Preventing and Treating Infection in Reverse Total Shoulder Arthroplasty

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Infections
• Arthroplasty

Background:

• Periprosthetic infection (PJI) following shoulder arthroplasty, while uncommon, leads to significant long-term patient morbidity.
• The 2018 International Consensus Meeting on Musculoskeletal Infection established a diagnostic and management framework for PJI.

Purpose of the Study:

• To review current literature on the definition, clinical evaluation, prevention, and management of PJI after reverse shoulder arthroplasty.

Main Methods:

• Systematic review of recent literature.
• Analysis of diagnostic criteria, preventative strategies, and treatment options for PJI in shoulder arthroplasty.

Main Results:

• Existing literature provides a framework for PJI diagnosis and management, largely based on consensus and extrapolation from hip and knee arthroplasty data.
• Evidence for specific interventions to reduce PJI in shoulder arthroplasty is limited.
• One-stage and two-stage revision strategies show similar outcomes, but lack of comparative studies prevents definitive recommendations.
• Much current literature does not differentiate between anatomic and reverse shoulder arthroplasty.

Conclusions:

• Further high-level, shoulder-specific studies are required to refine PJI diagnosis, prevention, and treatment protocols.
• Current management guidelines are based on limited evidence and require validation through dedicated research.