The results of two-stage re-implantation for infected shoulder replacement.
While frequently discussed as a standard treatment for the management of an infected shoulder replacement, there is little information on the outcome of two-stage re-implantation. We examined the outcome of 17 consecutive patients (19 shoulders) who were treated between 1995 and 2004 with a two-stage re-implantation for the treatment of a deep-infection after shoulder replacement. All 19 shoulders were followed for a minimum of two years or until the time of further revision surgery. The mean clinical follow-up was for 35 months (24 to 80). The mean radiological follow-up was 27 months (7 to 80). There were two excellent results, four satisfactory and 13 unsatisfactory. In 12 of the 19 shoulders (63%) infection was considered to be eradicated. The mean pain score improved from 4.2 (3 to 5 (out of 5)) to 1.8 (1 to 4). The mean elevation improved from 42 degrees (0 degrees to 140 degrees ) to 89 degrees (0 degrees to 165 degrees ), mean external rotation from 30 degrees (0 degrees to 90 degrees ) to 43 degrees (0 degrees to 90 degrees ), and mean internal rotation from the sacrum to L5. There were 14 complications. Our study suggests that two-stage re-implantation for an infected shoulder replacement is associated with a high rate of unsatisfactory results, marginal success at eradicating infection and a high complication rate.
Strickland
J P
JP
Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
Sperling
J W
JW
Cofield
R H
RH
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000379:methods; D012092:Replantation / Q000009:adverse effects / Q000379:methods*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome