Skip to main content

Advertisement

Log in

Arthroscopic debridement with continuous irrigation for septic arthritis of the shoulder joint

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Purpose

The purpose of this study was to investigate the outcome of arthroscopic debridement with continuous irrigation in patients with septic arthritis of the shoulder joint.

Methods

Ten patients (four men, six women) with septic arthritis of the shoulder joint were treated with a combination of arthroscopic debridement and continuous irrigation. All patients were followed for a minimum of 4 years. The average age was 61.7 years with a range of 25 to 86. The etiology of infection was determined to be a subacromial injection in six cases, EMG needle puncture in one, hematogenous in two, and unknown in one case. Causative bacteria, follow-up period, recurrence, shoulder pain, University of California, Los Angeles (UCLA) shoulder score, and radiographic findings were evaluated.

Result

Staphylococcus aureus was cultured in six cases, and Staphylococcus epidermidis, in four cases. The average follow-up period was 103.3 months with a range of 48 to 199. The infection was eradicated completely with a single arthroscopic debridement with continuous irrigation in nine patients. One patient required a second operation. In all patients, severe pain before operation improved. The average UCLA shoulder score increased from 5.7 points prior to the operation to a post-operation score of 26.4 points. In standard radiographic findings, five cases had aggravated osteoarthritis in the affected joint.

Conclusion

This study shows that arthroscopic debridement with continuous irrigation for septic arthritis of the shoulder joint improves shoulder pain, functional scores, and subjective outcome and prevents recurrence in many cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Le Dantec L, Maury F, Flipo RM, Laskri S, Cortet B, Duquesnoy B, Delcambre B (1996) Peripheral pyogenic arthritis. A study of one hundred seventy-nine cases. Rev Rhum Engl Ed 63:103–110

    PubMed  Google Scholar 

  2. Lossos IS, Yossepowitch O, Kandel L, Yardeni D, Arber N (1998) Septic arthritis of the glenohumeral joint: a report of 11 cases and review of the literature. Medicine 77:177–187

    Article  PubMed  CAS  Google Scholar 

  3. Leslie BM, Harris JM, Driscoll D (1989) Septic arthritis of the shoulder in adults. J Bone Joint Surg 71A:1516–1522

    Google Scholar 

  4. Gelberman RH, Menon J, Austerlitz MS, Weisman MH (1980) Pyogenic arthritis of shoulder in adults. J Bone Joint Surg 62A:550–553

    Google Scholar 

  5. Pfeiffenberger J, Meiss L (1996) Septic conditions of the shoulder an up-dating of treatment strategies. Arch Orthop Trauma Surg 115:325–331

    Article  PubMed  CAS  Google Scholar 

  6. Jeon IH, Choi C-H, Seo J-S, Seo K-J, Ko S-H, Park J-Y (2006) Arthroscopic management of septic arthritis of the shoulder joint. J Bone Joint Surg 88A:1802–1806. doi:10.2106/JBJS.E.00917

    Article  Google Scholar 

  7. Vispo Seara JL, Barthel T, Schmitz H, Eulert J (2002) Arthroscopic treatment of septic joints: prognostic factors. Arch Orthop Trauma Surg 122:204–211. doi:10.1007/s00402-001-0386-z

    Article  PubMed  CAS  Google Scholar 

  8. Stutz G, Kuster MS, Kleinstuck F, Gächter A (2000) Arthroscopic management of septic arthritis: stages of infection and results. Knee Surg Sports Traumatol Arthrosc 8:270–274. doi:10.1007/s001670000129

    Article  PubMed  CAS  Google Scholar 

  9. Iulian N, Majid KAJ, Elliott GP (2006) Arthroscopic treatment of septic arthritis of the hip. Arthroscopy 22:902.e1–3. doi:10.1016/j.arthro.2005.12.057

    Article  Google Scholar 

  10. Omer AI, Ghassan AAH, James RB, Hugh ST, Michael HH (2005) Arthroscopic debridement of acute periprosthetic septic arthritis of the knee. Arthroscopy 21:303–306. doi:10.1016/j.arthro.2004.10.010

    Article  Google Scholar 

  11. Oizumi N, Suenaga N, Fukuda K, Minami A (2007) Massive rotator cuff tears repaired on top of humeral head by McLaughlin’s procedure. J Shoulder Elbow Surg 16:321–326. doi:10.1016/j.jse.2006.08.004

    Article  PubMed  Google Scholar 

  12. Gächter A (1985) Der Gelenkinfekt. Inf Arzt 6:35–43

    Google Scholar 

  13. Bremell T, Abdelnour A, Tarkowski A (1992) Histopathological and serological progression of experimental Staphylococcus aureus arthritis. Infect Immun 60:2976–2985

    PubMed  CAS  Google Scholar 

  14. Tsumura H, Ikeda S, Ono T, Itonaga I, Taira H, Torisu T (2005) Synovectomy, debridement, and continuous irrigation for infected total knee arthroplasty. Int Orthop 29:113–116. doi:10.1007/s00264-004-0626-2

    Article  PubMed  Google Scholar 

  15. Mont MA, Waldman B, Baneree C, Pacheco IH, Hungerford DS (1997) Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty. J Arthroplasty 12:426–433

    Article  PubMed  CAS  Google Scholar 

  16. Polzhofer GK, Hassenpflug J, Petersen W (2004) Arthroscopic treatment of septic arthritis in a patient with posterior stabilized total knee arthroplasty. Arthroscopy 20:311–333. doi:10.1016/j.arthro.2003.11.039

    Article  PubMed  Google Scholar 

  17. Mastrokalos DS, Zahos KA, Korres D, Soucacos PN (2006) Arthroscopic debridement and irrigation of periprosthetic total elbow infection. Arthroscopy 22:1140.e1–3. doi:10.1016/j.arthro.2005.06.037

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomoya Matsuhashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsuhashi, T., Suenaga, N., Oizumi, N. et al. Arthroscopic debridement with continuous irrigation for septic arthritis of the shoulder joint. Eur Orthop Traumatol 2, 87–92 (2011). https://doi.org/10.1007/s12570-011-0062-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12570-011-0062-x

Keywords

Navigation