Friday, May 14, 2021

Periprosthetic shoulder infection after reverse shoulder arthroplasty

Management of periprosthetic infection after reverse shoulder arthroplasty.

These authors reviewed 36 patients with a chronic periprosthetic shoulder infection after a reverse shoulder arthroplasty. Surgical treatment included d├ębridement and implant retention (n=6); 1-stage revision (n=1); 2-stage revision (n=16); multiple stage revisions (> 2 stages) (n=7); definitive spacer (n=2) and resection arthroplasty (n=4). The most common causative pathogens were Staphylococcus epidermidis (n=11) and Cutibacterium acnes (n=9). 

All four patients having a recurrent infection had been initially treated with d├ębridement and implant retention.

As a result of their analysis of this small series, the authors suggest that patients with chronic periprosthetic infection of a reverse total shoulder should be treated with implant exchange. 

This view is supported by the observation that chronic periprosthetic infections are associated with a biofilm on the implant (especially titanium alloy). In that antibiotics do not penetrate the biofilm easily, removal of the implant is needed to resolve the infection.

Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The total shoulder arthroplasty (see this link).
The ream and run technique is shown in this link.
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).