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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 4, 460-465.
doi: 10.1302/0301-620X.90B4.20002  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The results of two-stage re-implantation for infected shoulder replacement

J. P. Strickland, MD, Resident1; J. W. Sperling, MD, MBA, Associate Professor1; and R. H. Cofield, MD, Professor1

Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.

Correspondence should be sent to Dr J. W. Sperling; e-mail: sperling.john{at}mayo.edu

While frequently discussed as a standard treatment for the management of an infected shoulder replacement, there is little information on the outcome of two-stage re-implantation.

We examined the outcome of 17 consecutive patients (19 shoulders) who were treated between 1995 and 2004 with a two-stage re-implantation for the treatment of a deep-infection after shoulder replacement. All 19 shoulders were followed for a minimum of two years or until the time of further revision surgery. The mean clinical follow-up was for 35 months (24 to 80). The mean radiological follow-up was 27 months (7 to 80). There were two excellent results, four satisfactory and 13 unsatisfactory. In 12 of the 19 shoulders (63%) infection was considered to be eradicated. The mean pain score improved from 4.2 (3 to 5 (out of 5)) to 1.8 (1 to 4). The mean elevation improved from 42° (0° to 140°) to 89° (0° to 165°), mean external rotation from 30° (0° to 90°) to 43° (0° to 90°), and mean internal rotation from the sacrum to L5. There were 14 complications.

Our study suggests that two-stage re-implantation for an infected shoulder replacement is associated with a high rate of unsatisfactory results, marginal success at eradicating infection and a high complication rate.






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