Work

Factors influencing recurrence rates and radiological outcomes after two-stage exchange arthroplasty for prosthetic joint infection utilizing a premade antibiotic loaded cement hemiarthroplasty

Year: 2025

Type: article

Abstract: Background: The purpose of this study was to describe the rate of infection recurrence in a patient cohort undergoing placement of a prefabricated antibiotic spacer in the setting of two-stage management of shoulder prosthetic joint infection (PJI). Methods: All patients who underwent placement of a prefabricated antibiotic cement spacer for infection by three surgeons between 2019 and 2024 with a minimum of 3-month follow-up after spacer placement were retrospectively reviewed. Subsequent infection was defined as development of a sinus tract, purulent drainage, or subsequent revision surgery-planned or unplanned- associated with ≥2 tissue specimens with growth of the same bacterial species taken during a biopsy prior to the second stage if performed, at the second stage if performed, or after the second stage during revision of the second stage. Patients were characterized by the International Consensus Meeting 2018 criteria, and comparisons were performed between criteria and reinfection. Radiographic review was performed analyzing spacer loosening, fracture, and glenoid wear. Reinfection and nonreinfection groups were compared. Results: > .05). Conclusion: Patients undergoing two-stage revision for PJI with a prefabricated antibiotic cement spacer demonstrate a high rate of recurrence (38.2%), using our conservative definition of recurrence and often become reinfected with a new bacterial species (85.7%). Patient factors are also important to consider given that recurrently infected patients were younger and had longer follow-up. A standardized definition of recurrent PJI is mandatory to accurately compare studies utilizing various treatment options.

Source: JSES International

DOI: 10.1016/j.jseint.2025.05.036