SynthesisInternational orthopaedics2017
Surgical treatment of infected shoulder arthroplasty. A systematic review.
Synthesis in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial.BMC musculoskeletal disorders · 2024Pooled it
- One- and two-stage surgical revision of infected shoulder prostheses following arthroplasty surgery: A systematic review and meta-analysis.Scientific reports · 2019Pooled it
- Mid- to Long-Term Outcomes of Two-Stage Revision Arthroplasty for Periprosthetic Joint Infection of the Shoulder.Journal of clinical medicine · 2025Article
- One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2024Review
- High infection control rate after systematic one-stage procedure for shoulder arthroplasty chronic infection.International orthopaedics · 2023Article
- Article
- Comparison of surgical treatment options in periprosthetic shoulder infections: a systematic review from 2016 to 2022.Annals of joint · 2023Review
- The safety and efficiency of benzoyl peroxide for reducingFrontiers in surgery · 2023Review
- The role of synovial fluid aspiration in shoulder joint infections.BMC musculoskeletal disorders · 2022Article
- Periprosthetic Infections of the Shoulder Joint: Characteristics and 5-Year Outcome of a Single-Center Series of 19 Cases.Antibiotics (Basel, Switzerland) · 2021Article
- Creation of a Custom-Length, Humeral Antibiotic Cement Spacer for Use in Treatment of Shoulder Periprosthetic Joint Infection.Arthroscopy techniques · 2021Article
- Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty.Shoulder & elbow · 2019Article
- Risk factors associated with periprosthetic joint infection after total elbow arthroplasty.Shoulder & elbow · 2019Article
- Review
- Two-stage revision of infected shoulder arthroplasty using prosthesis of antibiotic-loaded acrylic cement: minimum three-year follow-up.International orthopaedics · 2018Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the best surgical management of infected shoulder arthroplasty.
methodsA literature review from 1996 to 2016 identified 15 level IV studies that met inclusion criteria. Persistent infection (PI) was considered as treatment failure. Success was regarded as the absence of symptomatic PI without necessity for further treatment. Surgical outcomes were reported according to the mean weighted Constant and Murley score (CMS) for each treatment group.
resultsOverall, 287 patients (146 males/141 females) were identified at a mean follow-up of 50.4 (range 32-99.6) months. The PI in the whole population was 11.5%. The pooled mean CMS, available for 218 patients, was 39 ± 13. Twenty-seven patients (9.4%) were treated with debridement (PI 29.6%, CMS 41 ± 12), 52 patients (18.1%) with resection arthroplasty (PI 11.5%, CMS 29 ± 16), 33 patients (11.5%) with permanent spacers (PI 6.1%, CMS 31 ± 14), 98 patients (34.2%) with two-stage revisions (PI 14.3%, CMS 42 ± 12) and 77 patients (26.8%) with one-stage revisions (PI 3.9%, CMS 49 ± 11). Debridement showed the highest PI rate (29.6%) and one-stage revisions reported the lowest PI rate (3.9%). Resection arthroplasty and spacers showed the poorest CMS when compared to the other procedures (p ≤ 0.0001). The debridement PI rate was significantly higher than almost any other procedure. CMS was significantly higher in patients undergoing revision compared to non-revision procedures (45 ± 12 vs. 35 ± 14) (p < 0.0001). One-stage revisions achieved significantly better results in terms of the PI rate compared to two-stage revisions (p = 0.0223), but not in terms of CMS.
conclusionDebridement showed the highest PI rate (29.6%) and should not be recommended for the management of infected shoulder arthroplasty. Revisions reported better functional outcomes compared to non-revision procedures. The presence of a significantly lower PI rate with comparablely high mean CMS values suggests that one-stage (where technically applicable) could be superior to two-stage revisions. Unfortunately, well-designed randomized controlled trials using validated patient-based outcomes are lacking in this field. LEVEL OF EVIDENCE: Systematic Review of level IV studies, Level IV.
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