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International Orthopaedics
Published in: International Orthopaedics 11/2023

23-08-2023 | Acne | Original Paper

High infection control rate after systematic one-stage procedure for shoulder arthroplasty chronic infection

Authors: Laëla El Amiri, Philippe Clavert, Jeannot Gaudias, Stéphane Klein, Cécile Rondé Oustau, Maxime Antoni

Published in: International Orthopaedics | Issue 11/2023

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Abstract

Purpose

The two stage revision procedure is the gold standard surgical technique in chronic shoulder periprosthetic joint infection (PJI). Series of one stage revision have been published with similar outcomes but with preoperative selection of patients. The aim of this work was to report the outcomes (infection eradication, functional, and radiographic) after systematic one stage revision, without preoperative selection of patients, in chronic shoulder PJI.

Methods

This was a retrospective monocentric study including 40 patients (14 women and 26 men) with a diagnosis of periprosthetic joint infection after a shoulder arthroplasty. A one stage shoulder prosthesis revision was performed in all patients, for a PJI evolving for more than three weeks, without preoperative patient selection. The primary endpoint was the absence of signs of persistent infection at a minimum follow-up of two years. Secondary endpoints were clinical and radiological outcomes.

Results

At the last follow-up, 36/40 patients had no recurrence of infection after the one stage revision, i.e., 90% of our series. In 45% (18/40) of the cases, the microbial organism was not known at the time of the one stage revision. Cutibacterium acnes was the most frequent pathogen, found in 67.5% (27/40) of the patients. The infection was polymicrobial in 40% (16/40) of the cases. At last follow-up, mean absolute Constant score was 48.4% (16–93) and weighted score was 65.5% (22–100), and satisfaction was evaluated by the patients as excellent or good in 75% (30/40). About 20% (8/40) of the patients had a postoperative complication.

Conclusion

A one stage revision procedure, combined with appropriate antibiotic therapy, made it possible to eradicate the PJI in 90% of the shoulders in our series with satisfactory functional outcomes.
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Metadata
Title
High infection control rate after systematic one-stage procedure for shoulder arthroplasty chronic infection
Authors
Laëla El Amiri
Philippe Clavert
Jeannot Gaudias
Stéphane Klein
Cécile Rondé Oustau
Maxime Antoni
Publication date
23-08-2023
Publisher
Springer Berlin Heidelberg
Keyword
Acne
Published in
International Orthopaedics / Issue 11/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-023-05927-2

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