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Infection after shoulder arthroplasty.

J W Sperling1, T K Kozak, A D Hanssen

  • 1Department of Orthopedics, Mayo Clinic/Mayo Foundation, Rochester, MN 55905, USA.

Clinical Orthopaedics and Related Research
|January 12, 2001
PubMed
Summary

Deep infection after shoulder arthroplasty is a serious complication. Delayed reimplantation after debridement offers the best outcomes for pain relief, infection eradication, and shoulder function.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Management

Background:

  • Deep periprosthetic infection is a rare but severe complication following shoulder arthroplasty.
  • Managing these infections presents significant challenges to orthopedic surgeons.

Purpose of the Study:

  • To evaluate the effectiveness of different treatment strategies for deep periprosthetic infection after shoulder arthroplasty.
  • To identify the optimal approach for managing shoulder arthroplasty infections to improve patient outcomes.

Main Methods:

  • Retrospective review of patients treated for deep periprosthetic infection after primary or revision shoulder arthroplasty between 1972 and 1994.
  • Patients were categorized into four treatment groups: resection arthroplasty, debridement with prosthetic retention, immediate reimplantation, and delayed reimplantation.

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  • Outcomes including reinfection rates, pain relief, and functional shoulder status were assessed at final follow-up.

    • Main Results:

    • Reinfection occurred in 28.6% of patients undergoing resection arthroplasty and 50% of those treated with debridement and prosthetic retention.
    • One patient (33.3%) in the immediate reimplantation group experienced reinfection.
    • No reinfections were reported in the delayed reimplantation group (0%).
    • Patients with a prosthesis in situ demonstrated superior pain relief and shoulder function compared to those treated with resection arthroplasty.

    Conclusions:

    • Delayed reimplantation following debridement appears to be the most effective strategy for managing deep periprosthetic shoulder infection.
    • This approach offers the best potential for eradicating infection while preserving shoulder function and providing pain relief.
    • Further research may be warranted to confirm these findings in larger patient cohorts.