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Updated: Feb 10, 2026

In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
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Low reoperation rate following arthroscopic débridement using diluted povidone-iodine irrigation for septic shoulder

Terufumi Shibata1, Satoshi Miyake1, Kotaro Miyazaki1

  • 1Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.

JSES Reviews, Reports, and Techniques
|February 9, 2026
PubMed
Abstract

Insights

Arthroscopic treatment for septic shoulder arthritis using povidone-iodine irrigation showed a low reinfection rate. This minimally invasive approach appears safe, though further studies are needed to confirm efficacy in managing shoulder infections.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Septic arthritis of the shoulder is often treated with arthroscopic irrigation and débridement.
  • Reinfection remains a significant concern despite minimally invasive approaches.
  • Povidone-iodine's antimicrobial properties suggest potential utility, but its use in shoulder surgery is not well-established.

Purpose of the Study:

  • To evaluate the efficacy and safety of arthroscopic irrigation and débridement with 0.35% povidone-iodine for septic shoulder arthritis.
  • To assess reoperation rates for reinfection and functional outcomes.
  • To identify any adverse effects associated with povidone-iodine use.

Main Methods:

  • Retrospective review of 15 patients with septic shoulder arthritis.
  • Arthroscopic irrigation and débridement using a 0.35% povidone-iodine solution.
  • Assessment of functional outcomes, reoperation rates, and radiographic changes at a minimum 6-month follow-up.

Main Results:

  • A 0% reoperation rate for reinfection was observed, with one patient (6.7%) experiencing nonoperatively managed reinfection.
  • No adverse effects related to povidone-iodine were reported.
  • Radiographic progression of glenohumeral arthritis occurred in 26.7% of patients, correlating with worse functional outcomes.

Conclusions:

  • Arthroscopic débridement with 0.35% povidone-iodine irrigation is associated with a low reinfection reoperation rate in septic shoulder arthritis.
  • The procedure demonstrated an acceptable safety profile.
  • Further controlled studies are necessary to validate the safety and efficacy of this treatment modality.
Keywords:
Arthroscopic débridementIrrigationPovidone-iodineReoperation rateSeptic arthritisShoulder

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