Background: Periprosthetic shoulder infection (PSI) is one of the most challenging complications after shoulder arthroplasty. Different treatments have been proposed, but the best surgical procedure remains disputed in the current literature. This systematic review investigated the outcomes of revision surgery after PSI.
Methods: The PubMed and Scopus databases were used to search keywords in April 2018. Of 2157 titles, 34 studies were finally analyzed. Demographics, laboratory and microbiological data, types of implants, surgical techniques with complications and reoperations, eradication rates, and clinical and functional outcomes were reported.
Results: A total of 754 patients were identified. Cutibacterium acnes (C. acnes) was the most common microorganism found both in PSI (33%) and persistent infections (40%). Preoperatively, C-reactive protein was elevated in 70% of patients with PSI. Reverse shoulder arthroplasty had a lower prevalence of infection (P < .001). The eradication rate was 96% with 1 stage, 93% with permanent spacers, 86% with 2 stages, 85% with resection arthroplasty, and 65% with irrigation and débridement. One-stage revision was the best treatment, considering postoperative flexion and abduction, compared with resection arthroplasty, permanent spacers, and 2-stage revision. One-stage revision showed fewer postoperative complications than irrigation and débridement, resection arthroplasty, and 2-stage surgery. Two-stage surgery was the most common treatment, and the functional score demonstrated no differences between 2-stage and 1-stage procedures.
Conclusions: Our review suggests that a 1-stage procedure should be recommended to treat PSI. Two-stage revision could be reserved for select cases in which the bacterium involved is unknown.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jse.2019.02.014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Characteristics of Resection Parameters in Robot-Assisted Total Knee Arthroplasty With the Ligament Balancing Workflow.
Orthop Surg
January 2025
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China.
Objective: Robotic-assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic-assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic-assisted TKA.
View Article and Find Full Text PDFIn functionally aligned total knee arthroplasty, femoral component rotation follows the transepicondylar axis to achieve flexion balance.
Knee Surg Sports Traumatol Arthrosc
January 2025
Clinical Research Department, Sydney Knee Specialists, Kogarah, New South Wales, Australia.
Purpose: In functionally aligned (FA) total knee arthroplasty (TKA), femoral component rotation (FCR) is personalised to optimise flexion gap balance. As axial malalignment has been attributed to patellofemoral complications, this study assessed FA FCR in relation to the surgical transepicondylar axis (TEA) and early implant survivorship.
Methods: We analysed 446 robotic-assisted primary TKAs in 393 patients using FA with preresection gap balancing.
Measure Subtrochanteric Osteotomy in Unilateral Crowe-IV Dysplasia-Surgical Technique.
Orthop Surg
January 2025
Department of Orthopedic Surgery, The General Hospital of the People's Liberation Army, Beijing, China.
Objective: Determining the optimal osteotomy length for patients with unilateral Crowe-IV developmental dysplasia of the hip undergoing subtrochanteric osteotomy remains challenging due to the significant variability in pelvic and spinal alignment. Incorrect osteotomy length, compounded by pelvic or spinal tilt, can adversely affect postoperative gait and long-term outcomes. Therefore, this study could introduce a method to calculate the osteotomy length for patients with unilateral Crowe-IV developmental dysplasia of the hip, correcting spinal and pelvic tilt, and improving patient gait.
View Article and Find Full Text PDFSafety of vancomycin-loaded cement spacers for treating gram-positive periprosthetic joint infections in two-stage resection arthroplasty among patients with renal insufficiency.
BMC Musculoskelet Disord
January 2025
Institute of Statistics, National Yang Ming Chiao Tung University, 1001 University Road, Hsinchu City, 300, Taiwan.
Background: The standard treatment for periprosthetic joint infections (PJI) typically involves a two-stage resection arthroplasty using antibiotic-loaded bone cement (ALBC) spacers. This study hypothesizes that there is no significant correlation between antibiotic levels in blood and synovial fluid and the patient's kidney function, and that the success rates of staged resection arthroplasty are comparable between groups, specifically targeting gram-positive bacterial infections.
Methods: This retrospective review included patients treated from 2017 to 2022 with two-stage arthroplasty using vancomycin-loaded ALBC spacers, selectively targeting gram-positive infections.
Design Rational for Total Ankle Arthroplasty: An Update.
J Am Acad Orthop Surg
November 2024
From the Medical University of South Carolina, Charleston, SC (Gross and Scott), the University of California Irvine, Orange, CA (Hsu), and the Palomar Health Medical Group, San Diego, CA (Palanca).
The design of total ankle arthroplasty (TAA) systems is rapidly evolving as device companies try to keep pace with the expansion of surgical indications and a refinement of techniques for TAA. Even since the publication of the latest "update," published in 2018, three new designs and three updates on preexisting third-generation implants came onto the market. Improvements in third-generation TAA systems include minimal bone resection, retaining ligamentous support, and anatomic balancing.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!