Strategies for Management of Periprosthetic Joint Infection.

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Abstract

[Indexed for MEDLINE] 6. J Bone Joint Surg Am. 2024 Dec 4;106(23):2265-2275. doi: 10.2106/JBJS.23.01073. Epub 2024 Oct 30. Shoulder Periprosthetic Joint Infection: Principles of Prevention, Diagnosis, and Treatment. Nazzal EM(1), Herman ZJ(1), Como M(1), Kaarre J(1), Reddy RP(1), Wagner ER(2), Klatt BA(1), Lin A(1). Author information: (1)Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. (2)Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia. ➢ Shoulder periprosthetic joint infection (PJI) is a potentially devastating complication after arthroplasty and is projected to rise with increasing numbers of performed arthroplasties, particularly reverse shoulder arthroplasties.➢ Important considerations for the diagnosis and treatment of shoulder PJI include age, sex, implant type, primary compared with revision shoulder surgery, comorbidities, and medications (i.e., corticosteroids and disease-modifying antirheumatic drugs). ➢ Diagnosis and management are unique compared with lower-extremity PJI due to the role of lower-virulence organisms in shoulder PJI, specifically Cutibacterium acnes.➢ Treatment pathways depend on chronicity of infection, culture data, and implant type, and exist on a spectrum from irrigation and debridement to multistage revision with temporary antibiotic spacer placement followed by definitive revision arthroplasty. Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated. DOI: 10.2106/JBJS.23.01073