Outcomes of revision arthroplasty for shoulder periprosthetic joint infection: a three-stage revision protocol

This study evaluated outcomes after treatment of shoulder periprosthetic joint infection (PJI) with a 3-stage revision protocol consisting of (1) débridement, explantation, and cement spacer placement, followed by parenteral antibiotics; (2) open biopsy and débridement; and (3) reimplantation if cul...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2019-02, Vol.28 (2), p.268-275
Main Authors: Tseng, Wo-Jan, Lansdown, Drew A., Grace, Trevor, Zhang, Alan L., Feeley, Brian T., Hung, Li-Wei, Ma, C. Benjamin
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Arthroplasty, Replacement, Shoulder
Biopsy
Debridement
Device Removal
Female
Follow-Up Studies
functional outcome
Hemiarthroplasty
Humans
Male
Middle Aged
Patient Reported Outcome Measures
patient-reported outcome
Prosthesis Implantation
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - surgery
Range of Motion, Articular
Reoperation - methods
Retrospective Studies
reverse total shoulder arthroplasty
Shoulder Joint - microbiology
Shoulder Joint - pathology
Shoulder Joint - physiopathology
Shoulder periprosthetic infection
three-stage protocol
Treatment Outcome
visual analog scale
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Summary:This study evaluated outcomes after treatment of shoulder periprosthetic joint infection (PJI) with a 3-stage revision protocol consisting of (1) débridement, explantation, and cement spacer placement, followed by parenteral antibiotics; (2) open biopsy and débridement; and (3) reimplantation if cultures were negative. We hypothesized this protocol would eradicate persistent infection while producing excellent functional and subjective outcomes, and there would be no difference in these parameters for patients with shoulder PJI compared with patients with revision for aseptic indications. We retrospectively analyzed a prospectively collected revision shoulder arthroplasty cohort to identify shoulder PJI patients treated with a 3-stage protocol. Demographics, culture data, range of motion, and patient-reported outcomes were collected. Outcomes for patients with shoulder PJI and revision to RTSA were compared with patients revised to RTSA for noninfectious indications. Significance was defined as P 
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2018.07.014