Infection control and outcome of staged reverse shoulder arthroplasty for the management of shoulder infections
Please always quote using this URN: urn:nbn:de:bvb:20-opus-230620
- Background The treatment of septic arthritis, caused by either hematogenous seeding, injections, or surgery, can be challenging. Staged reverse shoulder arthroplasty (RSA) with temporary implantation of an antibiotic-loaded spacer is widely accepted but still discussed controversially. This study investigated the shoulder-specific bacterial spectrum, infection control rate, functional outcome, and infection-free survival rate after staged RSA in the mid- to long-term follow-up. It was hypothesized that staged RSA would show a highBackground The treatment of septic arthritis, caused by either hematogenous seeding, injections, or surgery, can be challenging. Staged reverse shoulder arthroplasty (RSA) with temporary implantation of an antibiotic-loaded spacer is widely accepted but still discussed controversially. This study investigated the shoulder-specific bacterial spectrum, infection control rate, functional outcome, and infection-free survival rate after staged RSA in the mid- to long-term follow-up. It was hypothesized that staged RSA would show a high infection-free survival rate. Methods A total of 39 patients treated with staged RSA for primary septic arthritis (n = 8), secondary infection (n = 8), or periprosthetic infection (n = 23) were retrospectively included. The infection control rate was calculated based on cultures taken intraoperatively at spacer removal and RSA implantation. Infection-free survival was defined as no revision due to infection. The minimum follow-up period for functional outcome assessment was 2 years (n = 14; mean, 76 months; range, 31-128 months). Results Cutibacterium (26%) and coagulase-negative staphylococci (23%) were the predominant pathogens. The infection control rate was 90%. The cumulative infection-free survival rate was 91% after 128 months. Follow-up examinations showed a mean Constant score of 48 (range, 7-85), a mean QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score of 40.0 (range, 11.4-93.3), and a mean pain score of 1.6 (range, 0-7). Conclusion Staged RSA implantation was confirmed to be a reliable treatment option for primary, secondary, and periprosthetic infections of the shoulder. The infection control rate and infection-free survival rate are satisfactory. However, patients and surgeons must be aware of functional impairment even after successful treatment of infections.…
Author: | Sebastian Philipp Boelch, Laura Elisa Streck, Piet Plumhoff, Christian Konrads, Frank Gohlke, Kilian Rueckl |
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URN: | urn:nbn:de:bvb:20-opus-230620 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Lehrstuhl für Orthopädie |
Language: | English |
Parent Title (English): | JSES International |
Year of Completion: | 2020 |
Volume: | 4 |
Pagenumber: | 959-963 |
Source: | JSES International 4 (2020) 959-963. https://doi.org/10.1016/j.jseint.2020.08.012 |
DOI: | https://doi.org/10.1016/j.jseint.2020.08.012 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | outcome; periprosthetic infection; reerse shoulder arthoplasty; shoulder arthroplasty; shoulder infection; spacer; two stage |
Release Date: | 2021/04/22 |
Collections: | Open-Access-Publikationsfonds / Förderzeitraum 2020 |
Licence (German): | CC BY-NC-ND: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Keine Bearbeitungen 4.0 International |