Clinical Orthopaedics and Related Research®

, Volume 469, Issue 9, pp 2538–2543 | Cite as

Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

  • Vani J. Sabesan
  • Jason C. Ho
  • David Kovacevic
  • Joseph P. Iannotti
Symposium: Reverse Total Shoulder Arthroplasty



Two-stage reimplantation for prosthetic joint infection reportedly has the lowest risk for recurrent infection. Most studies to date have evaluated revision surgery for infection using an anatomic prosthetic. As compared with anatomic prostheses, reverse total shoulder arthroplasty is reported to have a higher rate of infection.


We determined reinfection rates, functional improvement, types and rates of complications, and influence of rotator cuff tissue on function for two-stage reimplantation for prosthetic joint infection treated with reverse shoulder arthroplasty.

Patients and Methods

We retrospectively reviewed 27 patients treated with a two-stage reimplantation for prosthetic shoulder infection using a uniform protocol for management of infection; of these, 17 had reverse shoulder arthroplasty at second-stage surgery. Types of organisms cultured, recurrence rates, complications, function, and radiographic followup were reviewed for all patients.


One of the 17 patients had recurrence of infection. The mean (± SD) Penn shoulder scores for patients treated with reverse shoulder arthroplasty improved from 24.9 ± 22.3 to 66.4 ± 20.8. The average motion at last followup was 123° ± 33° of forward flexion and 26° ± 8° of external rotation in patients treated with a reverse shoulder arthroplasty. The major complication rate was 35% in reverse shoulder arthroplasty, with five dislocations and one reinfection. There was no difference in final Penn score between patients with and without external rotation weakness.


Shoulder function and pain improved in patients treated with a second-stage reimplantation of a reverse prosthesis and the reinfection rate was low.

Level of Evidence

Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.


Rotator Cuff Shoulder Arthroplasty Prosthetic Joint Infection Reverse Shoulder Arthroplasty Reverse Total Shoulder Arthroplasty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Vani J. Sabesan
    • 1
  • Jason C. Ho
    • 2
  • David Kovacevic
    • 1
  • Joseph P. Iannotti
    • 1
    • 2
  1. 1.Department of Orthopedic Surgery, A-41The Cleveland Clinic FoundationClevelandUSA
  2. 2.Cleveland Clinic Lerner College of Medicine, Case Western Reserve UniversityClevelandUSA

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