Arthroscopy of the symptomatic shoulder arthroplasty

Doherty, Ciaran; Furness, N; Batten, Timothy; White, William J.; Kitson, J.; Smith, Christopher D.

doi:10.1016/j.jse.2019.02.027

Cited by 17 publications

(12 citation statements)

References 36 publications

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“…The value of shoulder arthroscopy for diagnostic purposes, especially to rule out infection or mechanical issues, has already been proven for anatomic shoulder arthroplasty. 2,3,7 Other reports showed that arthroscopy also helps to achieve successful therapeutic intervention in complications related to anatomic shoulder arthroplasty. O'Driscoll et al 8 reported 5 cases of removal of loosened glenoid component, and Abildgaard et al 9 also reported 1 case, associated with bone grafting and patch augmentation for glenoid osseous defect.…”

Section: Discussionmentioning

confidence: 99%

“…Garberina and Williams 5 reported for the first time the value of diagnostic shoulder arthroscopy in RSA disclosing a polyethylene dissociation that helped to make the decision of performing revision surgery. Akgün et al 2 and Doherty et al 3 reported recently series showing the advantage of arthroscopy in evaluating and making diagnosis of infected shoulder arthroplasties, despite only 1 and 2 cases of RSA respectively being included in these reports, and there was a lack of technical information. The first Technical Note related to therapeutic use of arthroscopy on RSA showed that the technique could facilitate the reduction of chronically dislocated shoulder prosthesis, thus avoiding open surgery.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Arthroscopy has successfully been used to treat stiffness affecting prosthesis in different joints, such as the knee, 1 as well as different complications of shoulder arthroplasty. [2][3][4][5] However, the arthroscopic technique to examine the RSA and to perform a standardized arthroscopic articular release technique has not yet been reported. The purpose of this Technical Note is to describe an arthroscopic technique of complete RSA examination aimed to identify potential causes of RSA stiffness and to perform a subsequent circumferential release of the prosthetic shoulder joint (Video 1).…”

Section: Introduction (With Video Illustration)mentioning

confidence: 99%

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Arthroscopic Circumferential Release for Stiff Reverse Total Shoulder Arthroplasty

Aguilar-González

Luengo-Alonso

Calvo

2020

Arthroscopy Techniques

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Stiffness is a well-known complication after reverse shoulder arthroplasty. Although multiple factors may be involved, the main cause for stiffness is rarely identified. Imaging studies frequently are inconclusive in ruling out mechanical or biological causes. Periprosthetic infection should be always suspected, but the absence of major clinical signs and accurate diagnostic tests is frequent. A lack of objective criteria establishing a diagnosis and when to proceed with revision surgery is often present in such cases. Moreover, additional surgical procedures should be carefully evaluated, as they can represent a point of no return. Shoulder arthroscopy plays an increasingly important role in these cases, either as a diagnostic or therapeutic tool. There are no reports about arthroscopy on stiffness after reverse shoulder arthroplasty. In this Technical Note, we describe an arthroscopic technique aimed to identify potential causes of reverse shoulder arthroplasty stiffness. Subsequent circumferential release is described and discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introduction (With Video Illustration)mentioning

confidence: 99%

See 2 more Smart Citations

Arthroscopic Circumferential Release for Stiff Reverse Total Shoulder Arthroplasty

Aguilar-González

Luengo-Alonso

Calvo

2020

Arthroscopy Techniques

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“…40,41 Other patients may simply just present with increased pain and stiffness. 2,42,43 In the context of such implant-related pain, any early radiological loosening suggests infection, although, in many cases, imaging shows no signs of loosening. 43 The mainstay of diagnosis of a shoulder joint infection is arthroscopic biopsy tissue samples.…”

Section: Identification Of Infected Joints?mentioning

confidence: 99%

The management of the shoulder skin microbiome (Cutibacterium acnes) in the context of shoulder surgery: a review of the current literature

et al. 2020

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Background This review aims to establish current knowledge of the shoulder skin microbiome and how to manage the bacteria that reside within it. Methods A review was undertaken of the current literature through OvidSP. All abstracts were reviewed by three independent researchers. Results Thirty-five studies met the inclusion criteria. With forward referencing an additional 14 were included. None commented on organisms specific to the shoulder microbiome other than Cutibacterium acnes. Therefore, this review is focussed on the current knowledge of C. acnes. Discussion C. acnes is a skin commensal within the pilo-sebaceous glands reported to be the primary pathogen in up to 86% of shoulder joint infections. Pre-operative culture of unprepared skin can be indicative of underlying joint infection in shoulder arthroplasty revision. Intra-articular biopsies may have a high false positive due to skin contamination. Correlating the number of positive samples and certain associated signs can give a greater than 90% probability of a true infection. Standard surgical skin preparation, peri-surgical intravenous antibiotics and oral pre-operative antibiotics do not reduce bacterial load within the skin. However, topical benzoyl peroxide and clindamycin have both demonstrated significantly reduced bacteria load. Phylogenetically there are six main types. Patients may have more than one phenotype present during infection.

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