Treatment of Deep Infection after Total Shoulder Arthroplasty with an Antibiotic-Impregnated Cement Spacer

Gorman, Matthew T.; Crosby, Lynn A.

doi:10.1097/00132589-200606000-00002

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…The eradication rate following permanent cement spacer was 66% 64 -100%. 21,27,35,37,47,49,50,58,61,71,74 Function was most commonly assessed using the Constant score which ranged from 26 74 to 57. 21 Three systematic reviews reported the average eradication rates between 90% and 95.6% [9][10][11] with average constant scores of 31-32 in the third.…”

Section: Surgical Management Of Psimentioning

confidence: 99%

Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty

et al. 2018

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Background: The aim of this scoping review is to assess the current evidence regarding periprosthetic shoulder infection to inform development of evidence and consensus-based guidelines. Methods: A search of Medline, Embase and PubMed was performed; two authors screened the results independently for inclusion. Results: Totally 88 studies were included. Incidence of periprosthetic shoulder infection ranged from 0.7% to 7%. The most common organisms to cause periprosthetic shoulder infection were Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and coagulase-negative Staphylococcus. Male gender and younger age are the most reported risk factors. Erythrocyte sedimentation rate, C-reactive protein and serum/synovial biomarkers had limited diagnostic accuracy. Thirty-nine studies reported the outcome of surgical management of periprosthetic shoulder infection. Eradication rates vary from 54% to 100% for debridement procedures; 66-100% for permanent spacers; 50-100% following single-stage revision; 60-100% following two-stage revision; and 66-100% following resection arthroplasty. Conclusion: There is wide heterogeneity in study designs and outcomes of studies are often contradictory and due to issues with methodology and small sample sizes the optimal pathways for diagnosis and management cannot be determined from this review. Future research should be based on larger cohorts and randomised trials where feasible to provide more valid research for guiding future treatment of periprosthetic shoulder infection.

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Section: Surgical Management Of Psimentioning

confidence: 99%

Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty

et al. 2018

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“…Infection recurrence rates have been reported to range from 0% to 30% 65,68,72,73,75,76 . Crosby et al demonstrated that surgeon-constructed and commercially available articulating cement spacers impregnated with vancomycin alone or in combination with an aminoglycoside are both effective treatment techniques [77][78][79] . Articulating antibiotic cement spacers allow for the preservation of a soft-tissue envelope and can often act as the definitive implant in a patient with minimal functional demands 80 .…”

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Periprosthetic Shoulder Infections

Mook

Garrigues

2014

The Journal of Bone and Joint Surgery

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➤ The unique bacterial flora of the shoulder present diagnostic and treatment challenges that are distinct from those seen with failed hip and knee arthroplasties.➤ The presentation, diagnosis, and management of suppurative periprosthetic joint infections of the shoulder are similar to those of the hip and the knee.➤ Failed arthroplasties with positive cultures (FAPCs) are poorly performing shoulder reconstructions associated with low-virulence microorganisms that do not evoke a suppurative inflammatory response. Propionibacterium acnes is the predominant bacterium isolated from these cases.➤ With improved surgeon awareness and the addition of longer tissue-culture incubation times, detection of FAPCs has become more common. However, management is hampered by the lack of reliable, timely tests that can determine the presence of less virulent organisms in the preoperative or intraoperative settings.➤ The implications of positive culture results in FAPCs are unclear. Key test characteristics such as the false-positive rate and the prevalence of positive cultures in well-performing shoulders are unknown as there is no useful confirmatory test to validate the culture data and no reliable way to detect the presence of less virulent microorganisms without reoperation.➤ Soft-tissue and osseous deficits are frequently encountered when revising previously infected shoulders. The rate of complications in these scenarios is high, and the outcomes are the least favorable compared with revisions for any other indication.➤ The development of a consensus definition of a periprosthetic shoulder infection is critical to future investigations of these devastating complications.

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“…22,24 Treatment of an infected shoulder arthroplasty with an intraoperatively crafted antibiotic-impregnated cement spacer has been reported to be effective in eradicating infection. 10 This article reports our experience treating infected shoulder arthroplasty and primary shoulder sepsis using a commercially produced antibioticimpregnated cement spacer.…”

mentioning

confidence: 99%

“…,4,10,13,17,[22][23][24] Several authors have reported successful eradication of deep infection using 2-stage revision with an articulating interval antibiotic-impregnated cement spacer 10,13,22,23. …”

mentioning

confidence: 99%

Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

Coffey

Ely

Crosby

2010

Journal of Shoulder and Elbow Surgery

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Treatment of Deep Infection after Total Shoulder Arthroplasty with an Antibiotic-Impregnated Cement Spacer

Cited by 11 publications

References 5 publications

Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty

Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty

Diagnosis and Management of Periprosthetic Shoulder Infections

Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

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