The Surgical Treatment of Deep Infection in the Native Shoulder Joint

Background: The overall clinical picture surrounding native shoulder infections, and, in particular, the associatedlong-term functional outcomes of treatment are presently underreported. The purpose of this study is to examine thedemographics, diagnostic and treatment strategies, and functional outcomes of isolated shoulder joint sepsis treatedwith surgical irrigation and debridement (I&D).Methods: All patients treated with I&D for native shoulder sepsis between ۲۰۰۷ – ۲۰۱۷ were identified. Those withouta minimum of one-year follow-up were excluded. Functional outcomes scores, reoperations, and predictors of pooroutcome were evaluated.Results: Twenty-three patients were included in the final study population. Mean age-adjusted CCI score was ۴.۱ (SD= ۳.۴, Range = ۰ – ۱۰). Twelve patients (۵۲.۲%) were treated with open I&D, while ۱۱ patients (۴۷.۸%) were treatedarthroscopically. Nine patients (۳۹.۱%) required multiple I&Ds (mean total number of I&Ds = ۱.۷, SD = ۱.۰, Range:۱ – ۴). Five patients (۲۱.۷%) had at least one documented reinfection after their initial hospitalization, with the initialrecurrence of infection occurring ۲ – ۱۵ months after the index procedure. Mean ASES score at final follow-up was ۵۵.۳(SD = ۲۶.۷, Range: ۵.۸ – ۹۸.۳) and mean SANE score was ۵۳.۳ (SD = ۳۰.۶, Range: ۰ – ۱۰۰). Stepwise multiple linearregression modeling identified intravenous drug abuse as the most significant predictor for final ASES score [F(۱,۱۸)= ۶.۱۲, p = .۰۲۴, adjusted R۲ = .۲۵۴].Conclusion: Following isolated shoulder joint sepsis, infection clearance and acceptable functional outcomes can beachieved using surgical I&D followed by a course of antibiotics, but outcomes are variable.Level of evidence: IV

Keywords:

Infection , native , outcomes , Sepsis , shoulder , Treatment