[Endoprosthesis infections of the shoulder: diagnosis and therapy algorithm]

Abstract

Periprosthetic shoulder joint infections are encountered by orthopedic surgeons mainly as complex situations which are highlighted by difficult treatment modalities. In a confirmed infection the general therapeutic principle is a surgical procedure. Several strategies orientate on the cause of an infection, the time course of postoperative symptoms, the pathogenicity of the isolated species and the specific comorbidities of the patient. An arthroscopic joint lavage with open debridement and component change may suffice in selected acute cases whereas a two-stage revision augmented by an articulating antibiotic spacer is mandatory in chronic infections. Early recognition is of paramount importance in order to prevent further spread, sepsis or even fatal outcome. Low grade infections are challenging conditions in terms of diagnosis and treatment. This article summarizes the principles of current classification, detection and treatment strategies for periprosthetic shoulder joint infections.