Strategies in Trauma and Limb Reconstruction

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VOLUME 5 , ISSUE 2 ( August, 2010 ) > List of Articles

CASE REPORT

Preservation of the shoulder joint by the use of a hybrid-spacer after septic loosening of a reversed total shoulder joint arthroplasty: a case report

Steffen Brodt, Gunther O. Hofmann, Andreas H. Tiemann

Keywords : Hybrid-spacer, Infection, Shoulder, TJR

Citation Information : Brodt S, Hofmann GO, Tiemann AH. Preservation of the shoulder joint by the use of a hybrid-spacer after septic loosening of a reversed total shoulder joint arthroplasty: a case report. 2010; 5 (2):111-114.

DOI: 10.1007/s11751-010-0086-8

License: CC BY-NC-SA 4.0

Published Online: 31-08-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Infections of a total joint replacement (TJR) of the shoulder are rare complications. After revision surgery, the incidence rises dramatically. If infection occurs, it leads to a loss of function and may be devastating to the joint. Treatment options range from single- to multiple-staged revision programs, permanent resection arthroplasty or exarticulation. In this case, a reversed shoulder endoprosthesis, which was implanted after multiple revisions of a TJR due to a posttraumatic omarthrosis and rotator cuff insufficiency, got infected. A hybrid-spacer, made of a humeral nail and a custom-made PMMA spacer forming the humeral head, was used during the revision program. After two operations, clinical and paraclinical signs turned back to normal. The patient felt well and was satisfied with the result of the therapy. The hybrid-spacer was then left in situ as a definitive solution with a satisfying range of motion. This case report shows that a hybrid-spacer can be helpful in the treatment of an infected shoulder TJR.


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  1. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F (2005) Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 14:147S-161S
  2. Braman JP, Sprague M, Bishop J, Lo IK, Lee EW, Flatow EL (2006) The outcome of resection shoulder arthroplasty for recalcitrant shoulder infections. J Shoulder Elbow Surg 15:549-553
  3. Cofield RH, Edgerton BC (1990) Total shoulder arthroplasty: complications and revision surgery. Instr Course Lect 39:449- 462
  4. Coste JS, Reig S, Trojani C, Berg M, Walch G, Boileau P (2004) The management of infection in arthroplasty of the shoulder. J Bone Joint Surg Br 86:65-69
  5. Jerosch J, Schneppenheim M (2003) Management of infected shoulder replacement. Arch Orthop Trauma Surg 123:209-214
  6. Ramsey ML, Fenlin JM Jr (1996) Use of an antibiotic-impregnated bone cement block in the revision of an infected shoulder arthroplasty. J Shoulder Elbow Surg 5:479-482
  7. Rispoli DM, Sperling JW, Athwal GS, Schleck CD, Cofield RH (2007) Pain relief and functional results after resection arthroplasty of the shoulder. J Bone Joint Surg Br 89:1184-1187
  8. Schmelz A, Kinzl L, Einsiedel T (2006) Osteitis. Infections of the locomotive system. Chirurg 77:943-961
  9. Seitz WH Jr, Damacen H (2002) Staged exchange arthroplasty for shoulder sepsis. J Arthroplasty 17:36-40
  10. Sperling JW, Kozak TK, Hanssen AD, Cofield RH (2001) Infection after shoulder arthroplasty. Clin Orthop Relat Res 382:206-216
  11. Swanson AB, de Groot SG, Sattel AB, Cendo RD, Hynes D, Jar- Ning W (1989) Bipolar implant shoulder arthroplasty. Long-term results. Clin Orthop Relat Res 249:227-247
  12. Themistocleous G, Zalavras C, Stine I, Zachos V, Itamura J (2007) Prolonged implantation of an antibiotic cement spacer for management of shoulder sepsis in compromised patients. J Shoulder Elbow Surg 16:701-705
  13. Wirth MA, Rockwood CA, Jr (1994) Complications of shoulder arthroplasty. Clin Orthop Relat Res 307:47-69
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