Staged exchange arthroplasty for shoulder sepsis

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Biomaterials in Orthopedics

Background:

• Shoulder sepsis presents a significant challenge in orthopedic surgery.
• Effective management strategies for deep joint infections are crucial for limb salvage and functional recovery.

Purpose of the Study:

• To evaluate the efficacy of staged exchange arthroplasty using antibiotic-impregnated polymethyl methacrylate (PMMA) spacers for shoulder sepsis.
• To assess clinical and laboratory outcomes in patients treated with this technique.

Main Methods:

• Eight patients with shoulder sepsis underwent extensive débridement and staged exchange arthroplasty.
• Custom antibiotic-impregnated PMMA spacers were utilized, followed by intravenous antibiotic therapy.
• Exchange prosthetic reconstruction involved standard implants with antibiotic-impregnated PMMA cement.

Main Results:

• No clinical or laboratory signs of infection were observed at the 6-month follow-up.
• All patients reported substantial pain relief and improved shoulder function.
• The procedure served as a satisfactory salvage option for glenohumeral joint sepsis.

Conclusions:

• Staged exchange arthroplasty with antibiotic-impregnated PMMA spacers is a viable and effective treatment for shoulder sepsis.
• This approach leads to significant pain reduction and functional improvement in affected patients.
• The technique demonstrates success in managing both primary and post-total shoulder arthroplasty glenohumeral joint infections.