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What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

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Abstract

Purpose

Controversy still exists as to the best surgical treatment for periprosthetic shoulder infections. The aim of this multi-institutional study was to review a continuous retrospective series of patients treated in four European centres and to assess the respective eradication rate of various treatment approaches.

Methods

Forty-four patients were available for this retrospective follow-up evaluation. Functional and clinical evaluation of treatment for infection was performed using the Constant-Murley score, visual analogue scale and patient satisfaction Neer score. Erythrocyte sedimentation rate, serum leucocyte count and C-reactive protein were measured and shoulder X-ray examination performed prior to surgery and at the latest follow-up.

Results

At a mean follow-up of 41 months (range 24–98), 42 of 44 patients (95.5%) showed no signs of infection recurrence/persistence. Comparable eradication rates were observed after resection arthroplasty (100%; 6/6), two-stage revision (17/17) or permanent antibiotic-loaded spacer implant (93.3%; 14/15). No patient was treated by one-stage revision. On average, both functional and pain scores improved significantly; the worst joint function was observed after resection arthroplasty.

Conclusions

This retrospective analysis conducted on the largest published series of patients to date shows comparable infection eradication rates after two-stage revision, resection arthroplasty or permanent spacer implant for the treatment of septic shoulder prosthesis.

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Competing interests

None of the authors has competing interests concerning the reported study.

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Authors and Affiliations

  1. Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4, Milano, 20161, Italy

    Carlo Luca Romanò & Lorenzo Monti

  2. Orthopaedic and Traumatologie Service, Septic Surgical Unit, Centre Hospitalier Universitaire Vaudois, Avenue Pierre Decker 4, Lausanne, 1011, Switzerland

    Olivier Borens

  3. Centro di Chirurgia Ortopedica Settica, Istituto Ortopedico G. Pini, Piazza Cardinal Ferrari, 1, Milano, 20122, Italy

    Enzo Meani

  4. Department of Orthopaedic Surgery, Leuven University, Oude Markt, 13, Leuven, 3000, Belgium

    Jose Stuyck

Authors
  1. Carlo Luca Romanò
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  2. Olivier Borens
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  3. Lorenzo Monti
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  4. Enzo Meani
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  5. Jose Stuyck
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Corresponding author

Correspondence to Carlo Luca Romanò.

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Romanò, C.L., Borens, O., Monti, L. et al. What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series. International Orthopaedics (SICOT) 36, 1011–1017 (2012). https://doi.org/10.1007/s00264-011-1467-4

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  • DOI: https://doi.org/10.1007/s00264-011-1467-4

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