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Review
. 2020 Dec;13(6):757-768.
doi: 10.1007/s12178-020-09670-8.

Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review

Erik S Contreras  1 , Travis L Frantz  1 , Julie Y Bishop  1 , Gregory L Cvetanovich  2
Affiliations
Review

Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review

Erik S Contreras et al. Curr Rev Musculoskelet Med. 2020 Dec.

Abstract

Purpose of review: Periprosthetic infection is a relatively rare but potentially devastating complication after shoulder arthroplasty. The purpose of this article is to review the incidence, diagnosis, prevention, and management of periprosthetic infections after reverse shoulder arthroplasty, with a focus on literature published within the last 5 years.

Recent findings: The 2018 International Consensus Meeting on Musculoskeletal Infection provides us with a framework for the diagnosis and management of periprosthetic infections after shoulder arthroplasty. Reverse shoulder arthroplasty has a higher reported rate of infection compared with anatomic total shoulder arthroplasty. Our current diagnostic tests do not appear to be as sensitive when compared with the hip and knee literature. Similar success has been reported with single and two-stage revision protocols, although prospective comparative data are lacking. The significance of unexpected positive cultures during revision arthroplasty remains unclear. We report current diagnostic and therapeutic options for periprosthetic infection after reverse shoulder arthroplasty. Much of the current literature does not distinguish between anatomic and reverse shoulder arthroplasty. Further high-level studies are warranted to refine these definitions and guide management.

Keywords: Periprosthetic infection; Prosthetic joint infection; Reverse shoulder arthroplasty; Shoulder infection.

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Conflict of interest statement

Erik Contreras, Travis Frantz, Julie Bishop, and Gregory Cvetanovich declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Left shoulder surgical site with erythema and skin changes, concerning for infection
Fig. 2
Fig. 2
Significant humeral osteolysis and broken glenoid screws status-post reverse shoulder arthroplasty, concerning for infection
Fig. 3
Fig. 3
a 62-year-old male with Hamada Grade 3 left shoulder rotator cuff arthropathy. b Status-post reverse shoulder arthroplasty. c 7-year post-op with proximal humeral osteolysis. d Status-post explant and antibiotic spacer placement. e CT-scan showing glenoid bone stock remaining after explant and antibiotic spacer placement. f Status-post re-implantation of reverse shoulder arthroplasty after infection was cleared
Fig. 4
Fig. 4
a RSA with significant glenoid osteolysis. b 6 months status-post explant and antibiotic spacer placement with poor remaining glenoid bone stock and subluxation. Despite this, patient was pain-free with functional range of motion without signs of infection and did not desire further surgery
See this image and copyright information in PMC

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