Treatment strategies for infection after reverse shoulder arthroplasty

Ortmaier, Reinhold; Resch, Herbert; Hitzl, Wolfgang; Mayer, Michaël; Stundner, Ottokar; Tauber, Mark

doi:10.1007/s00590-013-1251-9

Cited by 55 publications

(44 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Prior reports have differed in the recommendation of 1-stage vs. 2-stage surgery for chronic infection because of the potential for bone loss with component removal. 2,23,30 In our series, both patients had presented late (>6 months), and we believe that a formal 2-stage exchange is necessary for full eradication of the infecting organism in these chronic situations. Outcomes experienced after reimplantation were fair and similar to the rest of our cohort.…”

Section: Discussionmentioning

confidence: 91%

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

Black

Roberts

Siegel

et al. 2015

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 91%

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

Black

Roberts

Siegel

et al. 2015

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

“…Periprosthetic joint infection (PJI) is a devastating complication following hemiarthroplasty and total arthroplasty of the shoulder. It complicates 0 to 3.9 % of primary anatomical shoulder arthroplasty [ 1 – 3 ], and 2 to 18.8 % of reverse shoulder arthroplasty [ 4 – 6 ]. The surgical management of such cases is varied and includes either a single- or two-stage exchange arthroplasty [ 7 , 8 ], resection arthroplasty with or without a permanent spacer [ 9 , 10 ], arthroscopic lavage or open debridement with implant retention [ 11 ], arthrodesis [ 12 ] or amputation [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Does exchange arthroplasty of an infected shoulder prosthesis provide better eradication rate and better functional outcome, compared to a permanent spacer or resection arthroplasty? a systematic review

George

Volpin

Scarponi

et al. 2016

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundThe best surgical modality for treating chronic periprosthetic shoulder infections has not been established, with a lack of randomised comparative studies. This systematic review compares the infection eradication rate and functional outcomes after single- or two-stage shoulder exchange arthroplasty, to permanent spacer implant or resection arthroplasty.MethodsFull-text papers and those with an abstract in English published from January 2000 to June 2014, identified through international databases, such as EMBASE and PubMed, were reviewed. Those reporting the success rate of infection eradication after a single-stage exchange, two-stage exchange, resection arthroplasty or permanent spacer implant, with a minimum follow-up of 6 months and sample size of 5 patients were included.ResultsEight original articles reporting the results after resection arthroplasty (n = 83), 6 on single-stage exchange (n = 75), 13 on two-stage exchange (n = 142) and 8 papers on permanent spacer (n = 68) were included.The average infection eradication rate was 86.7 % at a mean follow-up of 39.8 months (SD 20.8) after resection arthroplasty, 94.7 % at 46.8 months (SD 17.6) after a single-stage exchange, 90.8 % at 37.9 months (SD 12.8) after two-stage exchange, and 95.6 % at 31.0 months (SD 9.8) following a permanent spacer implant. The difference was not statistically significant (p = 0.650).Regarding functional outcome, patients treated with single-stage exchange had statistically significant better postoperative Constant scores (mean 51, SD 13) than patients undergoing a two-stage exchange (mean 44, SD 9), resection arthroplasty (mean 32, SD 7) or a permanent spacer implant (mean 31, SD 9) (p = 0.029). However, when considering studies comparing pre- and post-operative Constant scores, the difference was not statistically significant.ConclusionThis systematic review failed to demonstrate a clear difference in infection eradication and functional improvement between all four treatment modalities for established periprosthetic shoulder infection. The relatively low number of patients and the methodological limitations of the studies available point out the need for well designed multi-center trials to further assess the best treatment option of peri-prosthetic shoulder infection.

show abstract

“…8 La principal complicación postoperatoria es la persistencia de infección, que puede alcanzar hasta el 33% en alguna serie 14 aunque es muy raro que esos pacientes requieran nuevas intervenciones. 13,18 Los resultados en cuanto a la remisión de la infección y mejoría del dolor son muy satisfactorios, llegando a tasas de curación de entre 70-100% 7,8,13,14,18,[22][23][24][25][26] (►Tabla 1) y mejoría del dolor de alrededor de 4-5 puntos en las escala VAS 8,20 a costa de una pobre funcionalidad con un Constant de alrededor de 30 puntos. 5 Eso se cumple también en nuestros casos ya que ambos estaban libres de enfermedad, mejoraron entre 4-6 puntos en la VAS y el Constant era bajo, aunque algo más alto que en otros estudios.…”

Section: Discussionunclassified

Artroplastia de resección de hombro como salvamento para infecciones recalcitrantes. Estado actual de la técnica a propósito de dos casos

Arbeloa-Gutierrez¹,

Arenas-Miquelez

2020

Revista Chilena de Ortopedia y Traumatología

View full text Add to dashboard Cite

Resumen Introducción y Objetivos La artroplastia de resección de hombro (ARH) se presenta como una técnica obsoleta y una opción no válida en la actualidad, debido a la evolución de las técnicas quirúrgicas y de los implantes. Pero, como consecuencia del aumento exponencial del uso de artroplastias de hombro, están aumentando en paralelo el número de fracasos e infecciones, con necesidad de revisión y rescate. Es por ello que, en determinadas situaciones y pacientes, esa técnica vuelve a ser una opción necesaria como salvataje, aunque tiene un alto coste funcional. El objetivo de nuestro trabajo, es presentar dos casos de artroplastia de resección de hombro como una opción válida de tratamiento en la actualidad y la revisión de la literatura. Casos Se presentan dos casos de ARH como tratamiento de rescate, en un caso de osteomielitis crónica de cabeza humeral y un caso de infección de hemiartroplastia de hombro. Ambos pacientes se encontraban sin dolor y libres de infección con un seguimiento de más de 30 meses. En un caso la funcionalidad fue limitada con un Constant de 45 pero el otro caso la funcionalidad fue aceptable con un Constant de 67. Conclusiones La ARH sigue siendo una técnica útil tras el fracaso de procedimientos de revisión, para resolver infecciones protésicas recalcitrantes u osteomielitis. Los resultados funcionales son pobres, por lo que debe reservarse para pacientes con baja demanda funcional y como salvataje, tras agotar otras opciones.

show abstract

Treatment strategies for infection after reverse shoulder arthroplasty

Abstract: The relatively high patient satisfaction can be explained by the low pain level once the patient is free from infection. However, functional results are poor in most cases, and this possible outcome must be discussed with the patient in the preoperative setting.

Cited by 55 publications

References 35 publications

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

Does exchange arthroplasty of an infected shoulder prosthesis provide better eradication rate and better functional outcome, compared to a permanent spacer or resection arthroplasty? a systematic review

Artroplastia de resección de hombro como salvamento para infecciones recalcitrantes. Estado actual de la técnica a propósito de dos casos

Contact Info

Product

Resources

About