Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review
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REVERSE SHOULDER ARTHROPLASTY (C CHAMBERS AND E CRAIG, SECTION EDITORS)
Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review Erik S. Contreras 1 & Travis L. Frantz 1 & Julie Y. Bishop 1 & Gregory L. Cvetanovich 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Periprosthetic infection is a relatively rare but potentially devastating complication after shoulder arthroplasty. The purpose of this article is to review the incidence, diagnosis, prevention, and management of periprosthetic infections after reverse shoulder arthroplasty, with a focus on literature published within the last 5 years. Recent Findings The 2018 International Consensus Meeting on Musculoskeletal Infection provides us with a framework for the diagnosis and management of periprosthetic infections after shoulder arthroplasty. Reverse shoulder arthroplasty has a higher reported rate of infection compared with anatomic total shoulder arthroplasty. Our current diagnostic tests do not appear to be as sensitive when compared with the hip and knee literature. Similar success has been reported with single and two-stage revision protocols, although prospective comparative data are lacking. The significance of unexpected positive cultures during revision arthroplasty remains unclear. Summary We report current diagnostic and therapeutic options for periprosthetic infection after reverse shoulder arthroplasty. Much of the current literature does not distinguish between anatomic and reverse shoulder arthroplasty. Further high-level studies are warranted to refine these definitions and guide management. Keywords Reverse shoulder arthroplasty . Prosthetic joint infection . Periprosthetic infection . Shoulder infection
Introduction Reverse shoulder arthroplasty (RSA) is becoming an increasingly common procedure with expanding indications [1]. The incidence of periprosthetic infection after primary RSA most commonly ranges from 3 to 4% in the literature, although rates as low as 0.5% and as high as 6.7% have been reported [2–9]. According to a 2018 study of 4063 complications after This article is part of the Topical Collection on Reverse Shoulder Arthroplasty * Gregory L. Cvetanovich [email protected] Erik S. Contreras [email protected] Travis L. Frantz [email protected] Julie Y. Bishop [email protected] 1
Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
shoulder arthroplasty reported to the FDA, infection after RSA comprised 13.8% of all RSA complications, with instability/dislocation being the most common complication reported at 32% [10]. Although there are well-established guidelines for management of infections after hip and knee arthroplasty, the diagnosis and management of periprosthetic infections of the shoulder remain less well defined. This review will focus on the definition, risk factors, diagnosis, prevention, and management of periprosthetic infections of the shoulder, with an emphasis on revers
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