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

Int Orthop. 2012 May;36(5):1011-7. doi: 10.1007/s00264-011-1467-4. Epub 2012 Feb 14.

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 retrospectiveseries 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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement / adverse effects*
  • Combined Modality Therapy
  • Europe
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis / adverse effects*
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / diagnostic imaging
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / surgery*
  • Radiography
  • Retrospective Studies
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents