USE OF A FUNCTIONAL ANTIBIOTIC SPACER IN TREATING INFECTED SHOULDER ARTHROPLASTY

Objective. Management of the infected shoulder arthroplasty remains challenging. Treatment goals include eradication of the infection, improvement in pain, and restoration of function. Two-stage revision using an antibiotic spacer and subsequent revision has shown variable success. Using a hemiarthroplasty and coating the stem with antibiotic cement (functional antibiotic spacer) during the first stage has the potential of achieving treatment goals without the need for a second revision. Background. To examine the outcomes of using a functional antibiotic spacer as a definitive hemiarthroplasty in the management of an infected shoulder arthroplasty. Methods. Fourteen patients with an infected shoulder arthroplasty underwent implantation of a functional antibiotic spacer, extensive surgical debridement, and a minimum of 6 weeks post-operative intravenous antibiotics. The ten patients who elected not to undergo revision surgery were included in this analysis. Pain scores, functional outcome scores, range of motion, strength and patient satisfaction were measured for these patients at last follow-up and compared to preoperative scores. Results. At an average follow-up of 18.2 months, significant improvements were observed in pain scores, functional outcome scores, shoulder abduction and elevation. There was one unsatisfied patient. No recurrent infection, progressive radiolucency or change in position of the functional antibiotic spacer was observed. Conclusion. Management of the infected shoulder arthroplasty using a functional antibiotic spacer achieves the treatment goals with no recurrent infections; significant improvements in pain, function and motion; high patient satisfaction; and a low rate of conversion to second stage revision. Grants. N/