Anchor, suture removal of infected rotator cuffs did not improve remission rate
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Published results showed removal of anchors or sutures, repeated revision surgery or antibiotic therapy beyond 6 weeks did not improve remission or reduce sequelae among patients with infected rotator cuff repairs.
Researchers identified 54 primary infected rotator cuff repairs among 44 men who underwent surgical revision of either open debridement or arthroscopy. Researchers included remission of infection and post-infection reoperations due to failed tendon healing for mechanical causes as the outcome variables. Researchers emphasized anchor and suture retention or removal in all analyses.
Results showed 52% of the infected rotator cuff repairs were not intact on revision surgery, with 10 presenting as partially intact and 18 as totally re-ruptured. Researchers noted a median number of surgical revisions of one and a median duration of post-surgical antibiotic therapy of 75 days. Patients had a recurrence rate of infection of 15% after a minimal follow-up of 2 years, according to results. Results also showed 72% of patients had some degree of post-therapeutic persistent pain on motion. Among 20 patients who needed revision surgery, researchers found intraoperative samples were negative for infection in all patients. Anchor removal at the first revision did not influence remission or the need for later revision surgery due to mechanical sequelae, according to results of a multivariate analysis. Researchers noted remission was also not influenced by the numbers of revision surgery and antibiotics beyond 6 weeks.
“As a practical conclusion and in line with the general lecture, we avoid systematic removal of anchors and sutures in [infection of rotator cuff repair] RCI cases, unless they are loose and easily surgically accessible,” the authors wrote. “Likewise, we could limit the number of surgical lavages to as few as possible and the duration of antibiotic therapy to a maximum of 6 weeks.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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