The Journal of Bone and Joint Surgery (American). 2006;88:1802-1806.
doi:10.2106/JBJS.E.00917
© 2006 The Journal of Bone and Joint Surgery, Inc.
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 Shoulder/Elbow Test 16: Fall 2006 (publication date November 15, 2006; expi...
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Arthroscopic Management of Septic Arthritis of the Shoulder Joint

In-Ho Jeon, MD1, Chang-Hyuk Choi, MD2, Jae-Sung Seo, MD3, Kyung-Jin Seo, MD4, Sang-Hun Ko, MD5 and Jin-Young Park, MD6

1 Department of Orthopaedic Surgery, Kyungpook National University Hospital, 50 Samduk, Chung-Gu, Daegu, South Korea 700-721. E-mail address: jeonchoi{at}chol.com
2 Department of Orthopaedic Surgery, Catholic University of Daegu, Dae Myung 4, Nam-Gu, 3056-6, Daegu, South Korea 705-034
3 Department of Orthopaedic Surgery, Yeungnam University, Dae Myung, Nam-Gu, 317-1, Daegu, South Korea 705-717
4 Department of Radiology, Dankook University, An Seo 16-5, Chun-An, Chungnam Province, South Korea 330-715
5 Department of Orthopaedic Surgery, Ulsan University Hospital, Jun Ha 290-3, Dong-Gu, Ulsan, South Korea 682-714
6 Department of Orthopaedic Surgery, Konkuk University Hospital, Hwa Yang 4-12, Kwang-Jin, Seoul, South Korea 143-914

Investigation performed at the Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, South Korea

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Nineteen patients with septic arthritis of the glenohumeral joint were treated with a combination of arthroscopic irrigation and débridement and systemic antibiotics according to bacterial sensitivity. We retrospectively reviewed the series to determine the efficacy and safety of this treatment.

Methods: There were seventeen men and two women, with a mean age of fifty-nine years. Underlying medical disease was present in thirteen patients, with six of them having diabetes. The average duration of symptoms prior to the arthroscopic lavage was three weeks. Fifteen patients had had local injections into the shoulder joint. The arthroscopic staging of the infection was based on the modified criteria of Gächter. The functional outcome was evaluated with use of the UCLA scoring system.

Results: As determined at arthroscopy, one infection was classified as stage I; seven, as stage II; nine, as stage III; and two, as stage IV. Staphylococcus was the most common organism identified. The infection was eradicated completely with a single arthroscopic procedure in fourteen patients. The mean UCLA score at the time of the last follow-up was 26 points, with a mean score of 23.7 points for the eleven patients with a rotator cuff tear and 29 points for the eight with an intact rotator cuff. Patients who had had symptoms for no more than two weeks prior to the arthroscopic lavage had better results than those who had had symptoms for longer than two weeks.

Conclusions: Arthroscopic débridement for the treatment of septic arthritis of the shoulder is safe and efficient, particularly in the early stages of the disease. Underlying medical diseases such as diabetes, prior injections, or a preexisting rotator cuff tear were seen in a high proportion of these patients.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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