shoulder arthroplasty (RTSA) has recently been proposed as an alternative to hemiarthroplasty (HA) and open reduction-internal fixation (ORIF). Several authors have questioned the additional impl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.044
更新日期:2014-02-01 00:00:00
abstract::Stereophotogrammetry was used to investigate the functional relations between the articular surface geometry, contact patterns, and kinematics of the glenohumeral joint. Nine normal shoulder specimens were elevated in the scapular plane by using simulated muscle forces in neutral rotation (NR) and starting rotation (S...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.111959
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Interscalene brachial plexus blocks are a common modality used to provide adjunctive pain relief with shoulder replacement surgery. In 2018, the Federal Drug Administration approved the use of liposomal bupivacaine (LB) for such nerve blocks. We sought to evaluate whether this formulation of bupivacaine woul...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.09.017
更新日期:2020-10-09 00:00:00
abstract:BACKGROUND:Many studies that describe factors affecting outcome in primary rotator cuff repair (RCR) have been published, but so far there is no review that summarizes them. This systematic review was conducted to identify prognostic factors influencing functional (clinical) outcome and radiologically proven cuff integ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2014.01.001
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 5-year follow-up in 45 shoulders that underwent total shoulder arthroplasty (TSA) using a system with a central porous titanium po...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.01.012
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Distal biceps tendon repair to the radial tuberosity can be conducted by means of an interference screw in combination with a transosseous button. Bioabsorbable interference screws have been associated with complications such as severe osteolytic reactions. We questioned whether patients with a distal biceps...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.12.007
更新日期:2016-03-01 00:00:00
abstract:HYPOTHESIS:We reviewed the outcome of angular stable plates in addressing displaced lateral-third clavicle fractures. We investigated union, shoulder function, request for implant removal, and return to sport. Our hypothesis was that these implants provide predictable union and return to sports without the negative con...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.09.024
更新日期:2015-05-01 00:00:00
abstract::The purpose of this study is to determine if bipolar radiofrequency energy (bRFE) can enhance delayed surgical repair of acute supraspinatus tendon tears. Bilateral supraspinatus tendon tears were created in 42 Sprague-Dawley rats and repaired at 6 weeks either with or without bRFE augmentation. There were 8 control (...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.11.008
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Radiofrequency technology for shoulder instability was rapidly adopted despite limited clinical evidence and a poor understanding of its indications. Reports of serious adverse events followed, leading to its abandonment. This paper presents findings from a multicenter randomized clinical trial evaluating th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jse.2014.02.022
更新日期:2014-08-01 00:00:00
abstract:HYPOTHESES:We hypothesized that body mass index (BMI) would be negatively associated with self-reported shoulder function/pain. A second objective was to investigate the significance of other potential contributing factors: age, sex, smoking status, tear size, and workers' compensation (WC) involvement. METHODS:In thi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.06.011
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:The DASH (Disabilities of the Arm, Shoulder and Hand) is a scored questionnaire that is widely used to evaluate the health-related quality-of-life of patients with upper-limb musculoskeletal disorders. However, numerical changes in the measure scores lack clinical significance without meaningful threshold ch...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.11.027
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:Overhead athletes are subject to adaptations in the shoulder including glenohumeral internal rotation deficit (GIRD). It has been documented that this alteration is more evident in overhead athletes with pain. Our objective was to compare glenohumeral rotation motion between symptomatic and asymptomatic hand...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.08.027
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Radial head arthroplasty (RHA) is a popular method of treatment for complex fractures of the radial head. The purpose of this study was to investigate patient outcomes and radiographic findings associated with a single anatomic monopolar press-fit radial head system commonly used for the treatment of radial ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.11.014
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Semiconstrained total elbow arthroplasty is used to improve elbow function and reduce pain. Although effective, high complication rates exist, with the polyethylene bushing especially susceptible to failure. The Discovery Elbow System (Biomet Inc, Warsaw, IN, USA) contains a spherical bearing designed to min...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jse.2013.12.033
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The eccentric glenosphere (EG) has been proposed as a way to prevent scapular notching in reverse shoulder arthroplasty (RSA). The purpose of this study was to investigate whether the use of an EG decreases scapular notching compared to matched standard concentric glenosphere (CG) controls. METHODS:A retros...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.032
更新日期:2020-12-01 00:00:00
abstract::The COVID-19 pandemic has redefined global health care. With almost 13 million confirmed cases worldwide, medical professionals have been forced to modify their practice to take care of an expanded, critically ill population. Institutions have been challenged to implement innovative ways to maximize the utility and th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2020.07.020
更新日期:2020-10-01 00:00:00
abstract::This study presents the results of a new surgical technique, resection of the medial end of the clavicle and interposition of the sternal head of the sternocleidomastoid muscle, that was used for the treatment of 17 painful sternoclavicular (SC) joints, 14 of which were available for review. The etiology of the pain w...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.04.005
更新日期:2006-01-01 00:00:00
abstract::Glenoid component loosening generates the greatest concern among surgeons performing total shoulder arthroplasty. Laboratory testing of glenoid prostheses may lead to improved design, subsequently leading to a reduction in the incidence of clinical loosening. The goals of this study were to develop a laboratory test m...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2000.105451
更新日期:2000-07-01 00:00:00
abstract::The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.07.011
更新日期:2006-03-01 00:00:00