Arthroscopic Tissue Culture for the Evaluation of Periprosthetic Shoulder Infection

Dilisio, Matthew F.; Miller, Lindsay R.; Warner, Jon J.P.; Higgins, Laurence D.

doi:10.2106/jbjs.m.01512

Cited by 119 publications

(73 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The advantage of biopsy is the possibility of combining the different diagnostic methods of cultivation and histological examination on several tissue samples [ 39 , 62 , 63 ]. Dilisio et al [ 64 ] studied 41 shoulder arthroplasties and found that biopsy is more reliable than aspiration of the synovial fluid and could accurately confirm or rule out the presence of an infection. The biopsy method was associated with a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100%, whereas the aspiration method was found to have a sensitivity of only 16.7%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 58.3%.…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options

Fink

Sevelda

2017

BioMed Research International

View full text Add to dashboard Cite

Periprosthetic joint infection (PJI) is one of the most frequent reasons for painful shoulder arthroplasties and revision surgery of shoulder arthroplasties. Cutibacterium acnes (Propionibacterium acnes) is one of the microorganisms that most often causes the infection. However, this slow growing microorganism is difficult to detect. This paper presents an overview of different diagnostic test to detect a periprosthetic shoulder infection. This includes nonspecific diagnostic tests and specific tests (with identifying the responsible microorganism). The aspiration can combine different specific and nonspecific tests. In dry aspiration and suspected joint infection, we recommend a biopsy. Several therapeutic options exist for the treatment of PJI of shoulder arthroplasties. In acute infections, the options include leaving the implant in place with open debridement, septic irrigation with antibacterial fluids like octenidine or polyhexanide solution, and exchange of all removable components. In late infections (more than four weeks after implantation) the therapeutic options are a permanent spacer, single-stage revision, and two-stage revision with a temporary spacer. The functional results are best after single-stage revisions with a success rate similar to two-stage revisions. For single-stage revisions, the microorganism should be known preoperatively so that specific antibiotics can be mixed into the cement for implantation of the new prosthesis and specific systemic antibiotic therapy can be applied to support the surgery.

show abstract

Section: Diagnostic Methodsmentioning

confidence: 99%

Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options

Fink

Sevelda

2017

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Bone and prosthesis interfaces must be cleared and examined throughout to rule out complications related to integration (Fig 3). Multiple soft-tissue samples must be obtained to rule out infection, preferably from bone prosthesis interfaces, as it has been shown to offer high sensitivity and specificity 7 (Fig 4). ROM should be tested completely, and any potential mechanical cause of stiffness around the humeral and glenoid components must be searched.…”

Section: Techniquementioning

confidence: 99%

Arthroscopic Circumferential Release for Stiff Reverse Total Shoulder Arthroplasty

Aguilar-González

Luengo-Alonso

Calvo

2020

Arthroscopy Techniques

View full text Add to dashboard Cite

Stiffness is a well-known complication after reverse shoulder arthroplasty. Although multiple factors may be involved, the main cause for stiffness is rarely identified. Imaging studies frequently are inconclusive in ruling out mechanical or biological causes. Periprosthetic infection should be always suspected, but the absence of major clinical signs and accurate diagnostic tests is frequent. A lack of objective criteria establishing a diagnosis and when to proceed with revision surgery is often present in such cases. Moreover, additional surgical procedures should be carefully evaluated, as they can represent a point of no return. Shoulder arthroscopy plays an increasingly important role in these cases, either as a diagnostic or therapeutic tool. There are no reports about arthroscopy on stiffness after reverse shoulder arthroplasty. In this Technical Note, we describe an arthroscopic technique aimed to identify potential causes of reverse shoulder arthroplasty stiffness. Subsequent circumferential release is described and discussed.

show abstract

“…Dilisio et al performed a retrospective review to examine the role of arthroscopic tissue culture for diagnosing indolent periprosthetic shoulder infection with Propionibacterium acnes 27 . The results of arthroscopic biopsy were much more accurate (100% sensitivity, specificity, and accuracy) than those of fluoroscopically guided fluid aspiration (17% sensitivity, 100% sensitivity, 100% positive predictive value, and 58% negative predictive value), when compared with results of intraoperative culture, the gold standard.…”

Section: Arthroplasty Infectionsmentioning

confidence: 99%

What’s New in Shoulder and Elbow Surgery

Chamberlain

Aleem

Keener

2017

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

This update is a review of the most impactful studies related to advances in shoulder and elbow surgery from March 2014 to March 2015. Included are basic science and clinical studies primarily from The Journal of Bone & Joint Surgery, the Journal of Shoulder and Elbow Surgery, and The American Journal of Sports Medicine. Specific emphasis has been placed on higherquality research (Level-I and II studies) and particularly relevant Level-III and IV studies. The level of evidence is provided (when known). Shoulder Rotator Cuff Clinical Presentation Specialty Update has been developed in collaboration with the Board of Specialty Societies (BOS) of the American Academy of Orthopaedic Surgeons.

show abstract

Arthroscopic Tissue Culture for the Evaluation of Periprosthetic Shoulder Infection

Abstract: Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 119 publications

References 26 publications

Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options

Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options

Arthroscopic Circumferential Release for Stiff Reverse Total Shoulder Arthroplasty

What’s New in Shoulder and Elbow Surgery

Contact Info

Product

Resources

About