title: What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series.
abstract: OBJECTIVE
  Controversy still exists as to the best surgical treatment for periprosthetic shoulder infections. The aim of this multi-institutional study was to review a continuous retrospectiveseries of patients treated in four European centres and to assess the respective eradication rate of various treatment approaches.
  
  
  METHODS
  Forty-four patients were available for this retrospective follow-up evaluation. Functional and clinical evaluation of treatment for infection was performed using the Constant-Murley score, visual analogue scale and patient satisfaction Neer score. Erythrocyte sedimentation rate, serum leucocyte count and C-reactive protein were measured and shoulder X-ray examination performed prior to surgery and at the latest follow-up.
  
  
  RESULTS
  At a mean follow-up of 41 months (range 24–98),42 of 44 patients (95.5%) showed no signs of infection recurrence/persistence. Comparable eradication rates were observed after resection arthroplasty (100%; 6/6), two-stage revision (17/17) or permanent antibiotic-loaded spacer implant (93.3%; 14/15). No patient was treated by one-stage revision. On average, both functional and pain scores improved significantly; the worst joint function was observed after resection arthroplasty.
  
  
  CONCLUSIONS
  This retrospective analysis conducted on the largest published series of patients to date shows comparable infection eradication rates after two-stage revision, resection arthroplasty or permanent spacer implant for the treatment of septic shoulder prosthesis.
authors.affiliation: Dipartimento di Chirurgia Ricostruttiva e delle InfezioniOsteo-articolari, Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4, Milano 20161, Italy. carlo.romano@grupposandonato.it
authors.forename: Carlo Luca
authors.initials: CL
authors.lastname: Romanò
authors.forename: Olivier
authors.initials: O
authors.lastname: Borens
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monti
authors.forename: Enzo
authors.initials: E
authors.lastname: Meani
authors.forename: Jose
authors.initials: J
authors.lastname: Stuyck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents