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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 5, 666-670.
doi: 10.1302/0301-620X.85B5.13915  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Arthrodesis of the shoulder after septic arthritis

LONG-TERM RESULTS

M. Wick, MD1; E. J. Müller, MD1; T. Ambacher, MD2; U. Hebler, MD1; G. Muhr, MD, Professor of Orthopaedic and Trauma Surgery1; and F. Kutscha-Lissberg, MD1

1 Department of Surgery, Berufsgenossenschaftliche Kliniken Bergmannsheil, Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany.
2 Department of Surgery, Katharinen Hospital, Kriegsbergstrasse 60, 70174 Stuttgart, Germany.

Correspondence should be sent to Dr M. Wick.

We analysed the long-term results of arthrodesis of the shoulder after infection in 15 patients. At the time of operation, 14 cultures were positive for Staphylococcus aureus. The mean follow-up was 8.3 years (3 to 14) and 90% of the patients were satisfied with the outcome. There were complications in five patients (33%); in three there was nonunion with loosening of the implant. One patient had a sound bony union but with a persistent sinus six years after arthrodesis and another had a sinus which healed after the metal was removed. Four of these five patients (80%) were heavy smokers (> 20 cigarettes/day). Cancellous bone grafting did not affect the incidence of complications. The mean age of the patients with complications was 58.6 v 48.6 years for those without (p = 0.2808 ; not significant). Those with complications had had more previous operations (6.4 v 2.5, p < 0.05). Antibiotics, as determined by the bacteriological cultures, were administered for six weeks.

The complication rate was higher in patients with active sepsis but the younger the patient and the fewer number of previous operations (<50 years, < four previous operations), the better was the outcome. Considering the rate of complications, we recommend early surgery in these patients.




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Home page
 J Am Acad Orthop SurgHome page
O. Safran and J. P. Iannotti
Arthrodesis of the shoulder.
J. Am. Acad. Ortho. Surg., March 1, 2006; 14(3): 145 - 153.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General