Shoulder prosthesis chronic infection is a rare but serious complication, likely to lead to re-interventions and poor functional outcome. Two-stage exchange surgery is considered the standard procedure by most authors. Our hypothesis was that one-stage revision procedure is a valid therapeutic option in the management of chronic infections of shoulder arthroplasty. This was a mono-center retrospective cohort study. All patients who underwent, during the inclusion period, a one-stage revision procedure for a chronic infection of shoulder arthroplasty were included. All patients underwent clinical evaluation (Constant-Murray score), radiological examination (standard X-rays) and a blood test (Complete Blood Count and C-reactive protein), at a minimal one-year follow-up. Primary endpoint of this study was the infectious outcome and secondary endpoints were the functional and radiographic outcomes.Aim
Method
The diagnosis of peri-prosthetic infection is sometimes difficult to assess, and there is no universal diagnostic test. The recommendations currently accepted include several diagnostic criteria, and are based mainly on the results of deep bacteriological samples, which only provide the diagnosis after surgery. A predictive score of the infection might improve the peri-operative management before repeat surgery after total hip arthroplasty (THA). The goal of this study was to attempt defining a composite score using conventional clinical, radiological and biological data that can be used to predict the positive and negative diagnosis of peri-prosthetic infection before repeat surgery after THA. The tested hypothesis was that the score thus defined allowed an accurate differentiation between infected and non-infected cases in more than 75% of the cases. 104 cases of repeat surgery for any cause after THA were analyzed retrospectively: 61 cases of infection and 43 cases without infection. There were 54 men and 50 women, with a mean age of 70 ± 12 years (range, 30 to 90 years). A univariate analysis looked for individual discriminant factors between infected and uninfected case file records. A multivariate analysis integrated these factors concomitantly. A composite score was defined, and its diagnostic effectiveness was assessed by the percentage of correctly classified cases and by sensitivity and specificity.Aim
Method
The diagnosis of peri-prosthetic infection may be difficult. But this diagnosis can guide antibiotic prophylaxis and implementation of intraoperative bacteriological samples. The hypothesis of this study was that a composite score using clinical, radiological and biological data could be used for positive and negative diagnostic of infection before reoperation on prosthetic hip or knee. 200 reoperations on hip and knee arthroplasty for any cause were analyzed retrospectively. 100 cases concerned infected cases, while the diagnosis of infection was excluded in the other 100 cases.INTRODUCTION
MATERIAL
