One-stage exchange shoulder arthroplasty for peri-prosthetic infection. J Bone Joint Surg Br 2005 Jun;87(6):814-8
Date
05/25/2005Pubmed ID
15911665DOI
10.1302/0301-620X.87B6.15920Scopus ID
2-s2.0-20844444628 (requires institutional sign-in at Scopus site) 148 CitationsAbstract
There are few reports in the literature of the diagnosis and treatment of the infected shoulder arthroplasty. Most deal with resection arthroplasty and two-stage exchange surgery. We present our results of one-stage exchange operation as treatment for the infected shoulder arthroplasty. Our group comprised 16 patients (ten men, six women) with 16 infected arthroplasties. By the time of follow-up, two patients had died (mean 5.8 years), two could not be located and three had already undergone revision surgery. Nine patients were thus available for clinical examination and assessment. The infections were largely caused by staphylococci, Propionibacterium species and streptococci. Two were early infections (within three months of surgery) and 14 were late infections. The mean follow-up was 5.8 years (13 months to 13.25 years) when the mean Constant-Murley score was 33.6 points and the mean University College of Los Angeles score 18.3 points. Further revision was performed in three patients. One sustained a peri-prosthetic humeral fracture, another developed an acromial pseudarthrosis after transacromial surgery and the third suffered recurrent dislocations. No patient had a recurrence of infection. A one-stage exchange procedure using antibiotic-loaded bone cement eradicated infection in all our patients and we suggest that such a procedure is at least as successful as either a resection arthroplasty or a two-stage exchange in the management of the infected shoulder arthroplasty.
Author List
Ince A, Seemann K, Frommelt L, Katzer A, Loehr JFMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Anti-Bacterial Agents
Arthroplasty, Replacement
Bone Cements
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prosthesis-Related Infections
Radiography
Reoperation
Retrospective Studies
Shoulder Joint
