Two-stage shoulder reconstruction for active glenohumeral sepsis

In some circumstances, two-stage reconstruction is recommended for the treatment of glenohumeral sepsis. This study retrospectively reviewed the results in 25 patients after this treatment. Pain was the only consistent preoperative symptom, found in 95% of patients. The most common infecting organisms were coagulase-negative Staphylococcus in 8 cases, Proprionibacterium acnes in 7, and methicillin-sensitive Staphylococcus aureus in 3. Outcomes were reviewed in 21 patients with 2-year minimum follow-up, at an average 4.1 years. Infection was eradicated in 18 of 21 shoulders. Success was related to the specific infecting organism, as all failures were among shoulders infected with Proprionibacterium (P=.0198). Pain was typically relieved, with a mean visual analog pain score of 1.67 at follow-up. Motion was similarly improved, with flexion increased to 100.9 degrees (P<.001), abduction to 93.6 degrees (P<.001), and external rotation 32.6 degrees (P=.0012). Two-stage shoulder reconstruction for infection is typically effective for curing the infection and improving pain and motion; however, function tends to remain limited.