Infected Shoulder Arthroplasty in Patients Younger than 60 Years: Results of a Multicenter Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics
2.2. Patients
- Benign wound problems with spontaneous favorable outcomes.
- Aseptic revision surgery, with positive systemic bacteriological samples, but no postoperative septic complication (without any specific treatment).
- Primary prostheses for septic arthritis sequelae with positive intraoperative bacteriological samples, treated by adapted antibiotic therapy postoperatively, without any subsequent septic complication.
2.3. Statistical Analysis
3. Results
3.1. Epidemiologic Study
3.2. Outcome Study
4. Discussion
4.1. Epidemiology
4.2. Management and Outcomes
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Infected Shoulders (N = 55) | Non-Infected Shoulders (N = 1349) | p | |
---|---|---|---|
Mean FU (months) (since 1st prosthesis) | 157 | 93 | |
Mean age at inclusion | 49.8 | 50.8 | >0.05 |
Sex: | |||
| 78.2% | 51.6% | 0.001 |
| 21.8% | 48.4% | |
BMI | 27.5 | 27.5 | >0.05 |
ASA score | |||
| 27.5% | 36.4% | |
| 60% | 51.2% | >0.05 |
| 12.5% | 12.2% | |
| 0% | 0.2% | |
Medical history | |||
| 11.6% | 6.6% | 0.21 |
| 29.3% | 25.6% | 0.59 |
Surgical history (before 1st prosthesis) | 42.6% | 35.1% | 0.26 |
Infected Shoulders (N = 55) | Non-Infected Shoulders (N = 1349) | p | Infection Rate in Shoulder History | Infection Rate after Primary Prosthesis | |
---|---|---|---|---|---|
Fracture sequelae | 16 (29.1%) | 276 (20.4%) | 0.12 | 5.5% | 2.7% |
PGHOA | 15 (27.3%) | 368 (27.3%) | 0.99 | 3.9% | 2.3% |
Instability arthropathy | 6 (10.9%) | 159 (11,8%) | 0.84 | 3.6% | 1.8% |
Acute fracture | 6 (10.9%) | 124 (9.2%) | 0.66 | 4.6% | 3.1% |
Rheumatoid arthritis | 5 (9.1%) | 125 (9.3%) | 0.96 | 3.8% | 3.1% |
MCT/CTA | 3 (5.5%) | 84 (6.2%) | 1 | 3.6% | 2.3% |
Tumor | 1 (1.7%) | 34 (2.5%) | 1 | 2.9% | 2.9% |
Aseptic osteonecrosis | 0 (0%) | 132 (9.8%) | 0.007 | 0% | 0% |
Other diagnosis | 3 (5.5%) | 47 (3.5%) | - | - | - |
Total (N = 1662) | Arthroplasty with Postoperative Infection (N = 59) | Arthroplasty with No Postoperative Infection (N = 1585) | p |
---|---|---|---|
Primary/Revision | 32 (54.2%)/27 (45.8%) | 1294 (81.6%)/291 (18.4%) | <0.001 |
Approach | 1 | ||
| 1444 (91%) | ||
| 53 (96.4%) | 54 (3.4%) | |
| 2 (3.6%) | 88 (5.6%) | |
Type of Arthroplasty: | |||
HA | 14 (23.7%) | 679 (42.8%) | 0.003 |
| 13 (92.8%) | 612 (90.1%) | |
| 1 (7.2%) | 67 (9.9%) | |
TSA | 19 (32.2%) | 557 (35.1%) | 0.24 |
| 13 (68.4%) | 490 (88%) | |
| 6 (31.6%) | 67 (12%) | |
RSA | 26 (44.1%) | 349 (22.1%) | <0.001 |
| 6 (23.1%) | 192 (55%) | |
| 20 (76.9%) | 157 (45%) |
Procedure | N | Infection Cured (%) | Last-FU | Prosthesis Reimplanted | Complication (%) |
---|---|---|---|---|---|
Open Washout | 17 | 52.9 | 57 | - | 0 |
Resection Arthroplasty | 11 | 81.8 | 27 | 4 spacers | 23.5 |
1-Stage Revision | 9 | 100 | 45 | 1 HA, 3 TSA, 5 RSA | 11.1 |
2-Stage Revision | 14 | 85.7 | 45 | 5 HA, 9 RSA | 35.7 |
1- and 2-Stage Revisions | 23 | 91.3 | 45 | 6 HA, 3 TSA, 14 RSA | 26.1 |
Nonoperated | 2 | - | 33 | - | 0 |
Comparisons of “Last-FU” between Groups | |||||
Resection Arthroplasty vs. 1-Stage Revision | 27 vs. 45 | p = 0.06 | |||
Resection Arthroplasty vs. 2-Stage Revision | 27 vs. 45 | p = 0.01 | |||
Resection Arthroplasty vs. 1- and 2-Stage Revision | 27 vs. 45 | p = 0.01 | |||
1-Stage Revision vs. 2-stage Revision | 45 vs. 45 | p = 0.97 |
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Jacquot, A.; Samargandi, R.; Peduzzi, L.; Mole, D.; Berhouet, J. Infected Shoulder Arthroplasty in Patients Younger than 60 Years: Results of a Multicenter Study. Microorganisms 2023, 11, 2770. https://doi.org/10.3390/microorganisms11112770
Jacquot A, Samargandi R, Peduzzi L, Mole D, Berhouet J. Infected Shoulder Arthroplasty in Patients Younger than 60 Years: Results of a Multicenter Study. Microorganisms. 2023; 11(11):2770. https://doi.org/10.3390/microorganisms11112770
Chicago/Turabian StyleJacquot, Adrien, Ramy Samargandi, Lisa Peduzzi, Daniel Mole, and Julien Berhouet. 2023. "Infected Shoulder Arthroplasty in Patients Younger than 60 Years: Results of a Multicenter Study" Microorganisms 11, no. 11: 2770. https://doi.org/10.3390/microorganisms11112770