Arthroscopic management of native shoulder septic arthritis

Matthew P. Abdel, Kevin I. Perry, Mark E. Morrey, Scott P. Steinmann, John W. Sperling, Joseph R. Cass

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: There is little information on the results of arthroscopic treatment of native shoulder sepsis. Therefore, the purpose of this study was to determine the presentation, preoperative indices, intraoperative findings, and outcomes related to native shoulder sepsis treated with arthroscopy. Materials and methods: We retrospectively reviewed 50 consecutive native shoulders with septic arthritis between 1994 and 2008. Patients (75% male) were an average age of 66 years. Four patients had bilateral involvement. All underwent arthroscopic irrigation and debridement. The mean follow-up was 31 months (range, 1-185 months). Results: Patients were immunocompromised in 57% of cases. The mean preoperative values (normal reference ranges) included white blood cell count, 13 × 109/L (3.5-10.5 × 109/L); erythrocyte sedimentation rate, 66 mm/h (0-29 mm/h), and C-creative protein, 83 mg/L (0-10 mg/L). The average aspiration cell count was 110,988, with a mean differential of 87% neutrophils. The most common organisms were methicillin-susceptible Staphylococcus aureus (44%). Repeat irrigation and debridement was required within the first month in 16 of 50 shoulders (32%). Within 1 year, 17% of patients had died. Final Gächter staging was I or II for 32 shoulders and III or IV for 18 shoulders. Conclusions: Most patients with native shoulder sepsis are elderly and immunocompromised and present with increased inflammatory markers and a supporting aspiration cell count. Patients and surgeons must be aware that after initial arthroscopy, 1 in 3 patients will require additional surgical intervention, whether anticipated or not.

Original languageEnglish (US)
Pages (from-to)418-421
Number of pages4
JournalJournal of Shoulder and Elbow Surgery
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2013

Keywords

  • Arthroscopic irrigation and debridement
  • Case series
  • Infection
  • Level IV
  • Septic shoulder arthritis
  • Treatment study

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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