Prognostic Factors Affecting the Clinical Outcome of Septic Arthritis of the Shoulder

Abstract

Both arthroscopic and open surgery for septic shoulders showed satisfactory clinical outcomes. Old age and comorbidity were poor prognostic factors of clinical outcomes after treatment.

Arthroscopic Treatment of Septic Arthritis of the Shoulder: Technical Pearls to Reduce the Rate of Reoperation

“…When we included data from studies [ 4 , 7 , 21 ] in which a mixed treatment approach was used, including open arthrotomy, our rate of reoperation of 5.6% was still low compared to reported rates ranging from 14.7% to 32%. We reviewed several studies that reported the reoperation rate for their case series ( Table 3 ).…”

“…The authors noted a 26% rate of reoperation overall and a 25% rate of reoperation among cases treated with only the arthroscopic technique. Cho and Oh [ 7 ] reported a 14.7% rate of reoperation among 34 septic shoulders, with 22 treated by arthroscopy and 12 by an open approach; an 18.2% rate of reoperation was noted among cases treated with arthroscopy only. The open method was performed when there was evidence of osteomyelitis or abscess formation in the subcoracoid space on preoperative MRI.…”

“…To access the posteroinferior SA space, where the infraspinatus and teres minor exist, open debridement was preferred. Cho and Oh [ 7 ] chose an open debridement in patients with subcoracoid abscesses to achieve thorough debridement and irrigation [ 6 ]. However, a 70º arthroscope can easily access the subcoracoid and posteroinferior SA space.…”

“…However, the importance should not be understated due to its association with specific health comorbidities (e.g., diabetes, liver cirrhosis, and malignancy), the high rate of mortality if not treated promptly, the potential for long-term morbidities (including osteomyelitis, arthritis, and shoulder stiffness), and increased incidence following needle placement around the shoulder joint [ 1 - 8 ]. Treatment options for septic arthritis of the shoulder joint include repetitive aspiration, open arthrotomy with debridement, and arthroscopic debridement and irrigation [ 1 - 4 , 7 ]. Of these, arthroscopic debridement and irrigation has become popular owing to its many advantages, including the use of a small incision, lower level of postoperative pain, better visualization of the joint compared to an open surgical approach, and overall good clinical results [ 3 , 5 , 9 - 11 ].…”

Polymyalgia Rheumatica: A Challenging Diagnosis in Elderly Patients - Case Reports

“…Adhesive capsulitis, rotator cuff disease, and osteoarthritis are main causes of shoulder pain 12) . Although septic arthritis of the shoulder is a relatively rare disease, it has recently increased in prevalence due to an increase in life expectancy, various shoulder problem, local injection on shoulder region, and immunocompromised conditions 13) . The clinical manifestations of septic arthritis, such as shoulder pain with stiffness and fever, and elevated APR, can mimic PMR.…”