ShoulderTreatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer
Section snippets
Materials and methods
This study was approved by the Institutional Review Board of Miami Valley Hospital, Dayton, Ohio (Protocol #09-0023).
Between 2006 and 2008, 17 shoulders in 16 patients were treated by 1 surgeon for infected arthroplasty or osteomyelitis of the proximal humerus, of which 16 shoulders were included in the present study. One patient was excluded because of reinfection of the revision total shoulder prosthesis. His prosthesis was presumed to have been seeded from a pelvic abscess that had cultures
Results
Of the 16 shoulders included in this study, 6 had an infected hemiarthroplasty, 5 had an infected total shoulder arthroplasty (3 of which were a reverse ball-and-socket prosthesis), 4 had primary osteomyelitis of the humeral head, and 1 had proximal humeral osteomyelitis with retained hardware from previous open reduction and internal fixation of a proximal humerus fracture. The group consisted of 11 right and 5 left shoulders in 12 men and 3 women, and their mean age was 58.9 years (range,
Discussion
Many modalities for treatment of deep infection of the shoulder have been reported. Although débridement and culture-specific intravenous antibiotics are almost ubiquitously advocated, various means of definitive treatment are currently used, including 1-stage and 2-stage revision arthroplasty with an articulating interval spacer.3, 4, 10, 13, 17, 22, 23, 24 Several authors have reported successful eradication of deep infection using 2-stage revision with an articulating interval
Conclusions
We treated 16 infected shoulders in 15 patients with staged revision arthroplasty with an interval, commercially produced, antibiotic-impregnated articulating cement spacer and observed no recurrence of infection. Our patients demonstrated improved pain and range of motion, as well as subjective and objective shoulder evaluation scores. A commercially produced spacer may be as effective in controlling infection as an intraoperatively crafted spacer because it allows for a more predictable level
Disclaimer
Authors Coffey and Ely, their immediate families, and any research foundations with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article. Dr Crosby is a paid consultant, member of the speakers' bureau, and has received royalties from Exactech Inc, Gainesville, Florida, USA.
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Tailored modular spacers and handmade spacers in periprosthetic shoulder infection: clinical and functional results after 2-year follow-up
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