Outcomes of revision arthroplasty for shoulder periprosthetic joint infection: a three-stage revision protocol
Autor: | Brian T. Feeley, Li-Wei Hung, Wo-Jan Tseng, Trevor R. Grace, Alan L. Zhang, C. Benjamin Ma, Drew A. Lansdown |
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Rok vydání: | 2018 |
Předmět: |
musculoskeletal diseases
Male Reoperation medicine.medical_specialty Open biopsy Prosthesis-Related Infections Shoulders Visual analogue scale medicine.medical_treatment Biopsy Elbow Periprosthetic Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Patient Reported Outcome Measures Range of Motion Articular Device Removal Aged Retrospective Studies 030222 orthopedics business.industry Shoulder Joint 030229 sport sciences General Medicine Middle Aged Arthroplasty Surgery Anti-Bacterial Agents medicine.anatomical_structure Treatment Outcome Debridement Arthroplasty Replacement Shoulder Patient-reported outcome Female Hemiarthroplasty business Range of motion Follow-Up Studies |
Zdroj: | Journal of shoulder and elbow surgery. 28(2) |
ISSN: | 1532-6500 |
Popis: | Background This study evaluated outcomes after treatment of shoulder periprosthetic joint infection (PJI) with a 3-stage revision protocol consisting of (1) debridement, explantation, and cement spacer placement, followed by parenteral antibiotics; (2) open biopsy and debridement; and (3) reimplantation if cultures were negative. We hypothesized this protocol would eradicate persistent infection while producing excellent functional and subjective outcomes, and there would be no difference in these parameters for patients with shoulder PJI compared with patients with revision for aseptic indications. Methods We retrospectively analyzed a prospectively collected revision shoulder arthroplasty cohort to identify shoulder PJI patients treated with a 3-stage protocol. Demographics, culture data, range of motion, and patient-reported outcomes were collected. Outcomes for patients with shoulder PJI and revision to RTSA were compared with patients revised to RTSA for noninfectious indications. Significance was defined as P Results There were 28 cases of shoulder PJI in 27 patients (age, 66.4 ± 11.2 years,); of these, 21 shoulders were revised to RTSA, and 7 shoulders were revised to hemiarthroplasty. There was no recurrent infection at a mean 32-month follow-up. One year after surgery, mean forward flexion was 110° ± 41° and abduction was 106° ± 42°. Mean final American Shoulder and Elbow Surgeons subjective score was 66.5 ± 23.3. The 21 shoulders with PJI revised to RTSA had no differences for functional and subjective outcomes compared with revised patients without shoulder PJI. Conclusions A 3-stage revision protocol for shoulder PJI reliably eradicated infection. Patients with PJI revised to RTSA can have similar outcomes as patients with noninfectious revision to RTSA. |
Databáze: | OpenAIRE |
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