title: Septic failure is not a septic loosening: A case report of a failed shoulder prosthesis.
abstract: Septic failure of a shoulder arthroplasty due to a low-grade infection is generally called septic loosening. However, it is often not investigated if a prosthesis is genuinely loose. We present a case of a failed resurfacing prosthesis in a 70-year-old woman. This prosthesis failed due to a low-grade infection and a revision procedure was mandatory. All intraoperative cultures were positive and revealed a combination of bacteria. Nevertheless, histology revealed a macroscopic and a microscopic stable prosthesis with full osseointegration beneath the prosthesis. The general conception is that an infection leads to interface formation (with neutrophils) and loosening of the prosthesis. We debate this with the presentation of this case of a failed shoulder prosthesis and we think that periprosthetic infection and septic prosthetic loosening are two different entities.
authors.affiliation: Orthopaedic Department, Spaarne Hospital, Hoofddorp, Netherlands.
authors.forename: Yde
authors.initials: Y
authors.lastname: Engelsma
authors.forename: Pieter
authors.initials: P
authors.lastname: Buma
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Geervliet
authors.forename: Arthur Van
authors.initials: AV
authors.lastname: Noort
keywords: Infection; loosening; osseointegration; prosthesis; shoulder