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International Orthopaedics
Published in: International Orthopaedics 5/2012

01-05-2012 | Original Paper

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

Authors: Carlo Luca Romanò, Olivier Borens, Lorenzo Monti, Enzo Meani, Jose Stuyck

Published in: International Orthopaedics | Issue 5/2012

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Abstract

Purpose

Controversy still exists as to the best surgical treatment for periprosthetic shoulder infections. The aim of this multi-institutional study was to review a continuous retrospective series of patients treated in four European centres and to assess the respective eradication rate of various treatment approaches.

Methods

Forty-four patients were available for this retrospective follow-up evaluation. Functional and clinical evaluation of treatment for infection was performed using the Constant-Murley score, visual analogue scale and patient satisfaction Neer score. Erythrocyte sedimentation rate, serum leucocyte count and C-reactive protein were measured and shoulder X-ray examination performed prior to surgery and at the latest follow-up.

Results

At a mean follow-up of 41 months (range 24–98), 42 of 44 patients (95.5%) showed no signs of infection recurrence/persistence. Comparable eradication rates were observed after resection arthroplasty (100%; 6/6), two-stage revision (17/17) or permanent antibiotic-loaded spacer implant (93.3%; 14/15). No patient was treated by one-stage revision. On average, both functional and pain scores improved significantly; the worst joint function was observed after resection arthroplasty.

Conclusions

This retrospective analysis conducted on the largest published series of patients to date shows comparable infection eradication rates after two-stage revision, resection arthroplasty or permanent spacer implant for the treatment of septic shoulder prosthesis.
Literature
1.
Braman JP, Sprague M, Bishop J, Lo IK, Lee EW, Flatow EL (2006) The outcome of resection shoulder arthroplasty for recalcitrant shoulder infections. J Should Elbow Surg 15:549–553CrossRef
2.
Cheung EV, Sperling JW, Cofield RH (2008) Infection associated with hematoma formation after shoulder arthroplasty. Clin Orthop Relat Res 466:1363–1367PubMedCrossRef
3.
Coste JS, Reig S, Trojani C, Berg M, Walch G, Boileau P (2004) The management of infection in arthroplasty of the shoulder. J Bone Joint Surg 86-B:65–69
4.
Cuff DJ, Virani NA, Levy J, Frankle MA, Derasari A, Hines B, Pupello DR, Cancio M, Mighell M (2007) The treatment of deep shoulder infection and glenohumeral instability with debridement, reverse shoulder arthroplasty and post-operative antibiotics. J Bone Joint Surg 90-B:336–342
5.
Duncan SFM, Sperling JW (2008) Treatment of primary isolated shoulder sepsis in the adult patient. Clin Orthop Relat Res 466:1392–1396PubMedCrossRef
6.
Jerosch J, Schneppenheim M (2003) Management of infected shoulder replacement. Arch Orthop Trauma Surg 123:209–214PubMed
7.
Proubasta IR, Itarte JP, Lamas CG, Escribá IU (2005) Permanent articulated antibiotic-impregnated cement spacer in septic shoulder arthroplasty: a case report. J Orthop Trauma 19:666–668PubMedCrossRef
8.
Mileti J, Sperling JW, Cofield RH (2004) Reimplantation of a shoulder arthroplasty after a previous infected arthroplasty. J Should Elbow Surg 13:528–531CrossRef
9.
Strickland JP, Sperling JW, Cofield RH (2008) The results of two-stage re-implantation for infected shoulder replacement. J Bone Joint Surg 90-B:460–465CrossRef
10.
Ince A, Seemann K, Frommelt L, Katzer A, Loehr JF (2005) One-stage exchange shoulder arthroplasty for peri-prosthetic infection. J Bone Joint Surg 87-B:814–818CrossRef
11.
Themislocleous G, Zalavras C, Stine I, Zachos V, Itamura J (2007) Prolonged implantation of an antibiotic cement spacer for management of shoulder sepsis in compromised patients. J Should Elbow Surg 16:701–705CrossRef
12.
Coffey MJ, Ely EE, Crosby LA (2010) Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer. J Shoulder Elbow Surg 19(6):868–873PubMedCrossRef
13.
Verhelst L, Stuyck J, Bellemans J, Debeer P (2011) Resection arthroplasty of the shoulder as a salvage procedure for deep shoulder infection: does the use of a cement spacer improve outcome? J Shoulder Elbow Surg 20(8):1224–1233PubMedCrossRef
14.
Sperling JW, Kozak TK, Hanssen AD, Cofield RH (2001) Infection after shoulder arthroplasty. Clin Orthop 382:206–216PubMedCrossRef
15.
Spangehl MJ, Masri BA, O’Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg 81-A:672–683
16.
Constant CR, Murley AH (2004) A clinical method of functional assessment of the shoulder. J Bone Joint Surg 86-B:65–69
17.
Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR (2005) Normalization of the Constant score. J Shoulder Elbow Surg 14:279–285PubMedCrossRef
18.
Neer CS 2nd (1970) Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 52(6):1090–1103PubMed
19.
Weber P, Utzschneider S, Sadoghi P, Andress HJ, Jansson V, Müller PE (2011) Management of the infected shoulder prosthesis: a retrospective analysis and review of the literature. Intern Orthop 35:365–373CrossRef
20.
Barrack RL, Jennings RW, Wolfe MW, Bertot AJ (1997) The Coventry Award. The value of preoperative aspiration before total knee revision. Clin Orthop Relat Res 345:8–16PubMedCrossRef
21.
Romanò CL, Romanò D, Bonora C, Degrate A, Mineo G (2009) Combined Diagnostic Tool” for joint prosthesis infection. Infez Med 17(3):141–150PubMed
22.
Wirth MA, Rockwood CA Jr (1996) Complications of total shoulder-replacement arthroplasty. J Bone Joint Surg Am 78(4):603–616PubMed
23.
Zeller V, Ghorbani A, Strady C, Leonard P, Mamoudy P, Desplaces N (2005) Propionibacterium acnes: an agent of prosthetic joint infection and colonization. J Infect 55(2):119–124CrossRef
24.
Romanò CL, Romanò D, Logoluso N, Meani E (2010) Septic versus aseptic hip revision: how different ? J Orthop Traumatol 11(3):167–174PubMedCrossRef
25.
Rispoli DM, Sperling JW, Athwal GS, Schleck CD, Cofield RH (2007) Pain relief and functional results after resection arthroplasty of the shoulder. J Bone Joint Surg Br 89(9):1184–1187PubMedCrossRef
26.
Seitz WH Jr, Damacen H (2002) Staged exchange arthroplasty for shoulder sepsis. J Arthroplasty 17(4 Suppl 1):36–40PubMedCrossRef
27.
Rolf O, Stehle J, Gohlke F (2007) Treatment of septic arthritis of the shoulder and periprosthetic shoulder infections. Special problems in rheumatoid arthritis. Orthopade 36(8):700–707PubMedCrossRef
28.
Cierny G 3rd, DiPasquale D (2002) Periprosthetic total joint infections. Staging, treatment, and outcomes. Clin Orthop Relat Res 403:23–28PubMedCrossRef
29.
McPherson EJ, Woodson C, Holtom P, Roidis N, Shufelt C, Patzakis M (2002) Periprosthetic total hip infection. Outcomes using a staging system. Clin Orthop Relat Res 403:8–15PubMedCrossRef
30.
Romanò CL, Logoluso N, F. Dell’Oro F, Elia A, Drago L (2011) Bone and joint infections in adults: a comprehensive classification proposal. European Orthopaedics and Traumatology 1/6: 207–217
Metadata
Title
What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series
Authors
Carlo Luca Romanò
Olivier Borens
Lorenzo Monti
Enzo Meani
Jose Stuyck
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 5/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1467-4

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