These authors review some of the important concepts regarding infections around shoulder arthroplasty components. Even though the recognized incidence of this complication is relatively low there is evidence that many infections are overlooked because (1) their manifestations may be subtle, presenting only as pain, stiffness or component loosening without the classical signs of inflammation and (2) some infections, such as those with Propionibacterium, require special approaches of specimen harvest and culture methods to establish the diagnosis. In this regard periprosthetic shoulder infections often differ from those of hip and knee arthroplasty - thus the guidelines for diagnosis and treatment of periprosthetic joint infections of the hip and knee are often not applicable to the shoulder (i.e. CBC, Sedimentation rate, C-reactive protein, joint aspiration for culture, and intraoperative frozen sections are often insensitive to the presence of Propionibacterium.
An evidence-based approach to culturing these organisms is shown here.
Because the diagnosis of periprosthetic infection may not become evident until cultures become positive weeks after the surgical revision, antibiotic therapy for suspected infection after operative intervention should be considered to avoid delay in treatment and re-colonization of the revised arthroplasty.
Risk factors have been identified: male gender, humeral osteolysis, humeral component loosening, glenoid wear, cloudy joint fluid and the formation of a membrane between the humeral component and the humeral bone each significantly increased the chances of a positive culture for Propionibacterium.
Because the diagnosis of periprosthetic infection may not become evident until cultures become positive weeks after the surgical revision, antibiotic therapy for suspected infection after operative intervention should be considered to avoid delay in treatment and re-colonization of the revised arthroplasty.
Risk factors have been identified: male gender, humeral osteolysis, humeral component loosening, glenoid wear, cloudy joint fluid and the formation of a membrane between the humeral component and the humeral bone each significantly increased the chances of a positive culture for Propionibacterium.
Our current management of possibly infected shoulders is described here.
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Consultation for those who live a distance away from Seattle.
Check out the new Shoulder Arthritis Book - click here.
Click here to see the new Rotator Cuff Book
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
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===
Consultation for those who live a distance away from Seattle.
Check out the new Shoulder Arthritis Book - click here.
Click here to see the new Rotator Cuff Book
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
To see other similar posts, click on the label of interest below.
