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Outcomes of revision surgery after periprosthetic shoulder infection: A systematic review

Journal of Shoulder and Elbow Surgery Apr 23, 2019

Mercurio M, et al. - Researchers investigated 754 candidates to examine the outcomes of revision surgery following Periprosthetic shoulder infection (PSI). The most common microorganism found in PSI (33%) and persistent infections both was Cutibacterium acnes (C. acnes). A lower prevalence of infection was reported in reverse shoulder arthroplasty. They noted the eradication rates: 96% with 1 stage, 93% with permanent spacers, 86% with 2 stages, 85% with resection arthroplasty, and 65% with irrigation and debridement. Considering postoperative flexion and abduction, they found one-stage revision as the best treatment when compared with resection arthroplasty, permanent spacers, and 2-stage revision. The functional score showed no differences between 2-stage and 1-stage procedures whereas two-stage surgery was the most common treatment. To treat PSI, the 1-stage procedure was suggested whereas two-stage revision could be reserved for the cases in which the bacterium involved was not known.
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