ArticleArchives of orthopaedic and trauma surgery2025
Resection arthroplasty for deep shoulder infection in a native shoulder with an intact rotator cuff: a salvage option when reverse shoulder arthroplasty is not feasible.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundResection arthroplasty is a salvage procedure for uncontrolled deep infection of the shoulder. Previous studies have reported poor functional outcomes, especially in patients with rotator cuff deficiency. We hypothesized that, although overall outcomes might be limited, patients with preserved rotator cuff tendons could still achieve pain relief and functional improvement after resection arthroplasty.
methodsBetween 2001 and 2025, 69 patients underwent surgery for deep shoulder infection. Twenty-seven had resection arthroplasty, of whom 14 were excluded (infection after hemiarthroplasty, chronic infection without bone involvement, full-thickness cuff tear, or follow-up < 2 years). Thirteen patients (mean age, 57 years; range, 39–86) with native shoulders and intact or partial-thickness rotator cuff tears were analyzed. The mean follow-up was 48.8 months (range, 24–180). Pain [visual analogue scale (VAS) at rest and during motion], shoulder motion (active forward flexion, external rotation, internal rotation), and functional scores (University of California Los Angeles [UCLA], Constant) were assessed. Infection control was monitored with white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Pre- and postoperative values were compared using paired t-tests after normality testing.
resultsVAS during motion improved from 6.5 to 2.3, and VAS at rest improved to 0.4. Forward flexion increased from 32.7° to 97.7°, and external rotation from 9.1° to 27.3° (all p < 0.01). UCLA and Constant scores improved from 9.6 to 29.4 to 25.7 and 60.6, respectively (p < 0.01). Ten of 13 patients reported satisfaction ≥ 6/10. One patient required additional debridement, but no reconstructive conversion was performed.
conclusionResection arthroplasty in native shoulders with preserved rotator cuff tendons provided reliable infection control, substantial pain relief, and functional improvement at mid-term follow-up (24–180 months). These findings support its role as a salvage option when reverse shoulder arthroplasty is not feasible. Limitations include the retrospective design, small sample size, and heterogeneous follow-up period. LEVEL OF EVIDENCE: Level IV, retrospective study.
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