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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
One-stage revision for patients with a chronically infected reverse total shoulder replacement
P D A Beekman1, D Katusic, B M Berghs
1Deparment of Orthopaedic Surgery Physical Medicine and Rehabilitation, Ghent University Hospital, B-9000 Ghent, Belgium.
Summary
One-stage revision surgery effectively treats infected reverse shoulder prostheses, achieving infection-free status in most patients. This approach offers reliable infection eradication and good functional outcomes with reduced treatment time.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Infected reverse shoulder prostheses present a significant clinical challenge.
- Treatment options for these infections often involve complex and lengthy procedures.
Purpose of the Study:
- To evaluate the efficacy of one-stage revision arthroplasty in treating infected reverse shoulder prostheses.
- To assess clinical and radiological outcomes, including infection eradication and functional recovery.
Main Methods:
- Retrospective review of 11 patients with infected reverse shoulder prostheses.
- Clinical, radiological, and laboratory assessments.
- Microbiological analysis of peroperative samples.
- Treatment with intravenous cefazolin followed by long-term oral antibiotics.
- One-stage revision arthroplasty.
Main Results:
- Propionibacterium acnes and coagulase-negative Staphylococcus were common pathogens.
- Eight patients (73%) developed a fistula, which did not affect function.
- All but one patient were infection-free at a median 24-month follow-up after one-stage revision.
- A median post-operative Constant-Murley score of 55 was achieved.
- Complications were infrequent, including dislocation, hematoma, and clavicular fracture.
Conclusions:
- One-stage revision arthroplasty is a reliable and effective method for eradicating infection in reverse shoulder prostheses.
- This approach can lead to good functional outcomes and reduces treatment duration and cost.
- Careful patient selection and management are crucial for successful outcomes.