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Diagnosis and Management of Periprosthetic Joint Infection After Shoulder Arthroplasty

Cooper, Maxwell E. MD1; Trivedi, Nikunj N. MD1; Sivasundaram, Lakshmanan MD1; Karns, Michael R. MD1; Voos, James E. MD1; Gillespie, Robert J. MD1

doi: 10.2106/JBJS.RVW.18.00152
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  • » The indolent microorganisms responsible for shoulder periprosthetic joint infection make diagnosis difficult because they do not have clear clinical signs or reliable serum laboratory markers.
  • » Administering benzoyl peroxide to the skin of the surgical site and intra-articular injections of antibiotics during a surgical procedure have shown potential for preventing periprosthetic joint infection in patients undergoing shoulder arthroplasty.
  • » Measuring the synovial levels of interleukin (IL)-6 and alpha (α)-defensin have demonstrated promise for predicting periprosthetic joint infection in patients undergoing shoulder arthroplasty.
  • » Two-stage revision shoulder arthroplasty has been consistently shown in the literature to effectively eradicate infection and have substantial functional improvement, especially in healthy patients.
  • » One-stage revision shoulder arthroplasty has been shown to have eradication rates comparable with those of 2-stage exchange and has the advantages of being more cost-effective and having expedited treatment time.

1Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio

E-mail address for R.J. Gillespie: Robert.Gillespie@uhhospitals.org

Investigation performed at the Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio

Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJSREV/A460).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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