Shoulder arthroplasty for the treatment of postinfectious glenohumeral arthritis.
BACKGROUND
Currently, no studies on shoulder arthroplasty after a previous infection of the shoulder have been published, as far as we know. The purpose of this study was to evaluate the rates of reinfection and the clinical results after shoulder arthroplasty for the treatment of postinfectious glenohumeral arthritis.


METHODS
Between 1975 and 2000, thirteen patients with a history of infection of the shoulder that resulted in severe glenohumeral arthritis underwent shoulder arthroplasty. One patient who had been followed for less than two years was excluded. Therefore, twelve shoulders that had been followed for a minimum of two years (mean, 9.7 years) or until the time of revision surgery were included in the study. Complications, clinical results (pain, satisfaction, and range of motion), and radiographic results were documented at the time of the latest follow-up.


RESULTS
No patient in this study had had a known reinfection at the time of the latest follow-up. Overall pain scores improved from 4.8 to 2.5 points after implantation of a prosthesis. Eight of the twelve patients had no pain or mild or moderate pain only after vigorous activity. The mean shoulder abduction improved from 75 degrees to 117 degrees, and the mean external rotation improved from 13 degrees to 36 degrees. Subjectively, only six of the twelve patients rated the result as much better or better. The results in the eight patients who underwent a full rehabilitation program were better than those in the four patients who underwent a limited-goals rehabilitation program.


CONCLUSIONS
Shoulder arthroplasty for the treatment of the sequelae of an infected shoulder can be performed with a low risk of reinfection. While overall pain and motion can be expected to improve, unsatisfactory clinical results that are related to the destructive effects of the initial infection are not uncommon.
Mileti
Joseph
J
Mayo Clinic, Rochester, Minnesota 55905, USA.
Sperling
John W
JW
Cofield
Robert H
RH
D000328:Adult; D000368:Aged; D016918:Arthritis, Reactive / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D001178:Arthroplasty; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012008:Recurrence; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome