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Arthroscopic debridement for septic arthritis of the shoulder joint: post-infectious arthritis is an inevitable consequence?

 Sung-Jae Kim  ;  Yun-Rak Choi  ;  Wonyong Lee  ;  Woo-Seok Jung  ;  Yong-Min Chun 
 Archives of Orthopaedic and Trauma Surgery, Vol.138(9) : 1257-1263, 2018 
Journal Title
 Archives of Orthopaedic and Trauma Surgery 
Issue Date
Arthroscopy ; Septic arthritis ; Shoulder
PURPOSE: The purpose of this study was to compare clinical outcomes and development of post-infectious arthritis of the shoulder joint after single (Group S) or repeated (Group R) arthroscopic debridement surgeries. We hypothesized that (1) repeated surgeries might be attributable to initial subchondral involvement resulting from septic arthritis and (2) the repeated surgery group would exhibit a higher incidence of post-infectious arthritic changes and inferior clinical outcomes due to prolonged resolution of the infection. METHODS: This study included 42 patients (single surgery, n = 29; repeated surgery, n = 13) who underwent arthroscopic debridement for septic arthritis and had a minimum of 2 years of postoperative follow-up data. All patients underwent preoperative magnetic resonance imaging (MRI) with gadolinium enhancement to evaluate subchondral bone involvement suspicious for osteomyelitis secondary to septic arthritis and extension of infection around the glenohumeral joint. Functional and radiological outcomes were assessed. RESULTS: Group S experienced a shorter duration (25.4 days) of infection than Group R (39.7 days) (p = 0.002). Increased signal intensity in the subchondral bone on preoperative MRI was identified in 9 patients (31%) in Group S and 5 patients (38%) in Group R. Post-infectious arthritic changes developed in 6 (21%) and 5 (38%) in Groups S and R, respectively. However, there were no significant differences between groups. At the final follow-up, there were no significant differences in functional assessments. CONCLUSION: Despite a prolonged period of infection in the repeated surgery group, there was no significant difference in development of post-infectious arthritic changes or clinical outcomes in patients requiring single or repeated surgeries.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실)
Yonsei Authors
김성재(Kim, Sung Jae)
이원용(Lee, Won Yong)
정우석(Jung, Woo Seok)
천용민(Chun, Yong Min) ORCID logo https://orcid.org/0000-0002-8147-6136
최윤락(Choi, Yun Rak)
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