Clin Orthop Surg.  2018 Sep;10(3):344-351. 10.4055/cios.2018.10.3.344.

Outcomes of Shoulder Arthroplasty Performed for Postinfectious Arthritis

• Padegimas
• Nicholson
• Silva S
• Ramsey ML
• Williams G
• Lazarus MD
• Namdari S

• KMID: 2418755
• DOI: http://doi.org/10.4055/cios.2018.10.3.344

Abstract

BACKGROUND
The purpose of this study was to evaluate the functional outcomes, infection rate, and complications associated with shoulder arthroplasty for sequelae of prior septic arthritis.
METHODS
This is a retrospective cohort study of 17 patients who underwent shoulder arthroplasty for sequelae of septic arthritis. Patients were analyzed for patient-reported outcomes, complications, and reoperations.
RESULTS
The 17 patients in this cohort were an average age of 65.4 ± 12.2 years old, were 58.8% male, and had an average body mass index of 27.9 ± 4.1 kg/m2. These patients underwent 14 reverse shoulder arthroplasties (RSAs; 11 after antibiotic spacer placement), one anatomic total shoulder arthroplasty after antibiotic spacer placement, and two hemiarthroplasties (both after antibiotic spacer placement). Two patients underwent reoperation (dislocated RSAs). There were four complications (23.5%): two RSA dislocations, one acromial stress fracture, and one atraumatic rotator cuff tear after hemiarthroplasty. There were no cases of postoperative wound complications or infection. At an average of 4.1 ± 1.8 years of follow-up for all 17 of 17 cases, the average visual analogue scale pain score was 4.6 ± 2.3, average Single Assessment Numeric Evaluation Score was 59.3 ± 23.7, average American Shoulder and Elbow Surgeons Score was 57.6 ± 15.5, and average Simple Shoulder Test was 6.9 ± 2.6 based on "yes" responses.
CONCLUSIONS
Shoulder arthroplasty after septic arthritis had inconsistent functional outcomes and high complication rates but no reinfection.

Keyword

Shoulder replacement arthroplasty; Infectious arthritis; Complications

MeSH Terms

Arthritis, Infectious
Arthritis, Reactive*
Arthroplasty*
Body Mass Index
Cohort Studies
Dislocations
Elbow
Follow-Up Studies
Fractures, Stress
Hemiarthroplasty
Humans
Male
Reoperation
Retrospective Studies
Rotator Cuff
Shoulder*
Surgeons
Tears
Wounds and Injuries

Figure

• 

  Fig. 1 Preoperative true anteroposterior (AP) (A), AP (B), and axillary (C) radiographs of an 81-year-old female who had multifocal septic native arthritis with one previous shoulder irrigation and debridement.

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  Fig. 2 Three-year postoperative true anteroposterior (AP) (A), AP (B), and scapular Y (C) views of an 81-year-old female who had multifocal septic native arthritis with one previous shoulder irrigation and debridement and underwent a two-staged reverse shoulder arthroplasty.

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