Der Orthopäde
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Periprosthetic shoulder joint infections are encountered by orthopedic surgeons mainly as complex situations which are highlighted by difficult treatment modalities. In a confirmed infection the general therapeutic principle is a surgical procedure. Several strategies orientate on the cause of an infection, the time course of postoperative symptoms, the pathogenicity of the isolated species and the specific comorbidities of the patient. ⋯ Early recognition is of paramount importance in order to prevent further spread, sepsis or even fatal outcome. Low grade infections are challenging conditions in terms of diagnosis and treatment. This article summarizes the principles of current classification, detection and treatment strategies for periprosthetic shoulder joint infections.
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In cervical spine syndromes, specific injections can reach the pain focus or diminish the nerve root irritation, thus overcoming the vicious circle. Indications, contra-indications, complications, the exact procedure of placing the needle, and the combined use with conservative treatment must be taken into consideration.