**3. Results**

Reimplantation was completed in only 35 (71%) of 49 cases and eradication of infection was achieved in 85.7% of patients with successful reimplantation after a mean follow-up duration of 5.1 years (range: 1.1 to 10.2 years). Nine of thirty-five (26%) patients underwent one revision surgery between the resection arthroplasty and reimplantation and one of 35 patients (3%) underwent two revision surgeries, which included additional spacer exchange due to wound-related complications and bone grafting procedures because of poor glenoid bone stock. The mean interval between resection arthroplasty and reimplantation was 2.4 months (range: 0.4 to 8 months). In one case, a hemiarthroplasty; in three cases, a total shoulder arthroplasty; and in the remaining 31 cases, a reverse shoulder arthroplasty was performed at the time of reimplantation.

Of the 14 cases that did not undergo reimplantation, infection eradication was achieved in 57% of the cases (8 of 14 cases) after a mean follow-up of 5 years (range: 2.6 to 11 years). Reasons for failure to reimplant were premature death in 5 patients (36%), high general morbidity in 4 patients (29%), satisfaction with the current status in 3 patients (21%), or severe infection with poor bone and soft tissues in 2 patients (14%). Patients who did not undergo subsequent reimplantation were significantly older (76 vs. 67 years, *p* = 0.009), had a significantly higher Charlson comorbidity index (6.2 vs. 3.3, *p* < 0.001), and mortality rate (8/14 vs. 4/35, *p* = 0.002) compared to patients who achieved a successful reimplantation (Table 1). Furthermore, more polymicrobial infections were identified in patients who did

not undergo reimplantation. However, this difference was statistically not significant (43% vs. 23%, *p* = 0.18).

A successful infection eradication was achieved in 38 patients of the entire cohort (78%) at the last follow-up. Patients with persistent infection had a significantly higher C-reactive protein on admission (49.4 vs. 14.3 mg/L, *p* = 0.003) and mortality (6/11 vs. 6/38, *p* = 0.02), compared to patients with successful eradication of infection (Table 2).

**Table 2.** Demographic data, clinical, and laboratory findings of the groups with infection eradication and infection persistence.


\* The values are given as the mean and the standard deviation. The values are given as the number with the percentage of the group in parentheses. CCI: Charlson comorbidity index.

> The overall mortality rate of the entire cohort was 25% (12 of 49 cases) at the latest follow-up, 10% (five cases) within ninety days after resection arthroplasty. Patients who deceased during the follow-up were significantly older (77 vs. 67.3 years, *p* = 0.005) and had a significantly higher Charlson comorbidity index (7.3 vs. 3.1, *p* < 0.001) (Table 3).

**Table 3.** Demographic data, clinical, and laboratory findings of the alive and deceased patients.


\* The values are given as the mean and the standard deviation. The values are given as the number with the percentage of the group in parentheses. CCI. Charlson comorbidity index.
