Use of an antibiotic-impregnated bone cement block in the revision of an infected shoulder arthroplasty

Ramsey, Matthew L.; Fenlin, John M.

doi:10.1016/s1058-2746(96)80022-x

Cited by 59 publications

(35 citation statements)

References 10 publications

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“…Control of infection continues to be the primary goal, and various treatment options have been reported in the literature, including long-term antibiotics, débridement with retention of prosthesis, resection arthroplasty, singlestage exchange, and delayed reimplantation [1,3,7,11,13,14]. The high rates of recurrent infection with IV antibiotics alone or débridement with retention of components (up to 65% [1,10]) have led surgeons to explore alternative treatment options, such as resection arthroplasty, which however is associated with substantial functional limitations [1,4,10].…”

Section: Discussionmentioning

confidence: 99%

“…Control of infection has been reported in a number of studies of two-stage exchange procedures [3,11,12,14]. Values are expressed as number/total number, with percentage in parentheses, or as mean ± SD, with range in parentheses.…”

Section: Discussionmentioning

confidence: 99%

“…An antibiotic-impregnated PMMA spacer was placed in all patients. When the subscapularis was available, the tissue was reattached to the anterior proximal humerus with monofilament absorbable suture [11]. During the second-stage reimplantation, the cement spacer was removed if reverse shoulder arthroplasty was performed.…”

Section: Patients and Materialsmentioning

confidence: 99%

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Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

Sabesan

Kovacevic

et al. 2011

Clinical Orthopaedics &Amp; Related Research

104

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Background Two-stage reimplantation for prosthetic joint infection reportedly has the lowest risk for recurrent infection. Most studies to date have evaluated revision surgery for infection using an anatomic prosthetic. As compared with anatomic prostheses, reverse total shoulder arthroplasty is reported to have a higher rate of infection. Questions/purposes We determined reinfection rates, functional improvement, types and rates of complications, and influence of rotator cuff tissue on function for twostage reimplantation for prosthetic joint infection treated with reverse shoulder arthroplasty. Patients and Methods We retrospectively reviewed 27 patients treated with a two-stage reimplantation for prosthetic shoulder infection using a uniform protocol for management of infection; of these, 17 had reverse shoulder arthroplasty at second-stage surgery. Types of organisms cultured, recurrence rates, complications, function, and radiographic followup were reviewed for all patients. ResultsOne of the 17 patients had recurrence of infection. The mean (± SD) Penn shoulder scores for patients treated with reverse shoulder arthroplasty improved from 24.9 ± 22.3 to 66.4 ± 20.8. The average motion at last followup was 123°± 33°of forward flexion and 26°± 8°o f external rotation in patients treated with a reverse shoulder arthroplasty. The major complication rate was 35% in reverse shoulder arthroplasty, with five dislocations and one reinfection. There was no difference in final Penn score between patients with and without external rotation weakness. Conclusions Shoulder function and pain improved in patients treated with a second-stage reimplantation of a reverse prosthesis and the reinfection rate was low.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

Sabesan

Kovacevic

et al. 2011

Clinical Orthopaedics &Amp; Related Research

104

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“…For example, cystic fibrosis (CF) patients are colonized by the gram-negative pathogen Pseudomonas aeruginosa, which may become highly resistant to antibiotics (4). Persistent inflammation and infection cause the dilation and destruction of the bronchioles, resulting in airway obstruction and death from respiratory failure (38).…”

mentioning

confidence: 99%

Peroxisome Proliferator-Activated Receptors Mediate Host Cell Proinflammatory Responses toPseudomonas aeruginosaAutoinducer

Jahoor¹,

Patel

Bryan³

et al. 2008

J Bacteriol

138

150

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The pathogenic bacterium Pseudomonas aeruginosa utilizes the 3-oxododecanoyl homoserine lactone (3OC 12 -HSL) autoinducer as a signaling molecule to coordinate the expression of virulence genes through quorum sensing. 3OC 12 -HSL also affects responses in host cells, including the upregulation of genes encoding inflammatory cytokines. This proinflammatory response may exacerbate underlying disease during P. aeruginosa infections. The specific mechanism(s) through which 3OC 12 -HSL influences host responses is unclear, and no mammalian receptors for 3OC 12 -HSL have been identified to date. Here, we report that 3OC 12 -HSL increases mRNA levels for a common panel of proinflammatory genes in murine fibroblasts and human lung epithelial cells. To identify putative 3OC 12 -HSL receptors, we examined the expression patterns of a panel of nuclear hormone receptors in these two cell lines and determined that both peroxisome proliferator-activated receptor beta/delta (PPAR␤/␦) and PPAR␥ were expressed. 3OC 12 -HSL functioned as an agonist of PPAR␤/␦ transcriptional activity and an antagonist of PPAR␥ transcriptional activity and inhibited the DNA binding ability of PPAR␥. The proinflammatory effect of 3OC 12 -HSL in lung epithelial cells was blocked by the PPAR␥ agonist rosiglitazone, suggesting that 3OC 12 -HSL and rosiglitazone are mutually antagonistic negative and positive regulators of PPAR␥ activity, respectively. These data identify PPAR␤/␦ and PPAR␥ as putative mammalian 3OC 12 -HSL receptors and suggest that PPAR␥ agonists may be employed as anti-inflammatory therapeutics for P. aeruginosa infections.

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“…Coste et al [57] stated that antibiotics or debridement alone are ineffective. Rarely, arthrodesis or even amputation have been used [31,[52][53][54][56][57][58][59][60][61][62].…”

Section: Infectionmentioning

confidence: 99%

Shoulder arthroplasty

2008

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Shoulder prostheses are now commonly used. Clinical results and patient satisfaction are usually good. The most commonly used types are humeral hemiarthroplasty, unconstrained total shoulder arthroplasty, and semiconstrained inversed shoulder prosthesis. Complications of shoulder arthroplasty depend on the prosthesis type used. The most common complications are prosthetic loosening, glenohumeral instability, periprosthetic fracture, rotator cuff tears, nerve injury, infection, and deltoid muscle dysfunction. Standard radiographs are the basis of both pre- and postoperative imaging. Skeletal scintigraphy has a rather limited role because there is overlap between postoperative changes which may persist for up to 1 year and early loosening and infection. Sonography is most commonly used postoperatively in order to demonstrate complications (hematoma and abscess formation) but may also be useful for the demonstration of rotator cuff tears occurring during follow-up. CT is useful for the demonstration of bone details both pre- and postoperatively. MR imaging is mainly used preoperatively, for instance for demonstration of rotator cuff tears.

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Use of an antibiotic-impregnated bone cement block in the revision of an infected shoulder arthroplasty

Cited by 59 publications

References 10 publications

Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

Peroxisome Proliferator-Activated Receptors Mediate Host Cell Proinflammatory Responses toPseudomonas aeruginosaAutoinducer

Shoulder arthroplasty

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