Memon M, et al. - This study reports the indications, patient outcomes, and complications of arthroscopic management of native shoulder joint septic arthritis. Findings demonstrated that such management was capable of affording pain relief and a return to full range of motion, daily activities, and sports, however, the reported rate of reoperation was high, which may correlate with poor patient prognostic factors. Notably, the superiority of either arthroscopic surgery or open arthrotomy for the management of shoulder septic arthritis was not demonstrated in this study.

Methods

• Researchers searched the literature using PubMed, MEDLINE, and Embase.
• Data abstraction was performed independently and in duplicate.
• They used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist as a guidance for reporting and data abstraction.
• In addition, they used the Methodological Index for Non-randomized Studies (MINORS) criteria to assess the quality of all included studies.
• Descriptive statistics including means, proportions, ranges, κ values, and intraclass correlation coefficient values were used to present the results in a narrative summary fashion.

Results

• This analysis included a total of 27 studies (19 case reports and 8 case series) with 115 patients (121 shoulders).
• The reported mean follow-up period was 29.1 months (range, 1-199 months).
• Researchers found that pain; limited range of motion; swelling, erythema, and tenderness; fever; elevated leukocyte count, erythrocyte sedimentation rate, and/or C-reactive protein level; synovial aspirate findings; and/or imaging findings were the indications for shoulder arthroscopy owing to infection.
• A single arthroscopic procedure afforded infection eradication and functional improvement in a total of 46 patients (40%).
• However, ongoing symptoms or complications were reported in 43 patients (37%); 32 (30%) needed revision arthroscopic procedures, 7 (6%) underwent open arthrotomy for septic arthritis management, 2 (2%) developed avascular necrosis of the humeral head, 1 (1%) developed adhesive capsulitis, and 1 (1%) had an irregular profile of the humeral epiphysis on plain radiographs.