Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

Coffey, Michael J.; Ely, Erin E.; Crosby, Lynn A.

doi:10.1016/j.jse.2010.01.012

Cited by 67 publications

(42 citation statements)

References 24 publications

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“…Themislocleous et al recently published their series of 11 patients with a permanent cement spacer. They concluded that in the low-demand patient, one can expect infection and pain control, with limited shoulder function [11], and similar results were found in a more recent publication by Coffey and Crosby [12]. On the other hand, Verhelst et al found no difference in clinical outcome in a mixed retrospective series of patients undergoing either resection arthroplasty or a spacer implant for chronic shoulder infection of different pathogenesis [13].…”

Section: Introductionmentioning

confidence: 58%

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

Romanò

Borens

Monti

et al. 2012

International Orthopaedics (SICOT)

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Purpose 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 retrospective series 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.

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Section: Introductionmentioning

confidence: 58%

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

Romanò

Borens

Monti

et al. 2012

International Orthopaedics (SICOT)

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“…They concluded that shoulder sepsis could be treated by spacer implantation, although they did not point out what benefit they achieved. 5 A recent report by Stine et al 20 again examined the use of a spacer in shoulder sepsis. These authors found no significant difference between patients treated with a permanent spacer and patients that were reimplanted.…”

Section: Discussionmentioning

confidence: 99%

“…This is in contrast to the results of other publications that showed no bone destruction even with longer follow-up. 5,30,33 These authors used moulded, well-fitting spacers or a commercially available implant. This might explain why our cohort had severe erosions.…”

Section: Discussionmentioning

confidence: 99%

Resection arthroplasty of the shoulder as a salvage procedure for deep shoulder infection: does the use of a cement spacer improve outcome?

Verhelst

Stuyck

Bellemans

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…Infection recurrence rates have been reported to range from 0% to 30% 65,68,72,73,75,76 . Crosby et al demonstrated that surgeon-constructed and commercially available articulating cement spacers impregnated with vancomycin alone or in combination with an aminoglycoside are both effective treatment techniques [77][78][79] . Articulating antibiotic cement spacers allow for the preservation of a soft-tissue envelope and can often act as the definitive implant in a patient with minimal functional demands 80 .…”

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Periprosthetic Shoulder Infections

Mook

Garrigues

2014

The Journal of Bone and Joint Surgery

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➤ The unique bacterial flora of the shoulder present diagnostic and treatment challenges that are distinct from those seen with failed hip and knee arthroplasties.➤ The presentation, diagnosis, and management of suppurative periprosthetic joint infections of the shoulder are similar to those of the hip and the knee.➤ Failed arthroplasties with positive cultures (FAPCs) are poorly performing shoulder reconstructions associated with low-virulence microorganisms that do not evoke a suppurative inflammatory response. Propionibacterium acnes is the predominant bacterium isolated from these cases.➤ With improved surgeon awareness and the addition of longer tissue-culture incubation times, detection of FAPCs has become more common. However, management is hampered by the lack of reliable, timely tests that can determine the presence of less virulent organisms in the preoperative or intraoperative settings.➤ The implications of positive culture results in FAPCs are unclear. Key test characteristics such as the false-positive rate and the prevalence of positive cultures in well-performing shoulders are unknown as there is no useful confirmatory test to validate the culture data and no reliable way to detect the presence of less virulent microorganisms without reoperation.➤ Soft-tissue and osseous deficits are frequently encountered when revising previously infected shoulders. The rate of complications in these scenarios is high, and the outcomes are the least favorable compared with revisions for any other indication.➤ The development of a consensus definition of a periprosthetic shoulder infection is critical to future investigations of these devastating complications.

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Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

Cited by 67 publications

References 24 publications

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

Resection arthroplasty of the shoulder as a salvage procedure for deep shoulder infection: does the use of a cement spacer improve outcome?

Diagnosis and Management of Periprosthetic Shoulder Infections

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