Arthrodesis of the shoulder after septic arthritis: Long-term results

• Published in: Journal of bone and joint surgery. British volume Vol. 85; no. 5; pp. 666 - 670
• Main Authors: WICK, M, MÜLLER, E. J, AMBACHER, T, HEBLER, U, MUHR, G, KUTSCHA-LISSBERG, F
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.07.2003; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Activities of Daily Living; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Arthritis, Infectious - microbiology; Arthritis, Infectious - surgery; Arthrodesis - methods; Biological and medical sciences; Female; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Pain - prevention & control; Patient Satisfaction; Postoperative Complications - etiology; Range of Motion, Articular - physiology; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Infection; Surgery; Shoulder; Diseases of the osteoarticular system; Arthrodesis; Arthritis
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.85B5.13915

We analysed the long-term results of arthrodesis of the shoulder after infection in 15 patients. At the time of operation, 14 cultures were positive for Staphylococcus aureus. The mean follow-up was 8.3 years (3 to 14) and 90% of the patients were satisfied with the outcome. There were complications in five patients (33%); in three there was nonunion with loosening of the implant. One patient had a sound bony union but with a persistent sinus six years after arthrodesis and another had a sinus which healed after the metal was removed. Four of these five patients (80%) were heavy smokers (> 20 cigarettes/day). Cancellous bone grafting did not affect the incidence of complications. The mean age of the patients with complications was 58.6 v 48.6 years for those without (p = 0.2808; not significant). Those with complications had had more previous operations (6.4 v 2.5, p < 0.05). Antibiotics, as determined by the bacteriological cultures, were administered for six weeks. The complication rate was higher in patients with active sepsis but the younger the patient and the fewer number of previous operations (< 50 years, < four previous operations), the better was the outcome. Considering the rate of complications, we recommend early surgery in these patients.