Two-stage shoulder arthroplasty after deep infection of the shoulder caused by arthroplasty, osteosynthesis or other surgical procedures: microbial spectrum, complications and functional outcome after at least 1 year follow-up

2021 ◽  
Author(s):  
Sandra Hornung ◽  
Gregor Reiter ◽  
Paul Alfred Grützner ◽  
Thorsten Gühring
Keyword(s):  
Functional Outcome ◽  
Surgical Procedures ◽  
Shoulder Arthroplasty ◽  
Deep Infection ◽  
Two Stage ◽  
Microbial Spectrum

scholarly journals The hospital cost of two-stage reimplantation for deep infection after shoulder arthroplasty

2017 ◽  
Vol 1 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Yaser M.K. Baghdadi ◽  
Hilal Maradit-Kremers ◽  
Taylor Dennison ◽  
Jeanine E. Ransom ◽  
John W. Sperling ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Hospital Cost ◽  
Deep Infection ◽  
Two Stage

scholarly journals Anatomic Total Shoulder Arthroplasty Using a Self-Pressurizing Pegged Bone-Preserving Cemented Glenoid Component: A 2- to 5-Year Follow-up Study

2018 ◽  
Vol 2 ◽  
pp. 247154921775047
Author(s):  
Joaquin Sanchez-Sotelo ◽  
Ngoc Tram V Nguyen ◽  
Mark Morrey
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Loose Body ◽  
Deep Infection ◽  
Glenoid Component ◽  
Total Shoulder Arthroplasties ◽  
Shoulder Arthroplasties ◽  
And Function

Background: High rates of radiographic loosening have been reported with various glenoid designs. Many available designs sacrifice most of the bone at the central portion of the glenoid vault, creating large areas of deficiency when revision becomes necessary. The purpose of this study was to report the 2- to 5-year outcome of shoulder arthroplasty using a bone-preserving all-polyethylene glenoid components with self-pressurizing pegs. Methods: Between August 2011 and December 2014, 202 consecutive anatomic total shoulder arthroplasties (TSAs) were performed by a single surgeon with implantation of a self-pressurizing cemented pegged glenoid component in 190 patients (12 patients had both shoulders replaced). Patients were followed up prospectively and evaluated for pain, motion, strength, American Shoulder and Elbow Surgeons (ASES) scores, and radiographic changes. The mean follow-up time was 2.7 (2–5) years. Results: TSA improved pain and function reliably. At the most recent follow-up, 94% of the shoulders had no or mild pain. Motion included 154 ± 25° of elevation, 68 ± 18° of external rotation, and median internal rotation to T10 (range, iliac crest to T4). The most recent average ASES score was 82 ± 15 points. Early postoperative radiographs showed no radiolucent lines. No humeral or glenoid component was considered radiographically loose at the most recent follow-up. Complications requiring reoperation included subscapularis insufficiency (4), posterior instability (2), deep infection (1), stiffness (1), and a painful loose body (1). No components were revised for loosening. Conclusions: Anatomic TSA using a cemented bone-preserving all-polyethylene pegged self-pressurizing glenoid component provided satisfactory clinical outcomes and survival at 2 to 5 years.

Importance of Neurological Evaluation Before Reverse Shoulder Arthroplasty in Patients with Previous Poliomyelitis

2009 ◽  
Vol 33 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Filippo Castoldi ◽  
Nicola Lollino ◽  
Francesco Caranzano ◽  
Marco Assom
Keyword(s):  
Case Report ◽  
Functional Outcome ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Cuff Tear Arthropathy ◽  
Shoulder Replacement ◽  
Cuff Tear ◽  
Neurological Evaluation

We present a case report of a patient, affected by post-polio syndrome and cuff tear arthropathy of his right shoulder, who underwent reverse shoulder arthroplasty. A previous radial deficiency was unmasked in the post-operative follow-up, with passive elbow bending when the forearm was put in an antigravitational position. A precise preoperative neurological evaluation is mandatory in shoulder replacement in order to estimate the functional outcome after surgery.

Two-stage reimplantation for the treatment of deep infection after shoulder arthroplasty

2017 ◽  
Vol 26 (5) ◽  
pp. e163 ◽  
Author(s):  
Andrew T. Assenmacher ◽  
Eduard Alentorn-Geli ◽  
Joaquin Sanchez-Sotelo ◽  
Robert H. Cofield ◽  
John W. Sperling
Keyword(s):  
Shoulder Arthroplasty ◽  
Deep Infection ◽  
Two Stage

scholarly journals Shoulder arthroplasty in patients with upper extremity lymphedema may result in transient or permanent lymphedema worsening

2019 ◽  
Vol 12 (1_suppl) ◽  
pp. 53-60
Author(s):  
Julia Lee ◽  
Ngoc Tram V Nguyen ◽  
Dave Shukla ◽  
John W Sperling ◽  
Robert H Cofield ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Upper Extremity ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Deep Infection ◽  
Node Dissection ◽  
Superficial Infection ◽  
Glenoid Loosening

Introduction Upper extremity lymphedema can complicate mastectomy, lymph node dissection, and radiation. The purpose of this study is to present the outcomes of shoulder arthroplasty in patients with lymphedema. Methods The 19 shoulders with a shoulder arthroplasty and lymphedema on the surgical side (6 anatomic, 12 reverse, 1 hemiarthroplasty) were followed for four years (1–10 years). There were 2 males and 17 females; average age was 67.8 (48–86) years. Breast carcinoma was the most common reason for lymphedema (75%). A dedicated lymphedema questionnaire could be completed for 14 shoulders. Results Pain improved from moderate or severe preoperatively to no or mild in 18 shoulders. Motion improved in elevation (55° preoperatively, 107° at last follow-up), external rotation (14°, 43°), and internal rotation (sacrum, L5). Complications included an acromion stress fracture with a deep infection (1), deep infection (1), superficial infection (1), and glenoid loosening (1). Lymphedema worsened in nine cases, but worsening was permanent in only four. Currently, lymphedema treatment is being performed by 93% of survey respondents. No patients reported lymphangitis or lymphangiosarcoma. Conclusion Shoulder arthroplasty for an upper extremity with lymphedema provides substantial improvements in pain and motion; however, infection is a concerning complication. Fifty percent of the patients will experience worsening of their lymphedema and in 20% worsening may be permanent.

Two-stage revision for infected shoulder arthroplasty after minimum 2-year follow-up

2017 ◽  
Vol 26 (5) ◽  
pp. e163
Author(s):  
Daniel B. Buchalter ◽  
Siddharth A. Mahure ◽  
Brent Mollon ◽  
Stephen Yu ◽  
Young W. Kwon ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Two Stage

scholarly journals Treatment Failure Among Infected Periprosthetic Total Hip Arthroplasty Patients

2014 ◽  
Vol 8 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Bassem Mikhael ◽  
Elizabeth Wright ◽  
Daniel M Estok ◽  
Jeffrey N Katz
Keyword(s):  
Joint Infection ◽  
Deep Infection ◽  
Prior History ◽  
Two Stage ◽  
Reactive Protein ◽  
Prosthetic Joint ◽  
History Of ◽  
Eradication Of Infection ◽  
One Year

Two-stage revision has been shown to be the most successful treatment in eradicating deep infection following total hiparthroplasty. We identified 62 patients treated by a two-stage revision. We defined “successful revision” as negative intraoperative cultures and no further infection-related procedure. We defined “eradication of infection” on the basis of negative cultures and clinical diagnosis at least one year after 2ndstage procedure. After a mean follow up of 2.7 years, eradication of the infection was documented in 91.1%, and a successful two-stage revision in 85.7% of patients. We observed no association between higher pre-reimplantation levels of ESR and C-reactive protein and lower likelihood of successful two-stage revision. We found an association between a history of another previous infected prosthetic joint and a failed 2ndstage procedure. Failure to achieve eradication of infection and successful two-stage revision occurs infrequently. Patients with prior history of a previous prosthetic joint infection are at higher risk of failure.

METHODOLOGY TO SURGICALLY APPROACH FOR LUMBAR CANAL STENOSIS;“WHEN TO” AND “WHEN NOT TO” DO INSTRUMENTAL FUSION- A PROSPECTIVE STUDY.

2021 ◽  
pp. 21-24
Author(s):  
Arun Kumar KV ◽  
Arun Kumar C ◽  
Pradeep E ◽  
Venkatachalam K ◽  
Arivoli Arivoli ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Conservative Management ◽  
Lumbar Fusion ◽  
Lumbar Vertebra ◽  
Deep Infection ◽  
Lumbar Canal Stenosis ◽  
Vas Score ◽  
Dural Sac ◽  
Canal Stenosis

Introduction:Lumbar canal stenosis is dened, as an abnormal narrowing of the ligamento-osseous canal of the lumbar vertebra or of the foramina intervertebralis, causing a direct compression or a compromise of either the dural sac or the nerve root or indirectly to their vasculature producing symptoms of radiculopathy or and claudication.Patient whose symptoms do not show improvement after non-surgical or conservative trial, become eligible for surgical relief. AIM: To Prospectively analyze, Canal decompression, interbody Lumbar fusion with or without posterior stabilization with postero-lateral bone grafting, in cases presenting with MRI proven Lumbar Canal Stenosis, not responding to conservative management. Materials and Methods:Our study was done in Chettinad Hospital and Research Institute from January 2016 to December 2020, Follow-up period was for a minimum period of 12 months. 54 patients participated in the study.JOA and VAS score was recorded at the end of 12 months postsurgery to analyze the functional outcome. Results: There were 32 males and 22 females in the study.Our mean male JOA score was pre-operatively 9.88 which improved to 14.8 at the 12th month follow-up. Our mean JOA for females was at 8.3 which improved post operatively to 13.8.The mean VAS score pre-operatively in the men th and women were 7.4 and 8.6 respectively. This, at the 12 month follow up dropped to 0.8 and 1.2 for men and women respectively.The complications encountered in the study patients are Dural tears in 6 patients, supercial infection in 8 patients, Deep infection and Neurological decit in 4 and 3 patients respectively. All of these complications subsequently got resolved without any long term sequelae. Conclusion:In patients with lumbar canal stenosis whose symptoms do not abate, with conservative management, surgical lumbar spinal canal decompression, whether it is single level or dual level, does provide for a good clinico- functional outcome.

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