Resection arthroplasty of the shoulder and hemiarthoplasty in the setting of infection: A narrative review

Failure after anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) leaves few options secondary to loss of bone stock and derangement of the soft tissues. Treatment modalities for prosthetic joint infection are as diverse as their efficacy and morbidity. Single- or two-stage revision arthroplasty is an option for treating prosthetic joint infections in patients who can be treated surgically. The use of an antibiotic cement spacer as definitive treatment also has been shown in recent literature to be a viable treatment in medically tenuous patients or in patients with infections. The utility of a hemiarthroplasty with an antibiotic-coated stem (functional spacer) has been shown to provide good pain relief in over half of patients, and conversion of a hemiarthroplasty to a reverse TSA can be performed with improvement in both motion and function. Two-stage revision methods have the highest likelihood of restoring function, with a reported 60% to 90% success rate. While arthrodesis and amputation are options in life-threatening infections or the severely ill patient, resection arthroplasty remains an option as a limb and limited motion-sparing alternative.
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: Special Focus: 2018 Arthroplasty Disasters International Conference Paper Source Type: research