Management of infected shoulder replacement

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Biomaterials in Medicine

Background:

• Infected shoulder alloarthroplasties present a significant clinical challenge.
• Early and late infections require distinct management strategies.
• Diagnostic indicators include clinical signs, elevated inflammatory markers (e.g., C-reactive protein), and joint fluid analysis.

Purpose of the Study:

• To present treatment options for infected shoulder replacements.
• To report outcomes of patients treated with various surgical interventions.
• To evaluate the efficacy of antibiotic-loaded spacers in managing shoulder implant infections.

Main Methods:

• Retrospective analysis of twelve patients with infected shoulder replacements.
• Treatment regimens included arthroscopic synovectomy, open synovectomy, and two-stage revision with a temporary antibiotic-loaded spacer.
• Patients underwent physiotherapy during the spacer phase.

Main Results:

• Two-stage revision with a temporary spacer allowed for stable reconstruction and maintained humeral length.
• Eight out of ten patients in the late infection group were successfully treated with spacer exchange for a regular implant.
• While Constant scores averaged 48, all shoulders remained stable with good elbow function post-treatment.

Conclusions:

• Antibiotic-loaded spacers are a successful treatment modality for infected shoulder replacements.
• This approach facilitates infection control and enables subsequent stable joint reconstruction.
• The use of spacers supports anatomical stability and functional recovery in patients with infected shoulder arthroplasty.