Two-stage revision of infected shoulder arthroplasty using prosthesis of antibiotic-loaded acrylic cement: minimum three-year follow-up

Lee, Sung Hyun; Kim, Se Jin; Kook, Seng Hwan; Kim, Jeong Woo

doi:10.1007/s00264-017-3699-4

Cited by 15 publications

(9 citation statements)

References 27 publications

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“…A total of 712 studies were found through the electronic search and 14 studies were added after cross-referenced research on the bibliography of the examined full-text articles. After a preliminary analysis, a total of 24 studies were included in this systematic review [13][14][15][16][17][18][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] (Table 2, Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen series reported on shoulder PJI treated with two-stage protocol, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] 4 studies reported on shoulder PJI treated with single-stage protocol, [13][14][15][16] while in two series both series of single-and two-stages protocols were reported. 17,18 Five studied were retrospective comparative cohort studies, 14,18,34,36,37 19 studies were retrospective case series.…”

Section: Resultsmentioning

confidence: 99%

“…17,18 Five studied were retrospective comparative cohort studies, 14,18,34,36,37 19 studies were retrospective case series. 13,[15][16][17][25][26][27][28][29][30][31][32][33]35,[38][39][40][41][42] The overall quality of the series assessed via IHE checklist resulted high [3][4][5][6][7][8][26][27][28][29][30][31][32][33][34]36,42 or moderate 25,35,[37][38][39][40][41] in all the cases (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Q20: were both competing interests and sources of support for the study reported? With respect to the two-stage protocol, the repetition of the first stage (implant removal, surgical debridement, and insertion of an antibiotic spacer) and the number of spacers used was reported in 10 studies [26][27][28][29]31,33,34,36,39,42 : 15 out of 194 patients analyzed (7.7%) required the use of more than one spacer during treatment (Table 3).…”

Section: Resultsmentioning

confidence: 99%

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Management of periprosthetic joint infection of shoulder arthroplasty: Single-stage versus two-stage protocols. A systematic review and meta-analysis of the literature

et al. 2022

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Background The treatment of shoulder prosthetic joint infections (PJIs) requiring removal of the prosthesis is not well defined. This article aims to systematically review and compare the results of the literature in single-stage and two-stage protocols in the treatment of shoulder PJI. Methods An in-depth search on PubMed/Scopus/Web of Science databases and cross-referencing search was carried out concerning the articles reporting detailed data on the topic. Results A total of 486 shoulder PJIs were included: 137 treated with single-stage and 349 with two-stage procedure. A similar distribution between early and not-early infections (19.1% vs 80.9%) was found between the two groups. The overall rate of success in terms of PJI eradication was significantly higher in the single-stage group (95.6% vs 85.7%, p < 0.001). The non-infection-related complications rate was 13.8% in the single-stage group and 37.6% in the two-stage group ( p < 0.001), the non-infection-related revision rate was 8% and 18.9%, respectively ( p = 0.005). Discussion The single-phase protocol showed a higher success rate in eradicating the infection and a lower complication rate. However, the low number of patients included, the low quality of the articles, the lack of data on clinical severity and bacteriological virulence suggest caution in conclusions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Management of periprosthetic joint infection of shoulder arthroplasty: Single-stage versus two-stage protocols. A systematic review and meta-analysis of the literature

et al. 2022

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“…The incidence of PSI after primary shoulder arthroplasty is estimated to be 1 to 5%, depending on the study; after revision surgery, however, the incidence can reach 15% [49, 55]. Operative approaches including debridement, antibiotics, and implant retention (DAIR) and one- and two-stage revision surgery have been used over the years, but the debate over which is the best for managing this disabling condition is still open [10, 27, 28].…”

Section: Introductionmentioning

confidence: 99%

Permanent Spacers Are a Reliable Solution for Peri-prosthetic Shoulder Infection: A Systematic Review

et al. 2020

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Background: Peri-prosthetic shoulder infection (PSI), a highly disabling complication of shoulder arthroplasty, often requires additional surgery and prolonged antibiotic therapy. Of strategies proposed to manage this devastating condition, the use of cement spacers, perhaps even as a definitive treatment, is debated. Questions/ Purposes: We sought to systematically review the literature on antibiotic-loaded cement spacers as a viable, perhaps definitive, treatment for PSI, evaluating the eradication rates, mechanical reliability, and functional results related to its use. Methods: We conducted a systematic review of studies published from January 1, 1980, through September 1, 2019. Following the Cochrane Handbook of Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-analysis, we searched for studies reporting functional and clinical outcomes in patients with PSI treated with a permanent spacer of the shoulder. Two independent reviewers searched eight databases, as well as reference lists of the retrieved articles. Results: After exclusion criteria were applied, 12 studies were included, involving a total of 143 patients. The mean age was 65.8 years; the mean follow-up was 37.4 months. A total of 133 patients (93%) were free from infection at latest follow-up. The mean postoperative active elevation of the shoulder ranged from 48.6 to 90°, the mean abduction ranged from 51 to 75°, and external rotation ranged from 3.6 to 29°. The mean Constant-Murley score ranged from 20.6 to 42 points (out of 100, from worst to best). Conclusion: The use of a permanent cement spacer is a reliable solution to PSI in low-demand, older patients with comorbidities, a population in whom it is desirable to avoid additional surgery. Our review found a high rate of infection eradication and moderate-to-good objective and subjective results. However, the overall level of evidence of included studies was very low, and higher-quality studies are needed to clarify the role of permanent spacers in the treatment of PSI.

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Incidence, Complications and Novel Treatment Strategies: Joint Arthroplasty

Simpson

2022

Musculoskeletal Infection

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Two-stage revision of infected shoulder arthroplasty using prosthesis of antibiotic-loaded acrylic cement: minimum three-year follow-up

Cited by 15 publications

References 27 publications

Management of periprosthetic joint infection of shoulder arthroplasty: Single-stage versus two-stage protocols. A systematic review and meta-analysis of the literature

Management of periprosthetic joint infection of shoulder arthroplasty: Single-stage versus two-stage protocols. A systematic review and meta-analysis of the literature

Permanent Spacers Are a Reliable Solution for Peri-prosthetic Shoulder Infection: A Systematic Review

Incidence, Complications and Novel Treatment Strategies: Joint Arthroplasty

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