One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
4.1. Search Strategy
4.2. Study Selection and Eligibility Criteria
4.3. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Year | No. of Patients | Mean Age (Years) | Follow-Up (Months) | One-Stage: a Two-Stage: b | Antibiotic-Impregnated Cement Spacer | |
---|---|---|---|---|---|---|---|
John W. Sperling [8] | 2001 | 2 | 54 | 24 | a | - | - |
3 | b | No | - | ||||
William H. Seitz [29] | 2002 | 5 | 62 | 49.5 | b | Yes | Tobramycin (2 g) |
Jörg Jerosch [30] | 2003 | 10 | 71 | 18 | b | Yes | NR |
Coste, J.S. [16] | 2004 | 3 | 64 | 34 | a | - | - |
10 | b | Yes | NR | ||||
Ince, A. [22] | 2004 | 16 | 68 | 69.6 | a | - | - |
Cuff, D [39] | 2008 | 7 | 67 | 43 | a | - | - |
10 | b | No | - | ||||
Strickland, J.P. [31] | 2008 | 19 | 62 | 35 | b | No | - |
Beekman, P.D. [23] | 2010 | 11 | 62 | 24 | a | - | - |
Dodson, C.C. [4] | 2010 | 5 | 60.1 | 48 | b | Yes | NR |
Coffey, M.J. [32] | 2010 | 12 | 58.9 | 18.3 | b | Yes | Gentamicin/Vancomycin |
Hattrup, S.J. [33] | 2010 | 21 | 66.9 | 49.2 | b | Yes | Gentamicin (4.8 g)/Vancomycin (2 g)/Cefazolin (2 g) |
Stine, I.A. [34] | 2010 | 15 | 61 | 24 | b | Yes | Tobramycin (1.2 g)/ Vancomycin (1 g) |
Jawa, A. [35] | 2011 | 15 | 63 | 27.6 | b | Yes | Tobramycin (3 g)/ Gentamicin (2 g) |
Millett, P.J. [36] | 2011 | 5 | 57.8 | 20.4 | b | Yes | NR |
Sabesan, V.J. [37] | 2011 | 17 | 67.6 | 46.2 | b | Yes | NR |
Amaravathi, R.S. [40] | 2012 | 18 | 67.7 | 29.5 | a | - | - |
13 | b | Yes | NR | ||||
Grosso, M.J. [24] | 2012 | 17 | 66.5 | 35.8 | a | - | - |
Romanò, C.L. [38] | 2012 | 17 | 63 | 41.1 | b | Yes | NR |
Achermann, Y. [48] | 2013 | 6 | 61 | 49 | b | No | - |
Boileau, P. [41] | 2013 | 2 | 67 | 34 | a | - | - |
4 | b | No | - | ||||
Ghijselings, S. [49] | 2013 | 3 | 65 | 56.3 | b | Yes | NR |
Klatte, T. O. [21] | 2013 | 35 | 66 | 56.4 | a | - | - |
Magnan, B. [50] | 2014 | 5 | 70.7 | 40.8 | b | Yes | Gentamicin (0.8 g)/ Vancomycin (1 g) |
Middernacht, B. [42] | 2014 | 19 | 71 | 41.2 | a | - | - |
4 | b | No | - | ||||
Ortmaier, R. [51] | 2014 | 12 | 65.2 | 24 | b | Yes | NR |
Black, E.M. [52] | 2015 | 2 | 68.6 | 58.9 | b | Yes | NR |
Jacquot, A. [43] | 2015 | 5 | 71 | 36 | a | - | - |
14 | b | Yes | NR | ||||
Morris, B.J. [53] | 2015 | 6 | 60.6 | 38.1 | b | No | - |
Zhang, A.L. [54] | 2015 | 11 | 69 | 24 | b | Yes | Tobramycin (1.2 g)/ Vancomycin (1 g) |
Hsu, J.E. [25] | 2016 | 27 | 63.5 | 45.8 | a | - | - |
Piggott, D.A. [44] | 2016 | 4 | 62 | 24 | a | - | - |
7 | b | Yes | NR | ||||
Stephens, B.C. [45] | 2016 | 13 | 66.7 | 24 | a | - | - |
5 | b | Yes | NR | ||||
Assenmacher, A.T. [55] | 2017 | 35 | 65 | 49.2 | b | Yes | Gentamicin (2 g)/ Vancomycin (2 g) |
Buchalter, D.B. [18] | 2017 | 19 | 63 | 63 | b | Yes | NR |
Padegimas, E.M. [14] | 2017 | 27 | 65,4 | 24 | b | Yes | NR |
Stone, G.P. [46] | 2017 | 55 | 69.5 | 45 | a | - | - |
19 | b | Yes | NR | ||||
Grubhofer, F. [56] | 2018 | 24 | 62 | 52 | b | Yes | Gentamicin (0.55 g)/ Vancomycin (1 g) |
Lee, S.H. [57] | 2018 | 12 | 69.5 | 40.9 | b | No | - |
Merolla, G. [58] | 2018 | 8 | 69.2 | 49 | b | Yes | NR |
Sevelda, F. [26] | 2018 | 14 | 71 | 69.6 | a | - | - |
Torrens, C. [59] | 2018 | 21 | 67.5 | 24 | b | Yes | Tobramycin |
Patrick, M. [60] | 2019 | 27 | 67.8 | 12 | b | Yes | Vancomycin (1 g) |
Pellegrini, A. [61] | 2019 | 11 | 66.6 | 96 | b | Yes | Gentamicin/Vancomycin |
Tseng, W.J. [62] | 2019 | 27 | 66.4 | 32 | b | Yes | Tobramycin (1.2 g)/ Vancomycin (1 g) |
Boelch, S.P. [63] | 2020 | 23 | 72 | 76 | b | Yes | Gentamicin/Vancomycin |
Brown, M. [64] | 2020 | 25 | 70.2 | 38.3 | b | Yes | Gentamicin/Clindamycin |
Akgün, D. [65] | 2021 | 35 | 67.1 | 61.2 | b | Yes | NR |
Bdeir, M. [15] | 2021 | 19 | 66.1 | 57.6 | b | Yes | Gentamicin/Vancomycin |
Hornung, S. [66] | 2021 | 13 | 68.2 | 13.2 | b | Yes | NR |
Klingebiel, S. [67] | 2021 | 16 | 65 | 33.2 | b | Yes | NR |
Lemmens, L. [19] | 2021 | 1 | 71 | 36 | a | - | - |
23 | b | Yes | NR | ||||
Meshram, P. [68] | 2021 | 17 | 64 | 60 | b | Yes | NR |
Vilchez, H.H. [47] | 2021 | 6 | 67.5 | 12 | a | - | - |
15 | b | No | - | ||||
Kim, D.H. [69] | 2022 | 2 | 66 | 28 | b | Yes | Vancomycin (4 g) |
Schiffman, C.J. [27] | 2022 | 35 | 55.5 | 164.5 | a | - | - |
Yao, J.J. [28] | 2022 | 92 | 65.1 | 49.2 | a | - | - |
Organism | One-Stage (n) | Two-Stage (n) |
---|---|---|
Pseudomonas aeruginosa | 2 | 4 |
Alcaligenes | 2 | 0 |
Cutibacterium acnes | 367 | 309 |
Coagulase-negative staphylococci (CNS) | 80 | 20 |
Corynebacterium | 5 | 4 |
Staphylococcus aureus | 140 | 17 |
Staphylococcus epidermidis | 89 | 21 |
Staphylococcus capitis | 51 | 0 |
MRSA | 2 | 7 |
MSSA | 0 | 9 |
Enterococci | 1 | 4 |
Enterobacter cloacae | 0 | 1 |
Enterococcus faecalis | 1 | 3 |
Escherichia coli | 1 | 2 |
Streptococcus Pneumoniae | 3 | 2 |
Streptococcus oralis | 1 | 0 |
Streptococcus dysgalactiae | 0 | 1 |
Citrobacter freundii | 0 | 1 |
Bacillus subtilis | 0 | 1 |
Mycobacterium tuberculosis | 2 | 0 |
Serratia | 0 | 1 |
Klebsiella | 0 | 1 |
No growth | 1 | 16 |
Parameter ± SD | Total | One-Stage | Two-Stage | p-Value |
---|---|---|---|---|
Age (Years) | 65.76 ± 4.28 | 65.91 ± 4.67 | 65.61 ± 3.89 | 0.7896 |
Follow-up (Months) | 45.67 ± 27.49 | 44.91 ± 31.79 | 38.74 ± 16.91 | 0.4425 |
CRP (mg/dL) | 3.24 ± 2.91 | 3.7 ± 4.12 | 3.85 ± 3.07 | 0.9191 |
Revisions | 1.84 ± 0.56 | 1.16 ± 0.18 | 2.25 ± 0.33 | <0.0001 * |
Abduction (°) | 88.47 ± 22 | 103.38 ± 40.31 | 87.22 ± 20.61 | 0.4208 |
Elevation (°) | 96.89 ± 19.10 | 101.47 ± 20.01 | 93.42 ± 17.20 | 0.5530 |
CS (Points) | 47.25 ± 10.29 | 51.82 ± 9.17 | 45.22 ± 12.07 | 0.1523 |
ASES (Points) | 63.39 ± 5.28 | 57.30 ± 3.72 | 67.06 ± 5.85 | 0.0326 |
SST (Points) | 6.49 ± 5.28 | 5.34 ± 1.72 | 11.43 ± 18.50 | 0.3526 |
Reinfection rate (%) | 12.3 ± 2.33 | 10.9 ± 2.77 | 12.9 ± 1.89 | 0.0062 * |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Bdeir, M.; Lerchl, A.; Hetjens, S.; Schilder, A.; Gravius, S.; Baumgärtner, T.; Darwich, A. One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis. Antibiotics 2024, 13, 440. https://doi.org/10.3390/antibiotics13050440
Bdeir M, Lerchl A, Hetjens S, Schilder A, Gravius S, Baumgärtner T, Darwich A. One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis. Antibiotics. 2024; 13(5):440. https://doi.org/10.3390/antibiotics13050440
Chicago/Turabian StyleBdeir, Mohamad, Aimée Lerchl, Svetlana Hetjens, Andreas Schilder, Sascha Gravius, Tobias Baumgärtner, and Ali Darwich. 2024. "One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis" Antibiotics 13, no. 5: 440. https://doi.org/10.3390/antibiotics13050440
APA StyleBdeir, M., Lerchl, A., Hetjens, S., Schilder, A., Gravius, S., Baumgärtner, T., & Darwich, A. (2024). One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis. Antibiotics, 13(5), 440. https://doi.org/10.3390/antibiotics13050440